Intraocular pressure reduction with topical medications and progression of normal-tension glaucoma: a 12-year mean follow-up study
Intraocular pressure reduction with topical medications and progression of normal-tension glaucoma: a 12-year mean follow-up study
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DOI：
10.1111/aos.12082
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发表时间：
2013-06-01
影响因子：
3.4
通讯作者：
Kim, Seok Hwan
中科院分区：
文献类型：
--
作者：
Kim, Martha;Kim, Dong Myung;Kim, Seok Hwan
Abstract.Purpose:为了探讨眼内压（IOP）降低与局部用药的量是否与正常眼压性青光眼（NTG）的进展，并确定NTG progression.Methods的危险因素：121例NTG患者的121眼的病历，谁与局部用药治疗超过7年，进行了审查。NTG进展定义为结构（视盘或视网膜神经纤维层）或功能（视野）恶化。根据IOP较基线降低的百分比将患者分为三分位数组，并使用Kaplan-Meier生存分析比较上三分位数组和下三分位数组之间NTG进展的累积概率。采用考克斯比例风险模型进行多因素分析，以确定NTG进展的临床因素的风险比（HR）。结果：平均随访时间为12.2年，56/121眼（46.3%）显示NTG进展。Kaplan-Meier分析显示，上三分位组（IOP降低百分比> 22.1%）显示出比下三分位组（IOP降低百分比<13.3%; p = 0.012）更大的非进展累积概率。多变量考克斯比例风险模型表明，（HR = 0.964; p = 0.007）和椎间盘出血的发生率（HR = 2.410; p = 0.008）与NTG进展显著相关。使用局部药物的IOP降低量与NTG进展相关，IOP降低百分比较低是进展的一致风险因素。
Abstract.Purpose: To investigate whether the amount of intraocular pressure (IOP) reduction with topical medications is associated with the progression of normal-tension glaucoma (NTG) and to identify risk factors for NTG progression.Methods: The medical records of 121 eyes of 121 NTG patients, who were treated with topical medications for more than 7 years, were reviewed. NTG progression was defined by either structural (optic disc or retinal nerve fibre layer) or functional (visual field) deterioration. Patients were divided into tertile groups according to the percentage IOP reduction from baseline, and the cumulative probability of NTG progression between upper and lower tertile group was compared using Kaplan-Meier survival analysis. Multivariate analysis with Cox's proportional hazard model was performed to identify the hazard ratio (HR) of clinical factors for NTG progression.Results: The average follow-up period was 12.2 years, and 56 of 121 eyes (46.3%) showed the NTG progression. Kaplan-Meier analysis revealed that upper tertile group (percentage IOP reduction >22.1%) showed a greater cumulative probability of non-progression than lower tertile group (percentage IOP reduction < 13.3%; p = 0.012). Multivariate Cox's proportional hazard model indicated that percentage reduction of IOP (HR = 0.964; p = 0.007) and the occurrence of disc haemorrhage (HR = 2.410; p = 0.008) were significantly associated with NTG progression.Conclusions: The amount of IOP reduction using topical medications was related to NTG progression, and lower percentage reduction in IOP was a consistent risk factor for progression.