Original articleLong-term Intraocular Pressure Fluctuations and Risk of Conversion from Ocular Hypertension to Glaucoma
Section snippets
Participants
This observational cohort study included 252 eyes of 126 ocular hypertensive patients who were observed without receiving ocular hypotensive treatment during follow-up. All patients were observed at the Hamilton Glaucoma Center, University of California San Diego as part of an ongoing prospective longitudinal study (Diagnostic Innovations in Glaucoma Study) designed to evaluate optic nerve structure, visual function, and risk factors in glaucoma. Patients in the Diagnostic Innovations in
Results
Demographic and clinical characteristics of the 252 eyes of 126 ocular hypertensive patients included in the study are shown in Table 1. Forty eyes of 31 subjects developed POAG during follow-up. Figure 1 shows the cumulative probability of developing glaucoma in at least one eye during the study. Mean follow-up time until conversion to glaucoma was 82.8 months (median, 70.4; first quartile, 56.9; third quartile, 106.7). Mean follow-up time for nonconverters was 86.3 months (median, 78.9; first
Discussion
In the current study, we investigated the association between long-term IOP fluctuation and mean IOP with risk of developing glaucoma among ocular hypertensive eyes. Although higher mean IOP levels were consistently associated with increased likelihood of developing glaucoma, IOP fluctuation was not associated with the study end points, in both univariable and multivariable models that adjusted for other clinically important variables.
The results of our study agree with those reported with the
References (22)
- et al.
Interim clinical outcomes in the Collaborative Initial Glaucoma Treatment Study comparing initial treatment randomized to medications or surgery
Ophthalmology
(2001) - et al.
Predictive factors for glaucomatous visual field progression in the Advanced Glaucoma Intervention Study
Ophthalmology
(2004) - et al.
Impact of intraocular pressure regulation on visual fields in open-angle glaucoma
Ophthalmology
(1999) - et al.
Fluctuation of intraocular pressure and glaucoma progression in the Early Manifest Glaucoma Trial
Ophthalmology
(2007) - et al.
Corneal thickness as a risk factor for visual field loss in patients with preperimetric glaucomatous optic neuropathy
Am J Ophthalmol
(2003) - et al.
Primary and subsequent coronary risk appraisal: new results from the Framingham study
Am Heart J
(2000) - et al.
Factors for glaucoma progression and the effect of treatment: the Early Manifest Glaucoma Trial
Arch Ophthalmol
(2003) - et al.
The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma
Arch Ophthalmol
(2002) The Advanced Glaucoma Intervention Study (AGIS): 7The relationship between control of intraocular pressure and visual field deterioration
Am J Ophthalmol
(2000)The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma
Am J Ophthalmol
(1998)
Large diurnal fluctuations in intraocular pressure are an independent risk factor in patients with glaucoma
J Glaucoma
Cited by (143)
Predictors of Glaucomatous Progression in Individuals with Small and Large Optic Discs
2024, Ophthalmology GlaucomaRisk Calculation in the Medication Arm of the Ocular Hypertension Treatment Study
2023, Ophthalmology GlaucomaThe natural history of untreated ocular hypertension and glaucoma
2023, Survey of OphthalmologyCitation Excerpt :Table 1) Most included studies evaluated the rate of conversion to definite glaucoma; only two studies focused instead on structural changes alone.[44], [57] Fourteen studies have been conducted to investigate the conversion of untreated OHT to open-angle glaucoma (OAG), based on visual field (7 studies)[9], [20], [25], [32], [35], [37], [51] or both visual field and optic disc deterioration (7 studies)[16], [30], [33], [34], [47], [48], [56]. There were no studies that have used OCT.
Various forms of glaucoma and their treatments
2022, Handbook of Basic and Clinical Ocular Pharmacology and Therapeutics
Manuscript no. 2007-285.
Supported in part by an independent research grant from Pfizer, Inc., New York, New York (FAM), and the National Eye Institute, Bethesda, Maryland (grant nos. EY11008 [LMZ], EY08208 [PAS]).