Incident open-angle glaucoma and ocular perfusion pressure.
Incident open-angle glaucoma and ocular perfusion pressure.
复制标题
开角型青光眼发生率和眼灌注压。
DOI：
10.1167/iovs.11-8394
复制
发表时间：
2011
影响因子：
4.4
通讯作者：
Hennis,Anselm
中科院分区：
文献类型：
--
作者：
Leske,MCristina;Wu,Suh-Yuh;Nemesure,Barbara;Hennis,Anselm
这封信的目的是纠正鹿特丹眼科研究1最近的一篇论文，该论文评估了开角型青光眼(OAG)与眼部灌注压(OPP)之间的关系。在对眼压(IOP)进行调整后，研究人员未能发现与OPP有显著关联，结论是先前报告的积极结果可能是由于没有对IOP进行调整。支持这一前提的讨论部分指出，对眼压进行调整的研究也与平均OPP没有显著关联，包括巴巴多斯眼科研究和早期显性青光眼试验。关于巴巴多斯数据的这一说法是不正确的，因为它是基于没有根据眼压调整的分析，也没有评估平均OPP；这些分析基于OAG患病率，得出了与舒张期OPP显著相关的结论。2巴巴多斯随后的报告，其中的数据根据眼压进行了调整，并以4年和9年的发病率为基础，3、4似乎与鹿特丹的发病率结果最相关，但没有提及。这些关于巴巴多斯发病率数据的报告记录了眼压调整前后与收缩压、舒张压和平均OPP、3、4之间的强烈关联。作为进一步的澄清，来自早期显性青光眼试验的眼压调整分析显示，OAG进展和收缩期OPP之间存在显著关系。5因此，这些纵向研究的结果与鹿特丹报告不一致。除了人群和研究设计不同外，研究之间OPP结果的差异可能是由于许多原因(例如，鹿特丹OAG标准仅基于视野缺陷，而巴巴多斯标准要求视野缺陷和视盘损伤)。此外，我们对OAG中的血管因素以及如何最好地评估OPP的作用还有不完全的了解。6鹿特丹研究所进行的调查是彻底的。然而，鉴于注意到的疏忽和OPP评估的复杂性-
The purpose of this letter is to provide corrections to a recent paper from the Rotterdam Eye Study, 1 which evaluated the relationship between incident open-angle glaucoma (OAG) and ocular perfusion pressure (OPP). After adjustment for intraocular pressure (IOP), the researchers failed to find significant associations with OPP, concluding that the positive results of previous reports may be due to nonadjustment for IOP. Supporting this premise, the Discussion section noted that studies with adjustment for IOP also had nonsignificant associations with mean OPP, including the Barbados Eye Study and the Early Manifest Glaucoma Trial. This statement on the Barbados data is incorrect, as it is based on analyses that were not adjusted for IOP and did not evaluate mean OPP; those analyses, based on OAG prevalence, yielded significant associations with diastolic OPP. 2 Subsequent Barbados reports, in which data were adjusted for IOP and were based on 4-and 9-year incidences, 3, 4 seem most relevant to the Rotterdam incidence results, but were not mentioned. These reports on the Barbados incidence data documented strong associations with systolic, diastolic, and mean OPP, 3, 4 both before and after IOP adjustment. As an additional clarification, the IOP-adjusted analyses from the Early Manifest Glaucoma Trial revealed significant relationships between OAG progression and systolic OPP. 5 The results of those longitudinal studies, therefore, are not consistent with the Rotterdam report.In addition to their diverse populations and research designs, differences in OPP results among studies could be due to many reasons (eg, the Rotterdam OAG criteria were based only on visual field defects, while the Barbados criteria required both field defects and disc damage). Furthermore, we have an incomplete understanding of vascular factors in OAG and how to best evaluate the role of OPP. 6 The investigations conducted by the Rotterdam Study were thorough. However, given the oversights noted and the complexity of OPP assess-