The relationship between the mean deviation slope and follow-up intraocular pressure in open-angle glaucoma patients

• Published in: Journal of glaucoma Vol. 22; no. 9; p. 689
• Main Authors: Fukuchi, Takeo, Yoshino, Takaiko, Sawada, Hideko, Seki, Masaaki, Togano, Tetsuya, Tanaka, Takayuki, Ueda, Jun, Abe, Haruki
• Format: Journal Article
• Language: English
• Published: United States 01.12.2013
• Subjects: Adult; Aged; Disease Progression; Female; Follow-Up Studies; Glaucoma, Open-Angle - diagnosis; Glaucoma, Open-Angle - physiopathology; Gonioscopy; Humans; Intraocular Pressure - physiology; Low Tension Glaucoma - diagnosis; Low Tension Glaucoma - physiopathology; Male; Middle Aged; Retrospective Studies; Tonometry, Ocular; Vision Disorders - diagnosis; Vision Disorders - physiopathology; Visual Field Tests; Visual Fields - physiology
• ISSN: 1536-481X
• DOI: 10.1097/ijg.0b013e318264b779

The purpose of this study was to analyze the relationship between the mean deviation (MD) slope as the progressive rate of visual field defects and the follow-up intraocular pressure (IOP) in open-angle glaucoma (OAG) patients. This study was a retrospective, nonrandomized comparative study. A total of 287 eyes from 287 Japanese OAG patients were examined. The MD slope of the Humphrey Field Analyzer was calculated and compared with the follow-up IOP. OAG was classified into the high-tension group (>21 mm Hg) and the normal-tension group (≤ 21 mm Hg) on the basis of the highest recorded IOP without treatment, and then the 2 groups were compared. After setting a threshold for the progression rate at -0.3 dB/y, related factors were compared between the fast-progression and slow-progression eyes in each group. The correlation line between the follow-up IOP and the MD slope was statistically significant in the high-tension group but not in the normal-tension group. Compared with eyes with slow progression, eyes with fast progression in the high-tension group were older and had a higher mean IOP, greater highest and lowest IOPs, and a smaller mean IOP reduction ratio, whereas eyes with fast progression in the normal-tension group had a greater SD of the mean IOP, a larger IOP range, and a greater highest IOP. Eyes with a faster visual field progression tended to have a higher follow-up IOP in the high-tension group and larger IOP fluctuations in the normal-tension group of OAG patients. We should monitor both the follow-up IOP and fluctuations in IOP to provide a safer and more reliable visual field prognosis for OAG.