Comparison of the Progression of High- and Low-tension Glaucoma as Determined by Two Different Criteria.
Comparison of the Progression of High- and Low-tension Glaucoma as Determined by Two Different Criteria.
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DOI：
10.3341/kjo.2016.30.1.40
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发表时间：
2016-02
影响因子：
--
通讯作者：
Lee JY
中科院分区：
文献类型：
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作者：
Lee JY;Sung KR;Lee JY
目的观察和比较经药物治疗的原发性开角型青光眼的基本眼压（IOP）变化。本研究共纳入345例患者的345只眼（平均随访时间为4.5年）。根据眼压的常规临界值将眼分为常规正压性青光眼（cNTG,≤21 mmHg）和常规高压性青光眼（cHTG, bb0 ~ 21 mmHg）两组。此外，使用中位眼压（15mmhg）创建另外两个组（中位NTG [mNTG]≤15mmhg和中位HTG [mHTG] > 15mmhg）。根据这些值，306只、39只、153只和192只眼睛分别被分配到cNTG、cHTG、mNTG和mHTG组。青光眼的进展通过视盘/视网膜神经纤维层照片或连续视野数据确定。cNTG组药物治疗后IOP和角膜中央厚度的平均降低较低，而椎间盘出血的患病率和基线视野平均偏差在cNTG组和cHTG组之间没有差异。药物治疗后IOP平均降低，mNTG组角膜中央厚度降低；mtg组椎间盘出血发生率高于mHTG组。在345只被分析的眼睛中，100只（29%）在随访期间出现进展。在cHTG组中，较高的基线IOP（风险比，1.147;p = 0.024）与青光眼进展相关。椎间盘出血（风险比，15.533;p < 0.001）也与mNTG组的进展密切相关。基线IOP是cHTG患者（占总参与者的10%）青光眼进展的重要危险因素，而椎间盘出血与mNTG组进展的相关性最强，这表明在所有NTG患者中占主导地位的人群中，需要一个临界值来定义真正的低张力青光眼，而不是传统的21 mmHg。
To investigate and compare the progression of medically treated primary open angle glaucoma according to the baseline intraocular pressure (IOP). This study included a total of 345 eyes from 345 patients (mean follow-up period, 4.5 years). Eyes were classified into either conventional normal tension glaucoma (cNTG, ≤21 mmHg) or conventional high-tension glaucoma (cHTG, >21 mmHg) groups according to the conventional cut-off value of the IOP. Additionally, the median IOP (15 mmHg) was used to create two other groups (median NTG [mNTG] ≤15 mmHg and median HTG [mHTG] >15 mmHg). Using these values, 306, 39, 153, and 192 eyes were assigned to the cNTG, cHTG, mNTG, and mHTG groups, respectively. Glaucoma progression was determined either by optic disc/retinal nerve fiber layer photographs or serial visual field data. Mean reduction of IOP after medical treatment and of central corneal thickness was lower in the cNTG group, while the prevalence of disc hemorrhage and baseline visual field mean deviation did not differ between the cNTG and cHTG groups. A mean reduction in the IOP was observed after medical treatment, and central corneal thickness was lower in the mNTG group; disc hemorrhage was more frequent in the mNTG than in the mHTG group. Among the 345 analyzed eyes, 100 (29%) showed progression during the follow-up period. In the cHTG group, a higher baseline IOP (hazard ratio, 1.147; p = 0.024) was associated with glaucoma progression. Disc hemorrhage (hazard ratio, 15.533; p < 0.001) was also strongly associated with progression in the mNTG group. Baseline IOP was a significant risk factor for glaucoma progression in cHTG patients (10% of our total participants), while disc hemorrhage showed the strongest association with progression in the mNTG group, indicating that a cut-off value other than the conventional 21 mmHg is required to define true low-tension glaucoma in populations where NTG predominates among all glaucoma patients.