Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures

Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma... PURPOSE: To determine if intraocular pressure plays a part in the pathogenic process of normal-tension glaucoma. METHODS: One eye of each eligible subject was randomized either to be untreated as a control or to have intraocular pressure lowered by 30% from baseline. Eyes were randomized if they met criteria for diagnosis of normal-tension glaucoma and showed documented progression or high-risk field defects that threatened fixation or the appearance of a new disk hemorrhage. The clinical course (visual field and optic disk) of the group with lowered intraocular pressure was compared with the clinical course when intraocular pressure remained at its spontaneous untreated level. RESULTS: One hundred-forty eyes of 140 patients were used in this study. Sixty-one were in the treatment group, and 79 were untreated controls. Twenty-eight (35%) of the control eyes and 7 (12%) of the treated eyes reached end points (specifically defined criteria of glaucomatous optic disk progression or visual field loss). An overall survival analysis showed a statistically significant difference between the two groups ( P < .0001). The mean survival time ±SD of the treated group was 2,688 ± 123 days and for the control group, 1,695 ± 143 days. Of 34 cataracts developed during the study, 11 (14%) occurred in the control group and 23 (38%) in the treated group ( P = .0075), with the highest incidence in those whose treatment included filtration surgery. CONCLUSIONS: Intraocular pressure is part of the pathogenic process in normal-tension glaucoma. Therapy that is effective in lowering intraocular pressure and free of adverse effects would be expected to be beneficial in patients who are at risk of disease progression. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Ophthalmology Elsevier

Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures

American Journal of Ophthalmology, Volume 126 (4) – Oct 1, 1998

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Publisher
Elsevier
Copyright
Copyright © 1998 Elsevier Science Inc.
ISSN
0002-9394
D.O.I.
10.1016/S0002-9394(98)00223-2
Publisher site
See Article on Publisher Site

Abstract

PURPOSE: To determine if intraocular pressure plays a part in the pathogenic process of normal-tension glaucoma. METHODS: One eye of each eligible subject was randomized either to be untreated as a control or to have intraocular pressure lowered by 30% from baseline. Eyes were randomized if they met criteria for diagnosis of normal-tension glaucoma and showed documented progression or high-risk field defects that threatened fixation or the appearance of a new disk hemorrhage. The clinical course (visual field and optic disk) of the group with lowered intraocular pressure was compared with the clinical course when intraocular pressure remained at its spontaneous untreated level. RESULTS: One hundred-forty eyes of 140 patients were used in this study. Sixty-one were in the treatment group, and 79 were untreated controls. Twenty-eight (35%) of the control eyes and 7 (12%) of the treated eyes reached end points (specifically defined criteria of glaucomatous optic disk progression or visual field loss). An overall survival analysis showed a statistically significant difference between the two groups ( P < .0001). The mean survival time ±SD of the treated group was 2,688 ± 123 days and for the control group, 1,695 ± 143 days. Of 34 cataracts developed during the study, 11 (14%) occurred in the control group and 23 (38%) in the treated group ( P = .0075), with the highest incidence in those whose treatment included filtration surgery. CONCLUSIONS: Intraocular pressure is part of the pathogenic process in normal-tension glaucoma. Therapy that is effective in lowering intraocular pressure and free of adverse effects would be expected to be beneficial in patients who are at risk of disease progression.

Journal

American Journal of OphthalmologyElsevier

Published: Oct 1, 1998

References

  • Pressure-dependent neuroretinal rim loss in normal-pressure glaucoma
    Jonas, J.B.; Gründler, A.E.; Gonzales-cortés, J.
  • Systemic hypotension
    Kaiser, H.J.; Flammer, J.
  • Association of endothelin-1 with normal-tension glaucoma
    Sugiyama, T.; Moriya, S.; Oku, H.; Azuma, I.
  • Anti-Ro/SS-A positivity and heat shock protein antibodies in patients with normal-pressure glaucoma
    Wax, M.B.; Tezel, G.; Saito, I.
  • Manifest glaucoma in the aged. II. Cases detected by ophthalmoscopy
    Bengtsson, B.
  • Automatic perimetry in a population survey
    Bengtsson, B.; Krakau, C.E.T.
  • Intraocular pressure reduction in normal tension glaucoma patients

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