Predictors of Long-term Progression in the Early Manifest Glaucoma Trial

Leske, M. Cristina; Heijl, Anders; Hyman, Leslie; Bengtsson, Bo; Dong, Liming; Yang, Zhong-Jin

doi:10.1016/j.ophtha.2007.03.016

Cited by 1,239 publications

(1,014 citation statements)

References 33 publications

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“…Among baseline factors included in the analysis, all lower PPs, meaning systolic, diastolic and mean PP, were associated with an increased risk of OAG incidence. In addition, the Early Manifest Glaucoma Trial (EMGT), a prospective randomized clinical trial (RCT) of 255 Caucasian participants with a median follow-up of 8 years, evaluated risk factors for progression of manifest OAG [33]. Overall progression was 67%, while baseline systolic PP ≤ 125 mm Hg was a risk factor for OAG progression (OR, 1.42; 95% CI, 1.04-1.94).…”

Section: The Role Of Pp In Glaucoma – a Risk Factor For Glaucoma Prevmentioning

confidence: 99%

“…In the Barbados Eye Study and the EMGT, results were adjusted for IOP, IOP-lowering and BP-lowering treatment [32, 33]. However, one may not exclude residual confounding.…”

Section: Pp: a Tricky Variable With Regards To Iop And Bpmentioning

confidence: 99%

“…It is possible that there is a different significance of BP depending on the IOP. In the EMGT subgroup analyses with regards to IOP, systolic BP ≤160 mmHg was associated with progression in patients with baseline IOP <21 mmHg [33]. However, only systolic PP ≤125mmHg, but not systolic BP ≤160 mm Hg was associated with progression in patients with higher baseline IOP.…”

Section: Pp: a Tricky Variable With Regards To Iop And Bpmentioning

confidence: 99%

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Weighing in Ocular Perfusion Pressure in Managing Glaucoma

Topouzis

Founti²

2009

TOOPHTJ

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The role of vascular risk factors in glaucoma is increasingly being supported by the literature, with the association between low ocular perfusion pressure (PP) and glaucoma being the most consistent result. However, we need to be cautious when interpreting these results and consider all possible confounders in the observed associations. While we assess PP through its principal components, the weight of intraocular pressure (IOP) and blood pressure (BP) in the PP equation remains unknown. Also, the role of PP in glaucoma needs to be elucidated with regards to IOP and BP fluctuation during the 24hour period and the effect of IOP-lowering and BP-lowering treatment. The complexity of the interaction of PP with other potential risk factors for glaucoma means that PP cannot be currently considered in the assessment of an individual patient. The role of PP in glaucoma warrants further research and randomized clinical trials assessing PP should include vision and/or structure preservation as end-points and ideally address all of the above issues.

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Section: The Role Of Pp In Glaucoma – a Risk Factor For Glaucoma Prevmentioning

confidence: 99%

“…In the Barbados Eye Study and the EMGT, results were adjusted for IOP, IOP-lowering and BP-lowering treatment [32, 33]. However, one may not exclude residual confounding.…”

Section: Pp: a Tricky Variable With Regards To Iop And Bpmentioning

confidence: 99%

Section: Pp: a Tricky Variable With Regards To Iop And Bpmentioning

confidence: 99%

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Weighing in Ocular Perfusion Pressure in Managing Glaucoma

Topouzis

Founti²

2009

TOOPHTJ

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“…Time of course has proved this latter point correct with the observation from incidence studies of low-baseline IOP and low-perfusion pressure in new glaucoma's. 9,10 At the time of the Bowman lecture delivered by Drance a systematic review on Medical Evidence by Eddy and Billings 11 had had profound effects on the medical community in general, and the glaucoma community in particular. Up until that time, topical hypotensive treatment had been prescribed on the basis that the IOP was elevated in a diseased eye, and that this was causal.…”

Section: Glaucoma At the Time Of Stephen Drancementioning

confidence: 99%

Glaucoma: an area of darkness

Hitchings

2008

Eye

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This review of Primary Open Angle Glaucoma looks at the management of the condition today. It does this by looking at the following areas: (a) the size of the problem; (b) the position of IOP, with respect to its elevation and fluctuation; (c) optic nerve head changes; and (d) visual function changes. In doing so, it contrasts what is known now with ideas and concepts that were prevalent at the time of the two previous Bowman lecturers, Duke Elder and Drance, as well as noting concepts about the disease that were current at the time of William Bowman. The review concludes by suggesting challenges in this area that lie ahead.

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“…O estudo EMGT (Early Manifest Glaucoma Trial), no seguimento de onze anos, identificou a ECC como um importante fator de predi-ção para progressão do glaucoma em pacientes com ní-veis pressóricos mais elevados (11) . É interessante notar que, provavelmente pelo fato que menos pacientes com glaucoma desenvolveram progressão da doença, o seguimento de cinco anos do mesmo estudo falhou em identificar tal associação clínicas (12) .…”

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Estudo das correlações entre a área do disco óptico e as características geométricas e biomecânicas da córnea

Silva¹,

Silva²,

Lima³

et al. 2011

Rev. bras.oftalmol.

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RESUMOObjetivo: Correlacionar área do disco óptico com parâmetros geométricos e biomecânicos da córnea. Métodos: Estudo retrospectivo nos arquivos de pacientes do Instituto de Olhos Renato Ambrósio a fim de se identificar os pacientes que realizaram exames HRT (Heidelberg Retina Tomography), Pentacam e ORA. A retinografia digital foi revisada de modo a se classificar na escala DDLS (Disc Damage Likelihood Scale).Resultados: 244 olhos de 122 pacientes (75 mulheres) foram incluídos no estudo. A média de idade foi de 47,2 anos (de 8 a 97 anos, desvio padrão de 21,7). Não houve correlação significante entre área do disco e nenhuma das medidas de PIO (IOPg, IOPcc). Encontrou-se uma relação negativa significativa com CRF (r=-0,1337, p=0,0263). A relação com histerese foi também negativa (-0,1123), mas o valor p foi maior que 0,05 (0,0625). Não houve correlação significante entre área do disco e progressão paquimétrica mínima ou média. Entretanto, observou-se correlação significante e positiva entre a área do disco e astigmatismo corneano (Delta K), sendo de 1,15 (p=0,0129). Conclusão: Existe uma correlação negativa entre a área do disco óptico e os parâmetros biomecânicos e estruturais da córnea. Tal correlação pode ser parte da explicação da córnea ser um fator de risco para maior susceptibilidade do nervo óptico para neuropatia glaucomatosa.

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Predictors of Long-term Progression in the Early Manifest Glaucoma Trial

Cited by 1,239 publications

References 33 publications

Weighing in Ocular Perfusion Pressure in Managing Glaucoma

Weighing in Ocular Perfusion Pressure in Managing Glaucoma

Glaucoma: an area of darkness

Estudo das correlações entre a área do disco óptico e as características geométricas e biomecânicas da córnea

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