April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Effect of Intraocular Pressure Fluctuations on Longitudinal Changes in Optic Disc Topographic Measurements Obtained by Confocal Scanning Laser Ophthalmoscopy
D. Chao; M. T. Leite; L. M. Zangwill; R. N. Weinreb; C. Bowd; P. A. Sample; J. M. Liebmann; C. A. Girkin; F. A. Medeiros
Author Affiliations & Notes
  • D. Chao
    Ophthalmology, University of California, San Diego, La Jolla, California
  • M. T. Leite
    Ophthalmology, University of California, San Diego, La Jolla, California
    Ophthalmology, Universidade Federal de Sao Paulo, San Paulo, Brazil
  • L. M. Zangwill
    Ophthalmology, University of California, San Diego, La Jolla, California
  • R. N. Weinreb
    Ophthalmology, University of California, San Diego, La Jolla, California
  • C. Bowd
    Ophthalmology, University of California, San Diego, La Jolla, California
  • P. A. Sample
    Ophthalmology, University of California, San Diego, La Jolla, California
  • J. M. Liebmann
    Ophthalmology, NYU School of Medicine, New York, New York
  • C. A. Girkin
    Ophthalmology, Univ of Alabama at Birmingham, Birmingham, Alabama
  • F. A. Medeiros
    Ophthalmology, University of California, San Diego, La Jolla, California
  • Footnotes
    Commercial Relationships  D. Chao, None; M.T. Leite, None; L.M. Zangwill, Carl Zeiss Meditec, Inc., F; Heidelberg Engineering, GmbH, F; Optovue, Inc., F; Topcon Medical Systems, Inc., F; R.N. Weinreb, Optovue, Inc., F; Optovue, Inc., C; Carl Zeiss Meditec, Inc., F; Heidelberg Engineering, GmbH, F; Novartis, F; Topcon Medical Systems, Inc., F; Alcon Laboratories, Inc., C; Allergan, Inc., C; Carl Zeiss Meditec, Inc., C; Glaxo, C; Pfizer, Inc., C; Topcon Medical Systems, Inc., C; C. Bowd, Lace Elettronica, F; P.A. Sample, Carl Zeiss Meditec, F; Haag-Streit, F; Welch-Allyn, F; J.M. Liebmann, Carl Zeiss Meditec, Inc., F; Diopsys, Inc., F; Topcon Medical Systems, Inc., F; Optovue, Inc., F; Alcon Laboratories, Inc., C; Allergan, Inc., C; Diopsys, Inc., C; Pfizer, Inc., C; Topcon Medical Systems, Inc., C; Optovue, Inc., C; C.A. Girkin, Alcon Laboratories, Inc., C; Allergan, Inc., C; Pfizer, Inc., C; Heidelberg Engineering, R; Optive, Inc., R; Carl Zeiss Meditec, Inc., R; Merck, Inc., R; F.A. Medeiros, Carl-Zeiss Meditec, F; Alcon, Inc., F; Pfizer, Inc., F; Allergan, Inc., C; Alcon, Inc., C; Pfizer, Inc., C; Carl-Zeiss Meditec, R; Allergan, Inc., R; Alcon, Inc., R; Pfizer, Inc., R; Reichert, Inc., R.
  • Footnotes
    Support  NEI EY08208 (PAS), NEI EY11008 (LMZ), NEI EY14267 (PAS, CAG, JML), EY13959 (CAG), Eyesight Foundation of Alabama (CAG)
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 2718. doi:
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      D. Chao, M. T. Leite, L. M. Zangwill, R. N. Weinreb, C. Bowd, P. A. Sample, J. M. Liebmann, C. A. Girkin, F. A. Medeiros; Effect of Intraocular Pressure Fluctuations on Longitudinal Changes in Optic Disc Topographic Measurements Obtained by Confocal Scanning Laser Ophthalmoscopy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2718.

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Abstract

Purpose: : To evaluate the effect of fluctuations in intraocular pressure (IOP) on longitudinal changes in neuroretinal rim area and retinal nerve fiber layer (RNFL) thickness, as measured by the Heidelberg Retina Tomograph (HRT).

Methods: : The study included 1610 eyes (313 healthy, 724 suspects and 573 glaucomatous) from 964 patients. Patients were recruited from the longitudinal Diagnostic Innovations in Glaucoma Study (DIGS) and from the African Descent and Glaucoma Evaluation Study (ADAGES) and followed for an average of 34 (±25) months. All patients had at least two visits with HRT imaging for a total of 5535 visits. The average interval between consecutive visits was 14 (±9) months. IOP measurements were obtained on the same day as HRT images. For each pair of consecutive visits, we calculated changes in topographic parameters and IOP. The relationship between changes in topographic parameters and change in IOP was investigated using generalized estimating equations to adjust for multiple measurements per patient.

Results: : For each 1 mmHg decrease in IOP between consecutive visits, there was a corresponding increase of 0.003 mm2 or 0.25% in rim area (P<0.001). When we restricted the maximum interval between visits to 12 months, each 1 mmHg decrease in IOP corresponded to a 0.13% increase in rim area (P=0.014). Selecting only patients that had an increase in rim area measurements during consecutive visits, we obtained a 0.16% increase in rim area for 1 mmHg decrease in IOP (P=0.032). Changes in IOP did not significantly influence mean RNFL thickness (P=0.33).

Conclusions: : Changes in IOP during follow-up were significantly related to changes in rim area as measured by the HRT. Considering average reported rates of 1%/year of progressive rim area loss in glaucoma, relatively small changes in IOP can significantly affect detection of glaucoma progression for this parameter with this instrument.

Keywords: intraocular pressure • visual fields • nerve fiber layer 
© 2010, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2024 Association for Research in Vision and Ophthalmology.
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