Impact of intraocular pressure fluctuations on progression of normal tension glaucoma

作     者：Susanne Hopf Doris Schwantuschke Irene Schmidtmann Norbert Pfeiffer Esther Maria Hoffmann 

作者机构：Department of OphthalmologyUniversity Medical Center MainzMainz 55131Germany Pediatric DentistryNieder-Olm 55268Germany Institute of Medical BiostatisticsEpidemiology and Informatics(IMBEI)University Medical Center MainzMainz 55131Germany 

出 版 物：《International Journal of Ophthalmology(English edition)》 (国际眼科杂志（英文版）)

年 卷 期：2021年第14卷第10期

页      面：1553-1559页

核心收录：

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

基　　金：a DFG(German Research Foundation)Grant(HO 3277/2-1) 

主　　题：intraocular pressure intraocular pressure fluctuation glaucoma progression visual field optical optical coherence tomography 

摘      要：AIM:To investigate short-and long-term intraocular pressure(IOP)fluctuations and fur ther ocular and demographic parameters as predictors for normal tension glaucoma(NTG)***:This retrospective,longitudinal cohort study included 137 eyes of 75 patients with NTG,defined by glaucomatous optic disc or visual field defect with normal IOP(21 mm Hg),independently from therapy *** fluctuation,mean,and maximum were inspected with a mean follow-up of 38 mo[standard deviation(SD)18 mo].Inclusion criteria were the performance of minimum two 48-hour profiles including perimetry,Heidelberg retina tomograph(HRT)imaging,and optic disc *** impact of IOP parameters,myopia,sex,cup-to-disc-ratio,and visual field results on progression of NTG were analyzed using Cox regression models.A sub-group analysis with results from optical coherence tomography(OCT)was ***:IOP fluctuations,average,and maximum were not risk factors for progression in NTG patients,although maximum IOP at the initial IOP profile was higher in eyes with progression than in eyes without progression(P=0.054).The 46/137(33.5%)eyes progressed over the followup *** progression(at least three progression confirmations)occurred in 28/137 eyes(20.4%).Most progressions were detected by perimetry(36/46).Longterm IOP mean over all pressure profiles was 12.8 mm Hg(SD 1.3 mm Hg);IOP fluctuation was 1.4 mm Hg(SD 0.8 mm Hg).The progression-free five-year rate was 58.2%(SD 6.5%).CONCLUSION:Short-and long-term IOP fluctuations do not result in progression of *** functional changes are most likely to happen,NTG should be monitored with visual field testing more often than with other devices.