Incidence of Elevation of Intraocular Pressure Over Time and Associated Factors in Normal-Tension Glaucoma

Oguri, Akihiro; Sogano, Shigeyo; Yamamoto, Tetsuya; Kitazawa, Yoshiaki

doi:10.1097/00061198-199804000-00009

Cited by 12 publications

(9 citation statements)

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“…Currently, the Nd:YAG CPC techniques have largely been replaced by DLCPC as the latter is easier to perform, has equivalent efficacy and has a better safety profile [ 27 – 29 ].…”

Section: Techniques and Evidence On Efficacymentioning

confidence: 99%

Cyclodestructive Procedures in Glaucoma: A Review of Current and Emerging Options

et al. 2018

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The first surgical modalities to reduce aqueous humor production by damaging the ciliary body date back to the early twentieth century. Until recently, however, cyclodestructive procedures (e.g., cyclocryotherapy and transscleral diode laser photocoagulation) have been reserved as last option procedures in refractory glaucoma patients with poor visual potential. Emerging technologic innovation has led to the development of promising, safer and less destructive techniques, such as micropulse diode cyclophotocoagulation, endoscopic cyclophotocoagulation and ultrasound cyclodestruction. Consequently, an emerging paradigm shift is under way with the selection of these surgical options in eyes with less severe glaucoma and good visual potential. Although existing evidence has not, as yet, adequately defined the role and value of these procedures, their emergence is a welcome expansion of available options for patients with moderate-to-severe glaucoma. This article reviews the pertinent evidence on both established and evolving cyclodestructive techniques and describes their growing role in the management of glaucoma.

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“…Currently, the Nd:YAG CPC techniques have largely been replaced by DLCPC as the latter is easier to perform, has equivalent efficacy and has a better safety profile [ 27 – 29 ].…”

Section: Techniques and Evidence On Efficacymentioning

confidence: 99%

Cyclodestructive Procedures in Glaucoma: A Review of Current and Emerging Options

et al. 2018

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“…Further, IOP may be gradually elevated during follow-up in some patients once diagnosed with NTG. One study reported that 5% of the patients who had been diagnosed with NTG after 24-h IOP fluctuation assessment showed an office-hour IOP elevation above the cut-off level at 1-year follow-up [ 110 ].…”

Section: Value Of Diurnal/24-h Iop Monitoring In the Management Of Nomentioning

confidence: 99%

Diurnal and 24-h Intraocular Pressures in Glaucoma: Monitoring Strategies and Impact on Prognosis and Treatment

et al. 2018

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The present review casts a critical eye on intraocular pressure (IOP) monitoring and its value in current and future glaucoma care. Crucially, IOP is not fixed, but varies considerably during the 24-h cycle and between one visit and another. Consequently, a single IOP measurement during so-called office hours is insufficient to characterize the real IOP pathology of a patient with glaucoma. To date IOP remains the principal and only modifiable risk factor for the development and progression of glaucoma. Only by evaluating IOP characteristics (mean, peak and fluctuation of IOP) at diagnosis and after IOP-lowering interventions can we appreciate the true efficacy of therapy. Unfortunately, a major limiting factor in glaucoma management is lack of robust IOP data collection. Treatment decisions, advancement of therapy and even surgery are often reached on the basis of limited IOP evidence. Clearly, there is much room to enhance our decision-making and to develop new algorithms for everyday practice. The precise way in which daytime IOP readings can be used as predictors of night-time or 24-h IOP characteristics remains to be determined. In practice it is important to identify those at-risk glaucoma patients for whom a complete 24-h curve is necessary and to distinguish them from those for whom a daytime curve consisting of three IOP measurements (at 10:00, 14:00 and 18:00) would suffice. By employing a staged approach in determining the amount of IOP evidence needed and the rigour required for our monitoring approach for the individual patient, our decisions will be based on more comprehensive data, while at the same time this will optimize use of resources. The patient’s clinical picture should be the main factor that determines which method of IOP monitoring is most appropriate. A diurnal or ideally a 24-h IOP curve will positively impact the management of glaucoma patients who show functional/anatomical progression, despite an apparently acceptable IOP in the clinic. The potential impact of nocturnal IOP elevation remains poorly investigated. The ideal solution in the future is the development of non-invasive methods for obtaining continuous, Goldmann equivalent IOP data on all patients prior to key treatment decisions. Moreover, an important area of future research is to establish the precise relationship between 24-h IOP characteristics and glaucoma progression.

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“…Yamamoto and associates demonstrated that IOP increased significantly with age in 11 (28%) of 40 NTG patients (mean age 56.9 years, range 34-73) during a mean 5.2 years' follow-up [9]. On the other hand, the same group recently reported that one ninth of NTG patients showed a significant IOP reduction during a 3-year follow-up period [8]. The individual IOP fluctuation in NTG seems to remain unchanged with increasing age in more than half of NTG patients.…”

Section: Discussionmentioning

confidence: 95%

The negative correlation between age and intraocular pressures measured nyctohemerally in elderly normal-tension glaucoma patients

Okada

Tsumamoto

Yamasaki

et al. 2003

Graefe's Arch Clin Exp Ophthalmol

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Purpose: To evaluate the correlation between age and intraocular pressure (IOP) measured every 3 h for 24 h in older normal-tension glaucoma (NTG) patients. Methods: Ninety consecutive patients suspected of having NTG on the basis of both visual field defect and disc appearance were hospitalized for measurement of nyctohemeral IOP every 3 h over a 24-h period with a Goldmann tonometer after a 4-week wash-out of any existing medication. Sixty-nine patients (76.7%) were diagnosed as having NTG. Sixty-nine eyes of 69 subjects were enrolled for this prospective, cross-sectional study. They were divided into two groups by age (cut-off between 59 and 60 years: group 1, under 60 years; group 2, over 60 years). The correlations between age and the mean, maximum and minimum IOP and IOP variation of the eight nyctohemeral IOP measurements nyctohemerally were evaluated for each group. The times of day at which the maximum and minimum IOPs were observed were recorded. Results: Groups 1 and 2 consisted of 28 patients (age: 50.2±6.1 years) and 42 patients (age: 70.3±6.1 years) (P<0.0001), respectively. Neither mean, maximum or minimum IOP nor the IOP variation was significantly different between the groups (all P values ≥0.115). The mean, maximum and minimum IOP in group 2 were all correlated with age (n=41; r=−0. 516, P=0.0004; r=−0.434, P=0.004; r=−0.522, P=0.0004, respectively), while none of those in group 1 was correlated with age (all P values ≥0.303). Conclusion: The IOPs of the elder NTG patients have a negative correlation with age while those of the younger ones have no relation to age.

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Incidence of Elevation of Intraocular Pressure Over Time and Associated Factors in Normal-Tension Glaucoma

Cited by 12 publications

References 0 publications

Cyclodestructive Procedures in Glaucoma: A Review of Current and Emerging Options

Cyclodestructive Procedures in Glaucoma: A Review of Current and Emerging Options

Diurnal and 24-h Intraocular Pressures in Glaucoma: Monitoring Strategies and Impact on Prognosis and Treatment

The negative correlation between age and intraocular pressures measured nyctohemerally in elderly normal-tension glaucoma patients

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