Impact of intraocular pressure reduction on visual field progression in normal-tension glaucoma followed up over 15 years
Impact of intraocular pressure reduction on visual field progression in normal-tension glaucoma followed up over 15 years
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DOI：
10.1007/s10384-017-0519-8
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发表时间：
2017-07-01
影响因子：
2.4
通讯作者：
Yamamoto, Tetsuya
中科院分区：
文献类型：
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作者：
Oie, Shinya;Ishida, Kyoko;Yamamoto, Tetsuya
为探讨手术或药物降眼压对进行性正常眼压性青光眼的影响，对60例60眼进行了15年以上的随访。（小梁切除术，n = 17）;组2（前列腺素类似物的IOP降低率ae15%，n = 24）;和组3（前列腺素类似物的IOP降低率< 15%，n = 19）。比较干预前后平均偏差（MD）斜率和IOP。通过多元回归分析确定了与视野进展率相关的因素，平均随访时间为19.8年。在第1组中，干预前和干预后IOP分别为14.7 +/- 1.3和9.1 +/- 2.0 mmHg（P <0.001，降低38%）。小梁切除术后MD斜率显著降低（-0.86 +/- 0.51对-0.19 +/- 0.20 dB/y; P <0.001）。在第2组中，干预前和干预后IOP分别为14.7 +/- 1.5和11.7 +/- 1.2 mmHg（P < 0.001，降低20%），MD斜率存在显著差异（-0.52 +/- 0.37 vs-0.31 +/- 0.30 dB/y; P = 0.019）。在第3组中，干预前和干预后IOP分别为14.4 +/- 1.8和13.2 +/- 1.6 mmHg（P < 0.001，降低8%），MD斜率无差异（-0.40 +/- 0.27 vs-0.50 +/- 0.65 dB/y; P > 0.05）。多元回归分析显示，平均眼压、眼压下降率和干预前MD斜率与干预后MD斜率下降的程度相关。干预前后MD斜率的差异与IOP降低率显著相关（r = 0.559，P <0.001）。在进行性正常眼压性青光眼中证实了视野的压力依赖性维持效应。
To investigate the impact of surgical or medical reduction of intraocular pressure (IOP) on progressive normal-tension glaucoma followed up over 15 years.Sixty eyes of 60 patients were divided into 3 intervention groups: group 1 (trabeculectomy, n = 17); group 2 (IOP reduction rate ae15% with prostaglandin analogs, n = 24); and group 3 (IOP reduction rate < 15% with prostaglandin analogs, n = 19). The preintervention and postintervention mean deviation (MD) slopes and IOP were compared. Factors associated with the rate of visual field progression were identified by multiple regression analysis.The mean follow-up was 19.8 years. In group 1, the preintervention and postintervention IOPs were 14.7 +/- 1.3 and 9.1 +/- 2.0 mmHg, respectively (P < .001, 38% reduction). The MD slope decreased significantly after trabeculectomy (-0.86 +/- 0.51 versus -0.19 +/- 0.20 dB/y; P < .001). In group 2, the preintervention and postintervention IOPs were 14.7 +/- 1.5 and 11.7 +/- 1.2 mmHg, respectively (P < 0.001, 20% reduction), with significant differences in the MD slope (-0.52 +/- 0.37 versus -0.31 +/- 0.30 dB/y; P = .019). In group 3, the preintervention and postintervention IOPs were 14.4 +/- 1.8 and 13.2 +/- 1.6 mmHg, respectively (P < 0.001, 8% reduction), with no differences in the MD slope (-0.40 +/- 0.27 versus -0.50 +/- 0.65 dB/y; P > .05). Multiple regression analysis showed that the average IOP, IOP reduction rate, and preintervention MD slope were related to the extent of the postintervention reduction in the MD slope. The difference in the preintervention and postintervention MD slopes significantly correlated with the rate of IOP reduction (r = 0.559, P < .001).A pressure-dependent maintenance effect of the visual field was confirmed in progressive normal-tension glaucoma.