Konstas Anastasios G P, Hollo Gabor, Astakhov Yuri S, Teus Miguel A, Akopov Evgeny L, Jenkins Jessica N, Stewart William C
University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece.
Arch Ophthalmol. 2004 Jan;122(1):29-33. doi: 10.1001/archopht.122.1.29.
To evaluate the effect of intraocular pressure (IOP) reduction on long-term progression or stability in patients with exfoliation glaucoma.
Multicenter (Greece, Spain, Russia, and Hungary), retrospective analysis.
Medical record analysis of 167 patients with at least 5 years of follow-up, who were stable (n = 85) or whose condition had progressed (n = 82) after the beginning of the follow-up period.
The mean +/- SD IOP was 18.1 +/- 2.6 mm Hg in the stable group and 20.1 +/- 4.3 mm Hg in the progressed group (P<.001). The mean +/- SD follow-up time was 6.1 +/- 2.3 years for the stable group and 3.4 +/- 1.7 years for the progressed group. The mean SD for each patient's average IOP was 2.9 mm Hg for the stable group and 4.6 mm Hg for the progressed group (P<.001). Twenty-eight percent of patients who had a mean IOP of 17 mm Hg or lower, 43% of those with an IOP of 18 to 19 mm Hg, and 70% of those with an IOP of 20 mm Hg or higher progressed. Progressed patients had statistically greater optic disc damage at baseline and more medication changes and trabeculectomies during follow-up than stable patients (P<.05).
This study suggests that IOP reduction helps to prevent glaucoma progression in patients with exfoliation glaucoma, although it does not guarantee the prevention or worsening of the disease.
评估降低眼压对剥脱性青光眼患者长期病情进展或稳定性的影响。
多中心（希腊、西班牙、俄罗斯和匈牙利）回顾性分析。
对167例至少随访5年的患者进行病历分析，这些患者在随访期开始后病情稳定（n = 85）或病情进展（n = 82）。
稳定组的平均眼压±标准差为18.1±2.6 mmHg，进展组为20.1±4.3 mmHg（P<0.001）。稳定组的平均随访时间±标准差为6.1±2.3年，进展组为3.4±1.7年。稳定组每位患者平均眼压的标准差为2.9 mmHg，进展组为4.6 mmHg（P<0.001）。平均眼压为17 mmHg或更低的患者中，28%病情进展；眼压为18至19 mmHg的患者中，43%病情进展；眼压为20 mmHg或更高的患者中，70%病情进展。与稳定患者相比，进展患者在基线时视神经盘损伤在统计学上更严重，随访期间用药变化和小梁切除术更多（P<0.05）。
本研究表明，降低眼压有助于预防剥脱性青光眼患者的病情进展，尽管不能保证预防病情或防止病情恶化。
