Discoveries in Sight Laboratories, Devers Eye Institute, Legacy Research Institute, Legacy Health, Portland, Oregon 97232, USA.
Ophthalmology. 2013 Apr;120(4):724-30. doi: 10.1016/j.ophtha.2012.09.056. Epub 2013 Jan 26.
Longitudinal testing plays a key role in glaucoma management. Variability between visits hampers the ability to monitor progression. It has previously been shown that average intraocular pressure (IOP) exhibits seasonal fluctuations. This study examines whether visual field sensitivity also exhibits seasonal fluctuations and seeks to determine whether such fluctuations are correlated to seasonal IOP effects.
Comparative case series.
A total of 33 873 visits by 1636 participants enrolled in the Ocular Hypertension Treatment Study. Participants were split into 6 geographic zones according to the prevailing climate in their location.
At each visit, standard automated perimetry was conducted on each eye, and IOP was measured.
Mixed effects regression models were formed to look for sinusoidal periodic effects on the change in perimetric mean deviation since the last visit (ΔMD) and on IOP, both overall and within each zone.
When all the data were included, a significant seasonal effect on ΔMD was found with magnitude 0.06 dB, peaking in February (P < 0.001). Five of the 6 geographic zones exhibited significant seasonal effects on ΔMD, peaking between January and April, with magnitudes ranging from 0.04 dB (P = 0.049) to 0.21 dB (P < 0.001). Zones with greater climactic variation showed larger seasonal effects on ΔMD. All 6 zones exhibited a seasonal effect on IOP, peaking in January or February, with magnitudes ranging from 0.14 to 0.39 mmHg (P ≤ 0.02 in all cases). However, there was no evidence of a significant association between the magnitudes or dates of peaks of the 2 seasonal effects.
The mean deviation was significantly higher in winter than in summer. There is no evidence of an association with seasonal IOP fluctuations. The cause of the seasonal effect on visual field sensitivity is unknown. These findings may help shed light on the glaucomatous disease process and aid efforts to reduce test-retest variability.
纵向测试在青光眼管理中起着关键作用。就诊之间的可变性阻碍了进展监测的能力。先前已经表明，平均眼内压（IOP）表现出季节性波动。本研究检查视野敏感性是否也表现出季节性波动，并试图确定这种波动是否与季节性IOP 效应相关。
比较病例系列。
共有 1636 名参与者的 33873 次就诊参加了眼高压治疗研究。根据其所在位置的主要气候，将参与者分为 6 个地理区域。
每次就诊时，对每只眼睛进行标准自动视野检查，并测量 IOP。
建立混合效应回归模型，以寻找上次就诊后（ΔMD）和 IOP 总体和每个区域内的周期性正弦效应。
当包括所有数据时，发现 ΔMD 存在显著的季节性影响，幅度为 0.06dB，峰值出现在 2 月（P<0.001）。6 个地理区域中有 5 个区域的 ΔMD 出现显著的季节性影响，峰值出现在 1 月至 4 月之间，幅度从 0.04dB（P=0.049）到 0.21dB（P<0.001）不等。气候变化较大的区域显示出对 ΔMD 的季节性影响较大。6 个区域均对 IOP 产生季节性影响，峰值出现在 1 月或 2 月，幅度从 0.14 到 0.39mmHg（所有情况下 P≤0.02）。然而，没有证据表明这两种季节性效应的幅度或峰值日期之间存在显著关联。
平均偏差在冬季比夏季高。没有证据表明与季节性 IOP 波动有关。视野敏感性季节性影响的原因尚不清楚。这些发现可能有助于阐明青光眼疾病过程，并有助于减少测试-复测变异性。
