Scoralick Ana Luiza B, Gracitelli Carolina Pb, Dias Diego T, Almeida Izabela, Ushida Michele, Dorairaj Syril, Kanadani Fábio N, Paranhos Augusto, Prata Tiago S
Glaucoma Service, Department of Ophthalmology and Visual Science, Federal University of São Paulo, São Paulo, Brazil; Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, Brazil; Department of Ophthalmology, Instituto de Olhos Ciências Médicas, Belo Horizonte, Brazil.
Glaucoma Service, Department of Ophthalmology and Visual Science, Federal University of São Paulo, São Paulo, Brazil.
J Curr Glaucoma Pract. 2019 Jan-Apr;13(1):28-31. doi: 10.5005/jp-journals-10078-1240.
To perform a correlation analysis between long-term intraocular pressure (IOP) variation parameters (mean, peak, and fluctuation) in patients with stable open-angle glaucoma (OAG).
A cross-sectional observational study was carried out, in which patients with stable OAG were consecutively enrolled. All patients had to have glaucomatous optic neuropathy and characteristic visual field (VF) defects. Key inclusion criteria were ≥5 VF tests, ≥3 disc photographs, and ≥3 years of follow-up without any changes in current medical regimen. Stable OAG was defined as nonprogressive VF results and absence of anatomical changes for at least 3 years. Long-term IOP variation parameters were obtained from isolated IOP measurements from each visit (minimum of five IOP measurements). The main outcome measure was the correlation between these IOP variation parameters.
Of the 63 patients studied, 37 (59%) were women, and the mean age was 61 ± 12 years. Among all the analyses, IOP mean and peak had the strongest correlation ( = 0.94; 95% CI = 0.92-0.97; < 0.001). There were also significant correlations between IOP peak and IOP fluctuation ( = 0.84; 95% CI = 0.75-0.90; < 0.001), and mean IOP and IOP fluctuation ( = 0.62; 95% CI = 0.43-0.75; < 0.001).
Most long-term IOP variation parameters evaluated seem to be highly correlated. Notably, the correlation between mean IOP and IOP peak was the strongest one. We believe this fact should be taken into consideration as their inclusion as individual variables in a multiple regression model could lead to misinterpretation of the data.
Different well-designed studies are conflicting regarding which long-term IOP variation parameter is more clinically relevant. Our findings suggest that collinearity issues could explain in part the discrepant results among these studies evaluating the relationship between long-term IOP variation parameters and glaucoma prognosis.
Scoralick ALB, Gracitelli CPB, Peak, Fluctuation, or Mean? A Correlation Analysis of Long-term Intraocular Pressure Variation Parameters in Patients with Stable Glaucoma. J Curr Glaucoma Pract 2019;13(1):28-31.
对稳定型开角型青光眼（OAG）患者的长期眼压（IOP）变化参数（平均值、峰值和波动值）进行相关性分析。
开展一项横断面观察性研究，连续纳入稳定型OAG患者。所有患者均须患有青光眼性视神经病变及特征性视野（VF）缺损。关键纳入标准为≥5次VF检查、≥3张视盘照片以及≥3年的随访且当前药物治疗方案无任何变化。稳定型OAG定义为VF结果无进展且至少3年无解剖学改变。长期IOP变化参数从每次就诊时单独的IOP测量值中获取（至少5次IOP测量）。主要观察指标是这些IOP变化参数之间的相关性。
在研究的63例患者中，37例（59%）为女性，平均年龄为61±12岁。在所有分析中，IOP平均值与峰值的相关性最强（ = 0.94；95%可信区间 = 0.92 - 0.97； < 0.001）。IOP峰值与IOP波动值之间也存在显著相关性（ = 0.84；95%可信区间 = 0.75 - 0.90； < 0.001），以及平均IOP与IOP波动值之间（ = 0.62；95%可信区间 = 0.43 - 0.75； < 0.001）。
所评估的大多数长期IOP变化参数似乎高度相关。值得注意的是，平均IOP与IOP峰值之间的相关性最强。我们认为在多元回归模型中将它们作为个体变量纳入可能会导致数据误解，这一事实应予以考虑。
关于哪个长期IOP变化参数在临床上更具相关性，不同的精心设计研究结果相互矛盾。我们的研究结果表明，共线性问题可能部分解释了这些评估长期IOP变化参数与青光眼预后关系的研究之间存在差异的结果。
斯科拉利克ALB，格拉西泰利CPB，峰值、波动值还是平均值？稳定型青光眼患者长期眼压变化参数的相关性分析。《当代青光眼实践杂志》2019；13(1)：28 - 31。
