Clinical Study
Eye (2009) 23, 73–78; doi:10.1038/sj.eye.6702995; published online 5 October 2007
Mean intraocular pressure and progression based on corneal thickness in patients with ocular hypertension
A G P Konstas1, M T Irkec2, M A Teus3, B Cvenkel4, Y S Astakhov5, E D Sharpe6, G Hollo7, N Mylopoulos1, B Bozkurt8, C Pizzamiglio3, V V Potyomkin5, A M Alemu9, Q J Nasser10, J A Stewart10 and W C Stewart10,11
- 1AHEPA Hospital, Thessaloniki, Greece
- 2Hacettepe Faculty of Medicine, Ankara, Turkey
- 3Vissum Hospital Oftalmologico de Madrid, Madrid, Spain
- 4University Eye Clinic Ljubljana, Ljubljana, Slovenia
- 5Pavlov State Medical University, Saint-Petersburg, Russia
- 6Glaucoma Consultants & Center For Eye Research, Mt Pleasant, SC, USA
- 7Semmelweis University, Budapest, Hungary
- 8Private Practice, Ankara, Turkey
- 9Ras Desta Hospital, Addis Ababa, Ethiopia
- 10PRN Pharmaceutical Research Network, LLC, Charleston, SC, USA
- 11Carolina Eye Institute, University of South Carolina, Columbia, SC, USA
Correspondence: WC Stewart, PRN Pharmaceutical Research Network, LLC, 1 Southpark Circle, Suite 110, Charleston, SC 29407, USA. Tel: +843-762-6500; Fax: +843-762-7444; E-mail: info@prnorb.com
Received 25 May 2007; Revised 8 August 2007; Accepted 8 August 2007; Published online 5 October 2007.
Abstract
Purpose
To determine the incidence of glaucomatous progression at mean intraocular pressure (IOP) levels in patients with ocular hypertension (OHT).
Methods
A retrospective, multicentre, cohort analysis of 230 OHT patients with 5 years of follow-up evaluated for risk factors associated with progressive optic disc and visual field loss to determine the incidence of glaucomatous progression.
Results
Forty percent of patients with IOPs
24 mmHg, 18% of patients with IOPs of 21–23 mmHg, 11% of patients with IOPs with 18–20 mmHg, and 3% of patients with IOPs of
17 mmHg progressed to glaucoma. The mean IOP was 19.8
2.4 mmHg in the stable group and 21.7
2.6 mmHg in the progressed group (P=0.0004). The highest average peak IOP was 23.4
4.0 mmHg in the stable group and 25.2
3.1 mmHg in the progressed group (P=0.006). Based on the pachymetry values for central corneal thickness, patients with thinner corneas more often progressed to glaucoma (P<0.0001). A multivariant regression analysis to determine risk factors for progression was positive primarily for higher peak IOPs, older age, male gender, argon laser trabeculoplasty, visual acuity
20/50, and no topical medical therapy or
-blocker therapy prior to the study.
Conclusions
IOP reduction within the normal range over 5 years of follow-up reduces the chance of progression to primary open-angle glaucoma in OHT patients.
Keywords:
progression, intraocular pressure, ocular hypertension, Ocular Hypertension Treatment Study

