Department of Ophthalmology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
Pediatric dentistry, Nieder-Olm, Germany.
Int Ophthalmol. 2020 Jun;40(6):1403-1410. doi: 10.1007/s10792-020-01306-7. Epub 2020 Feb 17.
To evaluate the role of intraocular pressure (IOP) fluctuations and other factors on conversion of ocular hypertension to open-angle glaucoma (OAG) within a retrospective, longitudinal cohort study.
The study population included patients with ocular hypertension defined by IOP > 21 mmHg with normal appearing optic discs and no visual field defect. IOP fluctuation, mean and maximum were examined in 61 eyes over a follow-up period of 36 months (standard deviation (SD) 24). All patients underwent at least two 48-h IOP profiles including night-time IOP measurements in the supine position, visual field examinations, Heidelberg retina tomograph analyses (HRT) and optic disc photographs. Regression analyses were performed to demonstrate the impact of IOP parameters, myopia, sex, cup/disc ratio and visual field results on conversion to glaucoma.
While IOP fluctuation and mean did not impact conversion, myopia proved to be a risk factor (HR 14.4; 95% CI: [3.9-53.0]; p ≤ 0.001). Over an average of three years, 6/61 converted to OAG. The study yielded a mean long-term IOP over all available pressure profiles of 18.1 mmHg (SD 3.2) and an IOP fluctuation of 1.9 mmHg (SD 1.1) within a mostly treated cohort. Conversion-free five-year rate was 59.8%.
The amount of fluctuation we measured in our study sample did not result in the development of glaucoma in treated ocular hypertension patients. Myopic subjects with ocular hypertension are at a higher risk for glaucoma conversion than non-myopic ocular hypertensive subjects are.
在回顾性、纵向队列研究中评估眼压（IOP）波动和其他因素在高眼压转化为开角型青光眼（OAG）中的作用。
研究人群包括眼压>21mmHg、视盘外观正常且无视野缺损的高眼压患者。在 36 个月的随访期内（标准差 24），对 61 只眼的 IOP 波动、平均值和最大值进行了检查。所有患者均至少进行了两次 48 小时眼压描记，包括仰卧位夜间眼压测量、视野检查、海德堡视网膜断层分析（HRT）和视盘照相。进行回归分析以证明 IOP 参数、近视、性别、杯/盘比和视野结果对转化为青光眼的影响。
尽管 IOP 波动和平均值对转化没有影响，但近视被证明是一个危险因素（HR 14.4；95%CI：[3.9-53.0]；p≤0.001）。在平均三年的时间里，6/61 例患者转化为 OAG。本研究得出的平均长期 IOP 为所有可用压力曲线的 18.1mmHg（标准差 3.2），在大多数接受治疗的队列中 IOP 波动为 1.9mmHg（标准差 1.1）。五年无转换率为 59.8%。
在我们的研究样本中测量的波动量并未导致治疗性高眼压患者发生青光眼。与非近视高眼压患者相比，近视的高眼压患者发生青光眼转化的风险更高。
