Abstract
Purpose::
To evaluate intra ocular pressure (IOP) peaks and fluctuation during office hours and after water-drinking test in glaucomatous patients with visual field progression
Methods::
Retrospective analysis of 81 glaucoma patients with documented visual field progression according to Anderson’s Criteria. These patients were divided into 3 groups, according to visual field damage classification : A- mild (30 eyes) , B -moderate (29) and C-severe (22) .All patients were treated with topical medication, and should have at least 4 office hour IOP measures within 6 months, under the same medication. Water-drinking test was performed in every patient to access IOP peak and fluctuation, defined as Maximum IOP (detected in the WDT) - Minimum IOP (detected in office hour measures). Data related to visual field Mean Deviation (MD), follow up time and number of topic medication were also recorded. For statistical analysis, ANOVA post hoc multiple comparison test was used.
Results::
Mean office hour IOPs in groups A, B, and C were 16.375 +/-2.41, 15.01 +/-2.67 and 13.51 +/-2.48 mmHg respectively ( A vs B, p= 0.0431; B vs C, p=0.0408; A vs C, p=0.002).WDT peak pressures were 19.66 +/-3.72, 20.0 +/- 4.1 and 19.38 +/-3.30 mmHg respectively (A vs B, p= 0.729; B vs C, p=0.562 and A vs C, p=0.791).IOP fluctuation in each group was 5.03 +/-3.03, 6.51 +/-3.24 and 7.18 +/-2.88 mmHg respectively (A vs B, p=0.069; B vs C, p=0.443 and A vs C, p=0.015).
Conclusions::
Mean IOP measured in office hours in glaucoma patients with visual field progression are higher in the mild group compared to the severe group. Despite this fact, advanced glaucomatous eyes show similar IOP peaks and higher IOP fluctuation in the WDT. This finding suggests that eyes with advanced glaucomatous damage have lower ability to deal with transient IOP elevation.
Keywords: visual fields • intraocular pressure • clinical (human) or epidemiologic studies: risk factor assessment