The Relationship Between the Mean Deviation Slope and Follow-up Intraocular Pressure in Open-angle Glaucoma Patients

Fukuchi, Takeo; Yoshino, Takaiko; Sawada, Hideko; Seki, Masaaki; Togano, Tetsuya; Tanaka, Takayuki; Ueda, Jun; Abe, Haruki

doi:10.1097/ijg.0b013e318264b779

Cited by 30 publications

(23 citation statements)

References 38 publications

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“…They found that after 3 years of follow-up, patients with POAG and an IOP SD greater than 2 mm Hg after surgery had a markedly worse mean VF deviation than did patients with an IOP SD of no more than 2 mm Hg. Fukuchi et al 22 similarly found that patients with normal tension glaucoma (NTG) designated as fast progressors based on VF had a higher SD and range in follow-up IOP compared to slow progressors, They found no such correlation for patients with open-angle glaucoma (OAG).…”

Section: Long-term Iop Fluctuationmentioning

confidence: 99%

Intraocular pressure fluctuation and glaucoma progression: what do we know?

et al. 2014

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While mean intraocular pressure (IOP) has long been known to correlate with glaucomatous damage, the role of IOP fluctuation is less clearly defined. There is extensive evidence in the literature for and against the value of short-term and long-term IOP fluctuation in the evaluation and prognosis of patients with glaucoma. We present here the arguments made by both sides, as well as a discussion of the pitfalls of prior research and potential directions for future studies. Until a reliable method is developed that allows for constant IOP monitoring, many variables will continue to hinder us from drawing adequate conclusions regarding the significance of IOP variation.

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Section: Long-term Iop Fluctuationmentioning

confidence: 99%

Intraocular pressure fluctuation and glaucoma progression: what do we know?

et al. 2014

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“…Regarding factors after switching, the mean MD slope for 3 years was correlated with the IOP reduction rate at 36 months according to univariate analysis, but not by multivariate analysis (Table 4). Fukuchi et al reported that the MD slope was negatively associated with the mean follow-up IOP in patients with POAG, but this association was not observed in patients with NTG 21. These results suggest that the reduction of IOP after switching to DTFC is the most important factor influencing the progression of visual field loss, but some other potential factors must also be considered.…”

Section: Discussionmentioning

confidence: 92%

Effect of dorzolamide/timolol combination on the visual field in glaucoma

Takeda¹,

Mimura²,

Matsubara³

2014

OPTH

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PurposeTo evaluate the effect of treatment for 3 years with a dorzolamide/timolol (1%/0.5%) fixed combination (DTFC) on visual field progression in patients with open-angle glaucoma.ParticipantsA total of 14 consecutive patients were enrolled who had been previously treated with monotherapy or any combination of a beta blocker, carbonic anhydrase inhibitor, and/or prostaglandin analog for primary open-angle glaucoma (POAG; n=4) or normal-tension glaucoma (NTG; n=10).MethodsPatients were switched to DTFC from their prior glaucoma therapy. The IOP was measured at intervals of 4–6 weeks, and the visual fields were examined at least twice a year for 3 years. The annual change of mean deviation (MD slope) was used to quantify visual field loss.ResultsThe mean MD value was −5.9±5.0 dB at baseline; it was −5.6±4.8 dB at 12 months, −5.9±5.0 dB at 24 months, and −5.6±5.1 dB at 36 months after switching. The mean MD slope was −0.2±0.8 dB/year before switching and 0.3±1.3 dB/year from baseline to 1 year, −0.3±1.1 dB/year from 1–2 years, and 0.3±0.9 dB/year from 2–3 years after switching. The mean MD slope from baseline to 36 months was correlated with the IOP reduction rate at 36 months after switching. Visual field progression was associated with the IOP reduction rate at 12 months after switching.ConclusionSwitching to DTFC from prior glaucoma therapy improved the MD slope for at least 3 years. Reduction of the IOP after switching to DTFC was effective for delaying visual field progression. Although our study was not nonrandomized and was small in scale, the findings suggest that DTFC might have a beneficial effect on the visual fields in patients with open-angle glaucoma.

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“…In this study, we set a threshold for fast/slow progression based on the median of the MD slope [ 15 ] or previously reported values [ 15 , 16 ]. Considering the difference of MD between Octopus (mean defect) and Humphrey perimetry (mean deviation) [ 17 ], 0.22 dB/y and 0.30 dB/y of Octopus may be comparable to the previous MD slope of Humphrey [ 11 , 15 , 16 ]. We found that VCDR and the extent of myopia were associated with fast/slow progression of VF.…”

Section: Discussionmentioning

confidence: 99%

“…The change in MD over time, i.e., the MD slope, was used for evaluating visual progression. Based on previously reported rates of VF progression [ 15 , 16 ], two different threshold values (0.22 dB/y and 0.30 dB/y) were used to distinguish slow progression from fast progression. Initially, the median of the MD slope (0.22 dB/y) was set as the cutoff threshold.…”

Section: Methodsmentioning

confidence: 99%

Axial Myopia Is Associated with Visual Field Prognosis of Primary Open-Angle Glaucoma

et al. 2015

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PurposeTo identify whether myopia was associated with the visual field (VF) progression of primary open-angle glaucoma (POAG).MethodsA total of 270 eyes of 270 POAG followed up for more than 3 years with ≥9 reliable VFs by Octopus perimetry were retrospectively reviewed. Myopia was divided into: mild myopia (-2.99 diopter [D], 0), moderate myopia (-5.99, 3.00 D), marked myopia (-9.00, -6.00 D) and non-myopia (0 D or more). An annual change in the mean defect (MD) slope >0.22 dB/y and 0.30 dB/y was defined as fast progression, respectively. Logistic regression was performed to determine prognostic factors for VF progression.ResultsFor the cutoff threshold at 0.22 dB/y, logistic regression showed that vertical cup-to-disk ratio (VCDR; p = 0.004) and the extent of myopia (p = 0.002) were statistically significant. When logistic regression was repeated after excluding the extent of myopia, axial length (AL; p = 0.008, odds ratio [OR] = 0.796) reached significance, as did VCDR (p = 0.001). Compared to eyes with AL≤23 mm, the OR values were 0.334 (p = 0.059), 0.309 (p = 0.044), 0.266 (p = 0.019), 0.260 (p = 0.018), respectively, for 23 26 mm. The significance of vertical cup-to-disk ratio of (p = 0.004) and the extent of myopia (p = 0.008) did not change for the cutoff threshold at 0.30dB/y.ConclusionsVCDR and myopia were associated with VF prognosis of POAG. Axial myopia may be a protective factor against VF progression.

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The Relationship Between the Mean Deviation Slope and Follow-up Intraocular Pressure in Open-angle Glaucoma Patients

Cited by 30 publications

References 38 publications

Intraocular pressure fluctuation and glaucoma progression: what do we know?

Intraocular pressure fluctuation and glaucoma progression: what do we know?

Effect of dorzolamide/timolol combination on the visual field in glaucoma

Axial Myopia Is Associated with Visual Field Prognosis of Primary Open-Angle Glaucoma

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The Relationship Between the Mean Deviation Slope and Follow-up Intraocular Pressure in Open-angle Glaucoma Patients

Cited by 30 publications

References 38 publications

Intraocular pressure fluctuation and glaucoma progression: what do we know?

Intraocular pressure fluctuation and glaucoma progression: what do we know?

Effect of dorzolamide/timolol combination on&nbsp;the&nbsp;visual field in glaucoma

Axial Myopia Is Associated with Visual Field Prognosis of Primary Open-Angle Glaucoma

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Effect of dorzolamide/timolol combination on the visual field in glaucoma