April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
The Relationship between Intraocular Pressure and Rates of Estimated Retinal Ganglion Cell Loss in Glaucoma.
Author Affiliations & Notes
  • Amir Marvasti
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, San Diego, CA
    Boston University School of Medicine, Boston, MA
  • Andrew J Tatham
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, San Diego, CA
  • Linda M Zangwill
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, San Diego, CA
  • Robert N Weinreb
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, San Diego, CA
  • Felipe A Medeiros
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, San Diego, CA
  • Footnotes
    Commercial Relationships Amir Marvasti, None; Andrew Tatham, Heidelberg Engineering (F); Linda Zangwill, Carl Zeiss Meditec Inc. (F), Heidelberg Engineering GmbH (F), Nidek Inc. (F), Optovue Inc. (F), Topcon Medical Systems Inc. (F); Robert Weinreb, Aerie (F), Alcon (C), Allergan (C), Bausch&Lomb (C), Carl Zeiss Meditec (C), Carl Zeiss Meditec (F), Genentech (F), Heidelberg Engineering GmbH (F), National Eye Institute (F), Nidek (F), Novartis (F), Optovue (F), Sensimed (C), Topcon (C), Topcon (F); Felipe Medeiros, Alcon Laboratories Inc. (F), Alcon Laboratories Inc. (R), Allergan Inc. (C), Allergan Inc. (F), Allergan Inc. (R), Bausch & Lomb (F), Carl Zeiss Meditec Inc. (F), Carl Zeiss Meditec Inc. (R), Carl-Zeiss Meditec Inc. (C), Heidelberg Engineering Inc. (F), Merck Inc. (F), Method for estimating retinal ganglion cell loss using structure and function. (P), National Eye Institute (F), Novartis (C), Reichert Inc. (F), Reichert Inc. (R), Sensimed (F), Topcon Inc. (F)
  • Footnotes
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Investigative Ophthalmology & Visual Science April 2014, Vol.55, 3551. doi:
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      Amir Marvasti, Andrew J Tatham, Linda M Zangwill, Robert N Weinreb, Felipe A Medeiros, ; The Relationship between Intraocular Pressure and Rates of Estimated Retinal Ganglion Cell Loss in Glaucoma.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3551.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To evaluate the influence of mean intraocular pressure (IOP) during follow up on rates of estimated retinal ganglion cell (RGC) loss in glaucoma.

 
Methods
 

270 eyes of 178 subjects with glaucoma and suspected glaucoma were followed for mean ± SD of 6.3 ± 2.7 (range: 2.1 to 11.0) years, with an average of 9 ± 3 (range: 5 to 17) visits duri

 
Results
 

At baseline, the average SAP mean deviation (MD) was -2.4 ± 3.8 dB and average estimated RGC count was 776,077 ± 230,127 cells. Mean IOP during follow up was 16.8 ± 4.4 mmHg (range: 4.8 to 27.6). Average CCT was 554.1 ± 36.7 μm. There was a significant nonlinear relationship between the estimated rate of RGC loss and mean IOP during follow up with higher IOP associated with a higher rate of RGC loss. In a multivariable model including mean IOP, (mean IOP)^2, CCT, an interaction term CCT*mean IOP, and age at baseline, all variables were significantly associated with rate of RGC loss (P<0.05). Eyes with a mean IOP of 10 mmHg during follow up had estimated RGC losses close to the expected age-related loss of 6,944 cells per year. In contrast, mean IOPs of 16 mmHg, 22 mmHg, and 28 mmHg were associated with losses of 9,869 cells, 17,794 cells, and 30,718 cells per year, respectively (Figure 1).

 
Conclusions
 

Higher mean IOP during follow up is associated with greater rates of estimated RGC loss in eyes with glaucoma or suspected glaucoma.

 
 
Modeled relationship between estimated rate of RGC loss and mean IOP during follow up.
 
Modeled relationship between estimated rate of RGC loss and mean IOP during follow up.
 
Keywords: 531 ganglion cells • 568 intraocular pressure • 464 clinical (human) or epidemiologic studies: risk factor assessment  
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