Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression

Juliane Matlach,1 Sandra Bender,2 Jochem König,2 Harald Binder,2,3 Norbert Pfeiffer,1 Esther M Hoffmann1 1Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany; 2Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz,...

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Autores principales:	Matlach J, Bender S, König J, Binder H, Pfeiffer N, Hoffmann EM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Glaucoma progression short-term IOP fluctuation long-term IOP fluctuation glaucoma imaging visual field Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/f4dbf1e577344958afdf304b91013e8c
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spelling	oai:doaj.org-article:f4dbf1e577344958afdf304b91013e8c2021-12-02T01:27:54ZInvestigation of intraocular pressure fluctuation as a risk factor of glaucoma progression1177-5483https://doaj.org/article/f4dbf1e577344958afdf304b91013e8c2018-12-01T00:00:00Zhttps://www.dovepress.com/investigation-of-intraocular-pressure-fluctuation-as-a-risk-factor-of--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Juliane Matlach,1 Sandra Bender,2 Jochem König,2 Harald Binder,2,3 Norbert Pfeiffer,1 Esther M Hoffmann1 1Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany; 2Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany; 3Institute of Medical Biometry and Statistics, Medical Center – University of Freiburg, Freiburg, Germany Purpose: Since the role of short- and long-term intraocular pressure (IOP) fluctuation as a predictor of glaucoma progression is still controversial, the purpose of this study was to investigate the role of IOP fluctuation in a non-selected patient cohort. Materials and methods: Two-hundred and forty eyes of 120 glaucoma patients (51% female) with a mean age of 64.5 years were included. Inclusion criteria were at least a visual field (VF) and a 48-hour diurnal phasing of IOP including nocturnal measurement. Glaucoma progression was defined as – if available – confirmed progression of reproducible VF defects in at least three VF examinations or increase of cup area on optic nerve imaging (Heidelberg Retina Tomograph [HRT]) with at least two images after baseline. If results were stable or less than previously mentioned VF or HRT examinations were available, it was classified as “no progression”. Results: Glaucoma progression was seen in seven of 240 eyes in the VF analysis and ten of 240 eyes on HRT. Of all 240 eyes, 92 and 41 eyes fulfilled the criteria to be included for progression evaluation on VF and HRT analysis, respectively. Mean time to progression ± standard error was 3.6±0.2 years on VF and 4.5±0.3 years on HRT. Univariate and multivariate Cox regression analyses revealed short-term IOP fluctuation (P<0.0001) and maximum IOP (P<0.001) as risk factors for glaucoma progression on VF. There was no significant influence of demographic characteristics, ocular or general health on glaucoma progression. Conclusion: Short-term IOP fluctuation was associated with the progression of glaucoma in this non-selected cohort of glaucoma patients receiving phasing of IOP. Keywords: glaucoma progression, short-term IOP fluctuation, long-term IOP fluctuation, glaucoma imaging, visual fieldMatlach JBender SKönig JBinder HPfeiffer NHoffmann EMDove Medical PressarticleGlaucoma progressionshort-term IOP fluctuationlong-term IOP fluctuationglaucoma imagingvisual fieldOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 9-16 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Glaucoma progression short-term IOP fluctuation long-term IOP fluctuation glaucoma imaging visual field Ophthalmology RE1-994
spellingShingle	Glaucoma progression short-term IOP fluctuation long-term IOP fluctuation glaucoma imaging visual field Ophthalmology RE1-994 Matlach J Bender S König J Binder H Pfeiffer N Hoffmann EM Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression
description	Juliane Matlach,1 Sandra Bender,2 Jochem König,2 Harald Binder,2,3 Norbert Pfeiffer,1 Esther M Hoffmann1 1Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany; 2Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany; 3Institute of Medical Biometry and Statistics, Medical Center – University of Freiburg, Freiburg, Germany Purpose: Since the role of short- and long-term intraocular pressure (IOP) fluctuation as a predictor of glaucoma progression is still controversial, the purpose of this study was to investigate the role of IOP fluctuation in a non-selected patient cohort. Materials and methods: Two-hundred and forty eyes of 120 glaucoma patients (51% female) with a mean age of 64.5 years were included. Inclusion criteria were at least a visual field (VF) and a 48-hour diurnal phasing of IOP including nocturnal measurement. Glaucoma progression was defined as – if available – confirmed progression of reproducible VF defects in at least three VF examinations or increase of cup area on optic nerve imaging (Heidelberg Retina Tomograph [HRT]) with at least two images after baseline. If results were stable or less than previously mentioned VF or HRT examinations were available, it was classified as “no progression”. Results: Glaucoma progression was seen in seven of 240 eyes in the VF analysis and ten of 240 eyes on HRT. Of all 240 eyes, 92 and 41 eyes fulfilled the criteria to be included for progression evaluation on VF and HRT analysis, respectively. Mean time to progression ± standard error was 3.6±0.2 years on VF and 4.5±0.3 years on HRT. Univariate and multivariate Cox regression analyses revealed short-term IOP fluctuation (P<0.0001) and maximum IOP (P<0.001) as risk factors for glaucoma progression on VF. There was no significant influence of demographic characteristics, ocular or general health on glaucoma progression. Conclusion: Short-term IOP fluctuation was associated with the progression of glaucoma in this non-selected cohort of glaucoma patients receiving phasing of IOP. Keywords: glaucoma progression, short-term IOP fluctuation, long-term IOP fluctuation, glaucoma imaging, visual field
format	article
author	Matlach J Bender S König J Binder H Pfeiffer N Hoffmann EM
author_facet	Matlach J Bender S König J Binder H Pfeiffer N Hoffmann EM
author_sort	Matlach J
title	Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression
title_short	Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression
title_full	Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression
title_fullStr	Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression
title_full_unstemmed	Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression
title_sort	investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/f4dbf1e577344958afdf304b91013e8c
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Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression

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