Mean intraocular pressure and progression based on corneal thickness in patients with ocular hypertension

Abstract

Purpose To determine the incidence of glaucomatous progression at mean intraocular pressure (IOP) levels in patients with ocular hypertension (OHT). Methods A retrospective, multicentre, cohort analysis of 230 OHT patients with 5 years of follow-up evaluated for risk factors associated with progressive optic disc and visual field loss to determine the incidence of glaucomatous progression. Results Forty percent of patients with IOPs X24 mmHg, 18% of patients with IOPs of 21-23 mmHg, 11% of patients with IOPs with 18-20 mmHg, and 3% of patients with IOPs of p17 mmHg progressed to glaucoma. The mean IOP was 19.872.4 mmHg in the stable group and 21.772.6 mmHg in the progressed group (P ¼ 0.0004). The highest average peak IOP was 23.474.0 mmHg in the stable group and 25.273.1 mmHg in the progressed group (P ¼ 0.006). Based on the pachymetry values for central corneal thickness, patients with thinner corneas more often progressed to glaucoma (Po0.0001). A multivariant regression analysis to determine risk factors for progression was positive primarily for higher peak IOPs, older age, male gender, argon laser trabeculoplasty, visual acuity X20/50, and no topical medical therapy or b-blocker therapy prior to the study. Conclusions IOP reduction within the normal range over 5 years of follow-up reduces the chance of progression to primary openangle glaucoma in OHT patients.

Peak Intraocular Pressure and Glaucomatous Progression in Primary Open-Angle Glaucoma

“…P eak intraocular pressure (IOP) has recently been evaluated as being a potential risk factor for long-term glaucomatous progression for which there are several general lines of supportive evidence: first, Stewart and associates have shown in 2 studies that long-term, 5-year peak pressure was an independent risk factor; and second, the Advanced Glaucoma Intervention Study (AGIS) showed a peak pressure of £ 18 mmHg, associated with a mean pressure of 12.8 mmHg, to be the best combination to prevent progression, although the independence of the peak pressure was not evaluated. [1][2][3] Despite these findings, there is not uniform acceptance regarding the importance of the peak pressure within the ophthalmic community. This is because, at least in part, not all studies have shown peak pressure to be an independent risk factor.…”

Characterization of the Thinnest Point of the Cornea Compared With the Central Corneal Thickness in Normal Subjects

“…It is helpful in the differentiation of ocular hypertension, normal tension glaucoma, and chronic open-angle glaucoma. 3 Furthermore, it is an important basic parameter in the planning of laser refractive surgery. For laser-assisted in situ keratomileusis or photorefractive keratectomy, the remaining postoperative residual corneal thickness is an important prognostic factor to guarantee the stability of the surgically altered corneal architecture.…”

Diurnal fluctuation of ocular blood flow parameters in patients with primary open-angle glaucoma and healthy subjects

“…Several studies have evaluated the role of IOP variation during the day as a risk factor for glaucoma progression,3 4 and considerable interest has been directed towards this topic in the recent years 5 – 7. Circadian fluctuation in ocular perfusion pressure (OPP) also appears to be an independent risk factor for POAG and normal tension glaucoma 8 – 10…”