Twenty-four Hour Ocular Perfusion Pressure Fluctuation and Risk of Normal-Tension Glaucoma Progression
Twenty-four Hour Ocular Perfusion Pressure Fluctuation and Risk of Normal-Tension Glaucoma Progression
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DOI：
10.1167/iovs.09-3716
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发表时间：
2009-11-01
影响因子：
4.4
通讯作者：
Kook, Michael S.
中科院分区：
文献类型：
--
作者：
Sung, Kyung Rim;Lee, Suhwan;Kook, Michael S.
目的。目的探讨经药物治疗的正常眼压性青光眼(NTG)患者24小时平均眼血流灌注压(MOPP，2/3 x平均动脉压[MAP]-眼内压[IOP])与视野进展的关系。方法：对101例101眼经内科治疗的正常眼压性青光眼患者进行了4年以上(平均6.2年+-12.1个月)的随访。探讨了几种临床因素，包括人口统计学、全身性、眼部危险因素和24小时最大呼气量与室颤下降的关系。采用Kaplan-Meier分析比较四个VF恶化危险因素(年龄、近视、MAP升高和Mopp波动)的预后。使用COX比例风险模型获得潜在危险因素与青光眼进展相关的危险比(HR)。结果：29只眼(28.7%)检测到VF进展。进展者和非进展者在夜间MAP和MOPP波动(均为P<；0.0001)、24小时MAP和MOPP波动(均为P<；0.0001)、初始平均偏差(P=0.0034)和模式标准差(P<；0.0001)方面存在显著差异。根据Kaplan-Meier分析，24小时MAP和MOPP波动升高都与更大的室颤进展概率相关。在调查的所有危险因素中，COX比例风险模型显示室颤进展与24小时MOPP波动和初始PSD评分显著相关。结论：在我们的一系列药物治疗的NTG眼中，除眼压外的临床因素与室颤进展有关。24小时的MOPP波动是青光眼进展的最一致的预后因素。(投资眼科VS科学。2009年；50：52665274)doi：10.1167/iovs.09-3716.
PURPOSE. To investigate the relationship between clinical factors including 24-hour mean ocular perfusion pressure (MOPP, 2/3 x mean arterial pressure [MAP] - intraocular pressure [IOP]) and visual field (VF) progression in eyes with medically treated normal-tension glaucoma (NTG).METHODS. One hundred one eyes of 101 NTG patients followed up for more than 4 years (mean follow-up, 6.2 years +/- 12.1 months) were included after retrospective chart review. Several clinical factors including demographic, systemic, ocular risk factors, and 24-hour MOPP were explored for associations with decreasing VF. Kaplan-Meier analyses were performed to compare outcomes with reference to four risk factors (age, myopia, and elevated MAP and MOPP fluctuation) for VF deterioration. Hazard ratios (HRs) for the association between potential risk factors and glaucoma progression were obtained using Cox proportional hazards models.RESULTS. Overall VF progression was detected in 29 (28.7%) eyes. There were significant differences between progressors and nonprogressors in nocturnal MAP and MOPP fluctuations (both P < 0.0001), 24-hour MAP, and MOPP fluctuations (both P < 0.0001), initial mean deviation (P = 0.0034), and pattern standard deviation (PSD) score (P < 0.0001). Both elevated 24-hour MAP and MOPP fluctuations were associated with greater VF progression probabilities based on Kaplan-Meier analyses. Among all risk factors investigated, the Cox proportional hazards model indicated that VF progression was significantly associated with 24-hour MOPP fluctuation and initial PSD score.CONCLUSIONS. Clinical factors other than IOP were associated with VF progression in our series of medically treated NTG eyes. Twenty-four-hour MOPP fluctuation was the most consistent prognostic factor for glaucoma progression. (Invest Ophthalmol Vis Sci. 2009;50:5266-5274) DOI:10.1167/iovs.09-3716