Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Ophthalmic Res. 2024;67(1):184-191. doi: 10.1159/000536314. Epub 2024 Jan 16.
INTRODUCTION: This study aimed to investigate intraocular pressure (IOP)-independent factors associated with the progression of primary open-angle glaucoma (POAG) with IOP ≤15 mm Hg. METHODS: POAG patients with maximum IOP ≤15 mm Hg at the Kyoto University Hospital between January 2011 and August 2021 were retrospectively enrolled. We evaluated effects of various factors on the rate of mean deviation (MD) changes in the visual field (VF) examinations using a linear mixed model. These factors included hypertension, diabetes mellitus (DM), hyperlipidemia (HL), cardiovascular disease, arrhythmia, disc hemorrhage, sleep apnea syndrome, orthopedic diseases, and malignant tumors. RESULTS: In total, 98 eyes from 68 patients were included. The baseline MD was -9.74 ± 7.85 dB. The mean rate of MD change and IOP during the observation period were -0.28 ± 0.04 dB/year and 11.8 ± 1.0 mm Hg, respectively. Comorbidity of DM or HL showed a significant positive association with the rate of MD change (β = 0.35, p = 0.0006 and β = 0.18, p = 0.036, respectively) in the model adjusted for age, sex, axial length, mean IOP, and standard deviation of IOP during the observation period. However, no significant association of DM or HL was found after adjusting for central corneal thickness. CONCLUSION: This study suggests that DM or HL is associated with VF deterioration in glaucoma with lower IOP, but the association may be due to differences in IOP characteristics.
简介:本研究旨在探讨眼压(IOP)≤15mmHg 的原发性开角型青光眼(POAG)进展与 IOP 无关的因素。
方法:回顾性纳入 2011 年 1 月至 2021 年 8 月期间在京都大学医院就诊的最大 IOP≤15mmHg 的 POAG 患者。我们使用线性混合模型评估了各种因素对视野(VF)检查平均偏差(MD)变化率的影响。这些因素包括高血压、糖尿病(DM)、高脂血症(HL)、心血管疾病、心律失常、盘出血、睡眠呼吸暂停综合征、骨科疾病和恶性肿瘤。
结果:共纳入 68 例患者的 98 只眼。基线 MD 为-9.74±7.85dB。观察期间 MD 变化的平均速率和 IOP 分别为-0.28±0.04dB/年和 11.8±1.0mmHg。DM 或 HL 的合并症与 MD 变化率呈显著正相关(β=0.35,p=0.0006 和 β=0.18,p=0.036),该模型调整了年龄、性别、眼轴长度、观察期间的平均 IOP 和 IOP 标准差。然而,在调整中央角膜厚度后,DM 或 HL 与 VF 恶化之间没有显著关联。
结论:本研究表明,DM 或 HL 与较低 IOP 的青光眼 VF 恶化有关,但这种关联可能是由于 IOP 特征的差异所致。
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