Long-Term (>8 Years) Evaluation of Progression in Patients with Low-Pressure Glaucoma
Long-Term (>8 Years) Evaluation of Progression in Patients with Low-Pressure Glaucoma
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DOI：
10.5301/ejo.5000624
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发表时间：
2015-05
影响因子：
1.7
通讯作者：
E. Erdem;A. Williams;Sarah Kuchar;M. Waisbourd;G. Spaeth
中科院分区：
文献类型：
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作者：
E. Erdem;A. Williams;Sarah Kuchar;M. Waisbourd;G. Spaeth
目的 描述低压青光眼（LPG）患者的长期临床病程并评估疾病进展的危险因素。方法 Wills Eye 青光眼研究中心回顾性回顾了 2000 年至 2013 年间随访超过 8 年的 LPG 患者的病历。对病历进行了全身性疾病、青光眼家族史、最佳矫正视力、屈光不正、治疗、中央角膜厚度 (CCT)、眼压 (IOP)、散瞳后 IOP 变化、视盘评估、视野 (VF) 平均偏差 (MD)、VF 的评估。评分和进展时间。当椎间盘和室颤似乎都恶化时，确定病情进展。结果 我们的分析包括 2000 年至 2013 年间归类为 LPG 的 850 张图表，其中包括 49 名患者的 49 只眼睛。平均 (± SD) 随访时间为 9.3 (± 1.9) 年。随访期间，25 只眼青光眼进展，24 只眼保持稳定。进展的眼睛具有更高的峰值 IOP (p = 0.043)。 CCT 较薄（p = 0.085）和椎间盘出血（p = 0.098）的患者有进展趋势。进展组中MD的估计年变化为-0.57 dB，稳定组中为-0.10 dB（第8年）。高峰值眼压是进展的重要危险因素。识别处于危险中的患者可能需要更密切的随访和更积极的治疗，以保留LPG患者的视功能。
Purpose To describe the long-term clinical course of patients with low-pressure glaucoma (LPG) and to assess the risk factors for disease progression. Methods The Wills Eye Glaucoma Research Center retrospectively reviewed the charts of LPG patients with documented follow-up of >8 years between 2000 and 2013. Medical records were evaluated for systemic diseases, family history of glaucoma, best-corrected visual acuity, refractive error, treatments, central corneal thickness (CCT), intraocular pressure (IOP), IOP change after pupil dilation, optic disc evaluation, visual field (VF) mean deviation (MD), VF grading, and time to progression. Progression was determined when both disc and VF appeared to have worsened. Results From 850 charts classified as LPG between 2000 and 2013, 49 eyes of 49 patients were included in our analysis. The mean (± SD) follow-up time was 9.3 (± 1.9) years. Glaucoma progressed in 25 eyes and remained stable in 24 eyes over the follow-up period. Eyes with progression had higher peak IOP (p = 0.043). There was a trend towards progression in patients with thinner CCT (p = 0.085) and disc hemorrhage (p = 0.098). Estimated annual change in MD was −0.57 dB in the progressing group and −0.10 dB in the stable group (p8 years. High peak IOP was a significant risk factor for progression. Identifying patients at risk may warrant closer follow-up and more aggressive treatment in order to preserve visual function in patients with LPG.