Abstract
Purpose: :
To determine the association between systemic antihypertensive medication and visual field (VF) progression in open-angle glaucoma
Methods: :
We reviewed the charts of open-angle glaucoma (OAG) patients who had visited the outpatient clinic of both ophthalmology and internal medicine in Severance hospital (Seoul, South Korea) between 2003 and 2007. Consecutive and treated open-angle glaucoma patients with 5 or more reliable visual field (30-2 Swedish interactive threshold algorithm (SITA)-standard, Humphrey visual field analyzer II, Carl Zeiss Meditec, Inc, Dublin, California) test results were enrolled. Visual field progression was evaluated with mean deviation (MD) and visual field index (VFI) of subject’s VF results which have one year interval. The collected data including age, gender, VF global indices, OAG subtypes, antihypertensive medications, peak intraocular pressure (IOP), mean IOP, axial length, central corneal thickness (CCT) were analyzed using linear mixed models.
Results: :
Total Five hundred and fifty two patients were reviewed and 80 eyes (80 patients; mean age, 55.86 ± 14.16; mean number of VF tests, 6.63 ± 1.77; mean follow-up, 5.80 ± 1.23 years) of them were finally included. Primary open-angle glaucoma (POAG, OAG with an IOP of 22 mmHg or more) group showed higher progression rate of MD and VFI than normal tension glaucoma (NTG, OAG with IOP of less than 22 mmHg) group (-0.73 vs -0.52 dB/year and -1.95 vs -1.05 %/year, MD and VFI, respectively). Especially, POAG patients with antihypertensive medication showed higher rate of progression (-1.45 dB/year, -3.27 %/year) with statistical significance comparing to those with no antihypertensive medication (-0.46 dB/year, -1.47 %/year) or NTG patients.
Conclusions: :
Among the verified factors in our study, systemic antihypertensive medication was a significant risk factor for higher rate of VF progression especially in conjunction with high IOP status. These data imply that the further study of larger scale about the effect of systemic antihypertensive drugs on glaucoma progression is needed.
Keywords: visual fields • clinical (human) or epidemiologic studies: risk factor assessment