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

  1. 1AHEPA Hospital, Thessaloniki, Greece
  2. 2Hacettepe Faculty of Medicine, Ankara, Turkey
  3. 3Vissum Hospital Oftalmologico de Madrid, Madrid, Spain
  4. 4University Eye Clinic Ljubljana, Ljubljana, Slovenia
  5. 5Pavlov State Medical University, Saint-Petersburg, Russia
  6. 6Glaucoma Consultants & Center For Eye Research, Mt Pleasant, SC, USA
  7. 7Semmelweis University, Budapest, Hungary
  8. 8Private Practice, Ankara, Turkey
  9. 9Ras Desta Hospital, Addis Ababa, Ethiopia
  10. 10PRN Pharmaceutical Research Network, LLC, Charleston, SC, USA
  11. 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.

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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 greater than or equal to24 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 less than or equal to17 mmHg progressed to glaucoma. The mean IOP was 19.8plusminus2.4 mmHg in the stable group and 21.7plusminus2.6 mmHg in the progressed group (P=0.0004). The highest average peak IOP was 23.4plusminus4.0 mmHg in the stable group and 25.2plusminus3.1 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 greater than or equal to20/50, and no topical medical therapy or beta-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

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