Effect of quantitative intraocular pressure reduction on visual field defect progression in normal tension glaucoma under medical therapy applying Markov model

Keiji Yoshikawa,1 Kazunori Santo,2 Hiroko Hizaki,2 Masayo Hashimoto2 1Yoshikawa Eye Clinic, Machida, Tokyo, Japan; 2Japan Medical Affairs, Santen Pharmaceutical Co., Ltd, Osaka, Japan Purpose: To quantitatively evaluate the association of intraocular pressure (IOP) reduction with visual field defe...

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Autores principales:	Yoshikawa K, Santo K, Hizaki H, Hashimoto M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	normal tension glaucoma visual field defect (VFD) progression long-term follow-up intraocular pressure reduction Markov model Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/90a5d9cfbb92455e96a3d43cb4484c49
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spelling	oai:doaj.org-article:90a5d9cfbb92455e96a3d43cb4484c492021-12-02T04:51:53ZEffect of quantitative intraocular pressure reduction on visual field defect progression in normal tension glaucoma under medical therapy applying Markov model1177-5483https://doaj.org/article/90a5d9cfbb92455e96a3d43cb4484c492018-08-01T00:00:00Zhttps://www.dovepress.com/effect-of-quantitative-intraocular-pressure-reduction-on-visual-field--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Keiji Yoshikawa,1 Kazunori Santo,2 Hiroko Hizaki,2 Masayo Hashimoto2 1Yoshikawa Eye Clinic, Machida, Tokyo, Japan; 2Japan Medical Affairs, Santen Pharmaceutical Co., Ltd, Osaka, Japan Purpose: To quantitatively evaluate the association of intraocular pressure (IOP) reduction with visual field defect (VFD) progression in normal tension glaucoma (NTG) under medical therapy. Patients and methods: Clinical data for 622 eyes of 311 primary open-angle glaucoma and NTG patients were collected from April 2006 to March 2016. Of these patients, those with normal IOP, glaucomatous VFD by Anderson’s criteria, corrected visual acuity ≥0.7, >5 years of medical therapy, ≥5 visual field tests at least five times at 12-month intervals, visual field testing reliability coefficients of ≤33%, and mean deviation (MD) exceeding below -20 dB in the initial visual field test were included in this retrospective data analysis. MD and IOP data were collected at baseline and after 5 years. Following MD categorization into stages I to IV, stage transition matrices were generated using a Markov model to evaluate VFD changes. Eyes were divided based on IOP reduction (0%, 10%, 15%, 20%, 25%, 30%) from baseline. VFD aggravations were compared using the Markov model and MD slopes with IOP reduction rates as cutoff values. Results: Overall, 132 eyes of 132 NTG patients fulfilled the eligibility criteria. MD decreased significantly (P<0.0001) at 5 years vs baseline. During follow-up, visual field stage using the Markov model was constant in ~60%, with transitions in ~40%. IOP decreased significantly (P<0.001) at 5 years vs baseline. Though MD slopes did not differ significantly between each of the groups that achieved the various IOP reduction cut-off values and the corresponding group that did not achieve the cut-off values, a significant difference (P=0.0432) in VFD was found between the group that achieved the 25% cut-off value and the group that did not when evaluated using the Markov model. Conclusion: In NTG patients, VFD aggravation was significantly suppressed in groups with IOP reductions of ≥25% from baseline. Keywords: normal tension glaucoma, visual field defect (VFD) progression, long-term follow-up, intraocular pressure reduction, Markov modelYoshikawa KSanto KHizaki HHashimoto MDove Medical Pressarticlenormal tension glaucomavisual field defect (VFD) progressionlong-term follow-upintraocular pressure reductionMarkov modelOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 1617-1624 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	normal tension glaucoma visual field defect (VFD) progression long-term follow-up intraocular pressure reduction Markov model Ophthalmology RE1-994
spellingShingle	normal tension glaucoma visual field defect (VFD) progression long-term follow-up intraocular pressure reduction Markov model Ophthalmology RE1-994 Yoshikawa K Santo K Hizaki H Hashimoto M Effect of quantitative intraocular pressure reduction on visual field defect progression in normal tension glaucoma under medical therapy applying Markov model
description	Keiji Yoshikawa,1 Kazunori Santo,2 Hiroko Hizaki,2 Masayo Hashimoto2 1Yoshikawa Eye Clinic, Machida, Tokyo, Japan; 2Japan Medical Affairs, Santen Pharmaceutical Co., Ltd, Osaka, Japan Purpose: To quantitatively evaluate the association of intraocular pressure (IOP) reduction with visual field defect (VFD) progression in normal tension glaucoma (NTG) under medical therapy. Patients and methods: Clinical data for 622 eyes of 311 primary open-angle glaucoma and NTG patients were collected from April 2006 to March 2016. Of these patients, those with normal IOP, glaucomatous VFD by Anderson’s criteria, corrected visual acuity ≥0.7, >5 years of medical therapy, ≥5 visual field tests at least five times at 12-month intervals, visual field testing reliability coefficients of ≤33%, and mean deviation (MD) exceeding below -20 dB in the initial visual field test were included in this retrospective data analysis. MD and IOP data were collected at baseline and after 5 years. Following MD categorization into stages I to IV, stage transition matrices were generated using a Markov model to evaluate VFD changes. Eyes were divided based on IOP reduction (0%, 10%, 15%, 20%, 25%, 30%) from baseline. VFD aggravations were compared using the Markov model and MD slopes with IOP reduction rates as cutoff values. Results: Overall, 132 eyes of 132 NTG patients fulfilled the eligibility criteria. MD decreased significantly (P<0.0001) at 5 years vs baseline. During follow-up, visual field stage using the Markov model was constant in ~60%, with transitions in ~40%. IOP decreased significantly (P<0.001) at 5 years vs baseline. Though MD slopes did not differ significantly between each of the groups that achieved the various IOP reduction cut-off values and the corresponding group that did not achieve the cut-off values, a significant difference (P=0.0432) in VFD was found between the group that achieved the 25% cut-off value and the group that did not when evaluated using the Markov model. Conclusion: In NTG patients, VFD aggravation was significantly suppressed in groups with IOP reductions of ≥25% from baseline. Keywords: normal tension glaucoma, visual field defect (VFD) progression, long-term follow-up, intraocular pressure reduction, Markov model
format	article
author	Yoshikawa K Santo K Hizaki H Hashimoto M
author_facet	Yoshikawa K Santo K Hizaki H Hashimoto M
author_sort	Yoshikawa K
title	Effect of quantitative intraocular pressure reduction on visual field defect progression in normal tension glaucoma under medical therapy applying Markov model
title_short	Effect of quantitative intraocular pressure reduction on visual field defect progression in normal tension glaucoma under medical therapy applying Markov model
title_full	Effect of quantitative intraocular pressure reduction on visual field defect progression in normal tension glaucoma under medical therapy applying Markov model
title_fullStr	Effect of quantitative intraocular pressure reduction on visual field defect progression in normal tension glaucoma under medical therapy applying Markov model
title_full_unstemmed	Effect of quantitative intraocular pressure reduction on visual field defect progression in normal tension glaucoma under medical therapy applying Markov model
title_sort	effect of quantitative intraocular pressure reduction on visual field defect progression in normal tension glaucoma under medical therapy applying markov model
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/90a5d9cfbb92455e96a3d43cb4484c49
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Effect of quantitative intraocular pressure reduction on visual field defect progression in normal tension glaucoma under medical therapy applying Markov model

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