Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression

• Published in: Clinical ophthalmology (Auckland, N.Z.) N.Z.), 2019-01, Vol.13, p.9-16
• Main Authors: Matlach, Juliane, Bender, Sandra, König, Jochem, Binder, Harald, Pfeiffer, Norbert, Hoffmann, Esther M
• Format: Article
• Language: English
• Subjects: Defects; Development and progression; Glaucoma; glaucoma imaging; Glaucoma progression; Health aspects; Hypertension; long-term IOP fluctuation; Ophthalmology; Original Research; Patients; Risk factors; Short term; short-term IOP fluctuation; Studies; visual field; Women
• ISSN: 1177-5467; 1177-5483; 1177-5483
• DOI: 10.2147/OPTH.S186526

Since the role of short- and long-term intraocular pressure (IOP) fluctuation as a predictor of glaucoma progression is still controversial, the purpose of this study was to investigate the role of IOP fluctuation in a non-selected patient cohort. Two-hundred and forty eyes of 120 glaucoma patients (51% female) with a mean age of 64.5 years were included. Inclusion criteria were at least a visual field (VF) and a 48-hour diurnal phasing of IOP including nocturnal measurement. Glaucoma progression was defined as - if available - confirmed progression of reproducible VF defects in at least three VF examinations or increase of cup area on optic nerve imaging (Heidelberg Retina Tomograph [HRT]) with at least two images after baseline. If results were stable or less than previously mentioned VF or HRT examinations were available, it was classified as "no progression". Glaucoma progression was seen in seven of 240 eyes in the VF analysis and ten of 240 eyes on HRT. Of all 240 eyes, 92 and 41 eyes fulfilled the criteria to be included for progression evaluation on VF and HRT analysis, respectively. Mean time to progression ± standard error was 3.6±0.2 years on VF and 4.5±0.3 years on HRT. Univariate and multivariate Cox regression analyses revealed short-term IOP fluctuation (