Pressure-cornea-vascular index (PCVI) for predicting disease progression in normal tension glaucoma

Leung, Dexter Y.L.; Iliev, Milko E; Chan, Poemen P.; Baig, Nafees; Stanley, Christina; Tham, Clement C.; Lam, Dennis Shun Chiu

doi:10.1136/bjo.2009.175992

Cited by 10 publications

(8 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…73 When DH is identified, rather than immediately relating to NPG, one should also consider other causes of DH, including posterior vitreous detachment, optic disc drusen, other causes of optic neuropathies, diabetic retinopathy, and vascular occlusive disease. 74 Despite a persistently lower level of IOP, NPG shares similar features of optic nerve damage compared with the higher-tension POAG. It is generally agreed that there is considerable overlap between NPG and POAG.…”

Section: Diagnosismentioning

confidence: 98%

Latest Developments in Normal-Pressure Glaucoma: Diagnosis, Epidemiology, Genetics, Etiology, Causes and Mechanisms to Management

Lee

Chan

Zhang

et al. 2019

Asia-Pacific Journal of Ophthalmology

View full text Add to dashboard Cite

Normal-pressure glaucoma (NPG) is part of the spectrum of the open-angle glaucomas and morphologically characterized, as any glaucoma, by a loss of neuroretinal rim parallel to an enlargement and deepening of the optic cup, and development or enlargement of parapapillary beta zone. These morphological characteristics, in addition to the therapeutic benefit of lowering the intraocular pressure (IOP), make NPG differ from vascular-induced optic neuropathy. Based on the anatomy of the optic nerve as a cerebral fascicle, the physiological counter-pressure against the IOP is the orbital cerebrospinal fluid pressure (CSFP), with both pressures forming the trans-lamina cribrosa pressure difference (TLCPD). In contrast to the IOP, the TLCPD is the true pressure exerting force on the optic nerve fibers when passing through the lamina cribrosa. As a theoretical notion, an abnormally high TLCPD due to a low CSFP, in association with a low arterial blood pressure, could therefore be involved in the pathogenesis of NPG. It fits with the finding that the reduction of the IOP (and thus indirectly of the TLCPD) is (the only proven) procedure for NPG therapy. This review additionally highlights the genetic background, diagnostic methods, and therapeutic modalities of NPG.

show abstract

Section: Diagnosismentioning

confidence: 98%

Latest Developments in Normal-Pressure Glaucoma: Diagnosis, Epidemiology, Genetics, Etiology, Causes and Mechanisms to Management

Lee

Chan

Zhang

et al. 2019

Asia-Pacific Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…The authors concluded that PCVI might be useful for predicting progression in NTG with a satisfactory AUC comparable to established scoring systems in neurovascular medicine. [ 14 ] In our study, we had not assessed any vascular parameters and did not evaluate the PCVI.…”

Section: Discussionmentioning

confidence: 99%

Correlation between the pressure-to-cornea index and both structural and functional measures of glaucoma

Franco¹,

Kasahara²

2014

Indian J Ophthalmol

View full text Add to dashboard Cite

Purpose:the pressure-to-cornea index (PCI) was proposed in order to integrate intraocular pressure and central cornea thickness as a single-risk factor for glaucoma. The purpose of this study was to correlate the PCI with a structural and two functional measures of glaucoma.Setting:University Hospital in South America.Materials and Methods:Pressure-to-cornea index was calculated for 70 eyes of 36 subjects (glaucoma and suspects). Cup-to-disc (C/D) ratio, mean deviation (MD) and pattern standard deviation (PSD) as recorded by Humphrey automated perimetry (SITA 24-2) were correlated with PCI (Pearson's correlation coefficient).Results:Pearson's correlation coefficient between PCI and C/D was 0.329 (95% confidence interval [95% CI], 0.09–0.526; P = 0.006); between PCI and MD was − 0.356 MD (95% CI, −0.549 to − 0.126; P = 0.003); and between PCI and PSD was − 0.215 (95% CI, −0.433 to 0.025; P = 0.07).Conclusion:In addition to serve as a single-risk factor, PCI can be used to stage glaucoma severity as well.

show abstract

“…It is important to note that, similar to most multivariate prediction models derived from prospective studies [14], we are making several assumptions when we apply the 5-year risk calculator to guide treatment decision: [1] we assume that the baseline variables that were measured are the most predictive of the risk of glaucoma development, [2] the model also assumes that the risk of glaucoma progression is linear, and [3] patients who are being assessed have similar clinical characteristics as the participants in the OHTS and EGPS.…”

Section: Variability Of Risk Factor Measurement and The Effects On Rimentioning

confidence: 98%

Risk Assessment of Ocular Hypertension and the Use of Medication

Chow¹,

Chan²

2020

Visual Impairment and Blindness - What We Know and What We Have to Know

View full text Add to dashboard Cite

Ocular hypertension (OHT) is the only known modifiable risk factor of glaucoma development. Intraocular pressure (IOP)-lowering therapy reduces the risk of glaucoma development. The 5-year risk of glaucoma conversion is <10% for untreated OHT patients. Cost-effectiveness analyses suggested that it is not costeffective to treat all patients with OHT. Treatment should be targeted towards the higher-risk group-namely, patients with older age, a higher level of IOP, a thinner central corneal thickness (CCT), a larger vertical cup-to-disc ratio (VCDR) and a smaller pattern standard deviation (PSD) value on visual field (VF) test. These risk factors were established by the Ocular Hypertension Treatment Study (OHTS) and the European Glaucoma Prevention Study (EGPS). However, there is significant variability in the measurement of the currently known risk factors, especially if the assessment is taken from a longitudinal perspective. This can lead to overtreatment or under-treatment: the former exposing the patient to unnecessary side effects of IOP-lowering eye drops and the latter putting the patient at risk of developing glaucoma. The advancement of new VF algorithm and ocular imaging can lead to the identification of new approaches to risk stratification and, thus, more specific treatment for OHT patients.

show abstract

Pressure-cornea-vascular index (PCVI) for predicting disease progression in normal tension glaucoma

Abstract: PCVI may be useful for predicting progression in NTG with a satisfactory AUC comparable to established scoring systems in neurovascular medicine. Validation of PCVI in other NTG cohorts, preferably of different ethnicity, is necessary. Trial registration number NCT00321386.

Cited by 10 publications

References 28 publications

Latest Developments in Normal-Pressure Glaucoma: Diagnosis, Epidemiology, Genetics, Etiology, Causes and Mechanisms to Management

Latest Developments in Normal-Pressure Glaucoma: Diagnosis, Epidemiology, Genetics, Etiology, Causes and Mechanisms to Management

Correlation between the pressure-to-cornea index and both structural and functional measures of glaucoma

Risk Assessment of Ocular Hypertension and the Use of Medication

Contact Info

Product

Resources

About