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Bianca Nicolela Susanna, Carolina Susanna, Fabio B Daga, Alberto Diniz-Filho, Linda M Zangwill, Robert N Weinreb, Felipe Medeiros; Association between Glaucoma Progression and Intraocular Pressure Measurements Over Time. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1596.
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© ARVO (1962-2015); The Authors (2016-present)
Intraocular pressure (IOP) is still considered the most important risk factor for the development and progression of glaucoma. Goldmann applanation tonometry (GAT) is the most widely used method of measuring IOP. However, it is well known that corneal properties affect the accuracy of this instrument. By measuring corneal biomechanical properties, the Ocular Response Analyzer corneal-compensated IOP (IOPcc) is proposed to be less dependent on corneal-induced artifacts when measuring the IOP. The purpose of this study was to determine the association between IOP measurements provided by GAT and ORA IOPcc and glaucoma progression over time.
This was a prospective observational cohort study including 213 eyes of 125 glaucoma patients followed for an average of 2.4 ± 0.6 years. At each visit, IOP measurements were obtained using GAT and ORA IOPcc. Glaucoma progression was defined based on a statistically significant slope from standard automated perimetry (SAP) mean deviation (MD) or spectral domain optical coherence tomography (SDOCT) Retinal Nerve Fiber Layer (RNFL) thickness change over time. Logistic regression models were used to investigate the relationship between mean IOP measurements and glaucoma progression over time, while adjusting for age and central corneal thickness (CCT).
Mean baseline IOPcc and GAT IOP were respectively 15.8±4.9and 14.2±4.8 mmHg. In univariable analyses, higher mean IOPcc measurements were associated with glaucoma progression (OR=1.08; 95% CI: 1.00 – 1.15; P=0.044). Although GAT IOP had similar odds ratio, the association with progression did not achieve statistical significance (OR = 1.04; 95% CI: 0.95 – 1.13; P=0.375). In multivariable analysis, higher mean IOPcc was also associated with glaucoma progression (OR=1.10; P=0.011).
ORA IOPcc measurements were significantly associated with structural and functional progression in glaucoma, indicating that they may provide valuable information when assessing the risk of disease progression.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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