The Value of Intraocular Pressure Asymmetry in Diagnosing Glaucoma

Williams, Alice; Gatla, Srinivas; Leiby, Benjamin E.; Fahmy, Iman; Biswas, Amitava; Barros, Daniela M. de; Ramakrishnan, Rengappa; Bhardwaj, Suruchi; Wright, Carol; Dubey, Suneeta; Lynch, Jorge F.; Bayer, Atilla; Khandelwal, Rekha; Ichhpujani, Parul; Gheith, Moataz E; Siam, Ghada A; Feldman, Robert M.; Henderer, Jeffrey; Spaeth, George L.

doi:10.1097/ijg.0b013e318237bfb8

Cited by 38 publications

(23 citation statements)

References 20 publications

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“…William et al did logistic regression analysis in his study on IOP asymmetry and demonstrated that inter-eye IOP asymmetry is a significant risk factor for having glaucoma (odds ratio, 2.14;95% confidence interval(CI), 1.86-2.47; p<0.001). 15 In our study, Odd's ratio was found to be 18.89%, thus indicative of a relative risk. The inference would be: A person with IOP asymmetry will have almost 19 times greater risk of developing glaucoma as compared to a normal individual.…”

Section: Discussionsupporting

confidence: 49%

Intraocular Pressure Asymmetry: An Indicator for Glaucoma Diagnosis

Khandelwal¹,

Banait²

2016

jebmh

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AIMTo investigate the amount of intraocular pressure asymmetry between fellow eyes in patients with and without primary open angle glaucoma. MATERIALS AND METHODSThis was a retrospective case control study conducted at a tertiary care hospital of Central India. A single pre-treatment IOP of the primary open angle glaucoma patients was recorded from the Glaucoma Clinic data from Jan 2013 to Dec 2013. The inter-eye IOP asymmetry of these cases was compared with normal subjects without primary open angle glaucoma (POAG). RESULTSThere were 84 (POAG) glaucoma patients and 168 control subjects in the study. It was observed that 23.8% patients suffering from glaucoma had an asymmetry of 2 mmHg while 20.23% had no asymmetry. Asymmetry as high as >20 mmHg was also seen in glaucomatous patients. Intraocular pressure asymmetry was a significant factor for having glaucoma (Odds ratio, 18.89%; P<0.001). CONCLUSIONInter-eye asymmetry of IOP is a common finding in patients with POAG. There is a direct relationship between the amount of IOP asymmetry between the fellow eyes and the likelihood of having glaucoma. KEYWORDSGlaucoma, Intraocular pressure asymmetry, Primary open angle glaucoma, POAG. HOW TO CITE THIS ARTICLE: Khandelwal RR, Banait J. Intraocular pressure asymmetry: An indicator for glaucoma diagnosis.

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Section: Discussionsupporting

confidence: 49%

Intraocular Pressure Asymmetry: An Indicator for Glaucoma Diagnosis

Khandelwal¹,

Banait²

2016

jebmh

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“…In fact, it is the emergence of asymmetry between the eyes that alerts the ophthalmologist to the possibility of glaucoma. Interocular differences in IOP (Cartwright and Anderson, 1988;Levine et al, 2006;Williams et al, 2013), optic disc characteristics (Armaly, 1969;Ong et al, 1999), OCT measurements of cpRNFL and macular thickness (Gugleta et al, 1999;Sullivan-Mee et al, 2013), and visual field sensitivity (Greenfield et al, 2007;Levine et al, 2006) are all features that raise suspicion of glaucoma. Indeed an interocular difference in cup-disc ratio of more than 0.2 has long been quoted as a diagnostic criterion for glaucoma (Armaly, 1969).…”

Section: Glaucoma Is Characterised By Accelerated Loss Of Retinal Ganmentioning

confidence: 99%

Lateral thinking – Interocular symmetry and asymmetry in neurovascular patterning, in health and disease

Cameron

Megaw

Tatham

et al. 2017

Progress in Retinal and Eye Research

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No biological system or structure is likely to be perfectly symmetrical, or have identical right and left forms. This review explores the evidence for eye and visual pathway asymmetry, in health and in disease, and attempts to provide guidance for those studying the structure and function of the visual system, where recognition of symmetry or asymmetry may be essential. The principal question with regards to asymmetry is not 'are the eyes the same?', for some degree of asymmetry is pervasive, but 'when are they importantly different?'. Knowing if right and left eyes are 'importantly different' could have significant consequences for deciding whether right or left eyes are included in an analysis or for examining the association between a phenotype and ocular parameter. The presence of significant asymmetry would also have important implications for the design of normative databases of retinal and optic nerve metrics. In this review, we highlight not only the universal presence of asymmetry, but provide evidence that some elements of the visual system are inherently more asymmetric than others, pointing to the need for improved normative data to explain sources of asymmetry and their impact on determining associations with genetic, environmental or health-related factors and ultimately in clinical practice.

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“…It is generally thought that IOPs between right and left eyes in healthy individuals are symmetric, and this hypothesis is commonly based on clinical experience and research studies. Asymmetric IOP results between the paired eyes have been considered as a hallmark of glaucoma (16). However, most of the early studies that analyzed the symmetry of the IOP focused on diurnal IOP curves of bilateral glaucoma patients.…”

Section: Discussionmentioning

confidence: 99%

Concordance of 24‑h intraocular pressure curve in patients with untreated unilateral primary open‑angle glaucoma

Lin

Huang

et al. 2018

Exp Ther Med

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The present study aimed to assess the concordance of 24-h intraocular pressure (IOP) curves between glaucomatous and contralateral eyes for patients with untreated unilateral primary open-angle glaucoma (POAG). A total of 32 patients with unilateral POAG and 32 age-matched normal subjects were enrolled. The IOP measurements were performed every 2 h over a 24-h period. The concordance of the 24-h IOP curves was assessed via the correlation coefficient (r), intraclass correlation coefficient (ICC) and repeated-measures analysis of variance (ANOVA). No significant difference was identified between all IOPs, as well as the mean, peak and trough IOP or IOP fluctuations of the paired eyes in the two groups. The strength of association of all IOPs was moderate in the glaucoma group (r, 0.752-0.867) and the normal controls (r, 0.625-0.873). IOP readings at each time-point indicated a high agreement in the glaucoma group (ICC, 0.857-0.929) and the normal controls (ICC, 0.768-0.932). Repeated-measures ANOVA indicated that the 24-h IOP curves of the paired eyes had parallel profiles in the two study groups (P=0.837 and P=0.897, respectively). The glaucoma patients had significantly higher proportions of all IOPs displaying absolute differences of ≥2 and ≥3 mmHg (46.09 vs. 35.68%, P<0.001; 29.69 vs. 12.50%, P<0.001, respectively). In conclusion, the 24-h IOP curves of the paired eyes had parallel profiles in unilateral glaucoma patients and normal subjects. However, unilateral glaucoma patients had a significantly larger proportion of IOP differences of ≥2 and ≥3 mmHg.

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The Value of Intraocular Pressure Asymmetry in Diagnosing Glaucoma

Abstract: Inter-eye asymmetry of IOP is a common finding in patients with glaucoma. There is a direct relationship between the amount of IOP asymmetry between the fellow eyes and the likelihood of having glaucoma.

Cited by 38 publications

References 20 publications

Intraocular Pressure Asymmetry: An Indicator for Glaucoma Diagnosis

Intraocular Pressure Asymmetry: An Indicator for Glaucoma Diagnosis

Lateral thinking – Interocular symmetry and asymmetry in neurovascular patterning, in health and disease

Concordance of 24‑h intraocular pressure curve in patients with untreated unilateral primary open‑angle glaucoma

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