Factors associated with topographic changes of the optic nerve head induced by acute intraocular pressure reduction in glaucoma patients

Factors associated with topographic changes of the optic nerve head induced by acute intraocular pressure reduction in glaucoma patients

Author Prata, Tiago dos Santos Autor UNIFESP Google Scholar
Lima, V. C. Autor UNIFESP Google Scholar
Moraes, C. G. Vasconcelos de Google Scholar
Guedes, L. M. Autor UNIFESP Google Scholar
Magalhaes, F. P. Autor UNIFESP Google Scholar
Teixeira, S. H. Autor UNIFESP Google Scholar
Ritch, R. Google Scholar
Paranhos, A. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
New York Eye & Ear Infirm
New York Med Coll
Abstract Purpose To investigate factors associated with changes in optic nerve head (ONH) topography after acute intraocular pressure (IOP) reduction in patients with primary open-angle glaucoma (POAG).Methods Untreated POAG patients (IOP >21 mm Hg) were prospectively enrolled. Systemic and ocular information were collected, including central corneal thickness (CCT) and corneal hysteresis (CH). All patients underwent confocal scanning laser ophthalmoscopy and tonometry (Goldmann) before and 1 h after pharmacological IOP reduction. the mean of three measurements was considered for analysis. Changes in each ONH topographic parameter were assessed (one eye was randomly selected), and those that changed significantly were correlated with patient's systemic and ocular characteristics.Results A total of 42 patients were included (mean age, 66.7 +/- 11.8 years). After a mean IOP reduction of 47.3 +/- 11.9%, significant changes were observed in cup area and volume, and in rim area and volume (P < 0.01), but not in mean cup depth (P = 0.80). Multiple regression analysis (controlling for baseline IOP and magnitude of IOP reduction) showed that CH (r(2) = 0.17, P < 0.01) and diabetes diagnosis (r(2) >= 0.21, P < 0.01) were negatively correlated with the magnitude of changes in ONH parameters, whereas the cup-to-disc ratio was positively correlated (r(2) = 0.30, P < 0.01). Age, race, disc area, and CCT were not significant (P >= 0.12). Including all significant factors in a multivariable model, only the presence of diabetes remained significantly associated with all ONH parameters evaluated (P < 0.01).Conclusions Different systemic and ocular factors, such as diabetes, CH, and the relative size of the cup, seem to be associated with the magnitude of changes in ONH topography after acute IOP reduction in POAG patients. These associations partially explain the ONH changes observed in these patients and suggest that other factors are possibly implicated in an individual susceptibility to IOP. Eye (2011) 25, 201-207; doi:10.1038/eye.2010.179; published online 3 December 2010
Keywords glaucoma
intraocular pressure
optic nerve head
corneal biomechanics
Language English
Date 2011-02-01
Published in Eye. London: Nature Publishing Group, v. 25, n. 2, p. 201-207, 2011.
ISSN 0950-222X (Sherpa/Romeo, impact factor)
Publisher Nature Publishing Group
Extent 201-207
Origin http://dx.doi.org/10.1038/eye.2010.179
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000287187300011
URI http://repositorio.unifesp.br/handle/11600/33388

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