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Mary Runkle, Alon Harris, Brent A Siesky, David Camp, Nathaniel J Kim, Sunu Mathew, Alice Chandra Verticchio Vercellin; Structure, function and intraocular pressure in open angle glaucoma patients over a 5 year period. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4057. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To examine functional and structural parameters and intraocular pressure (IOP) in open angle glaucoma (OAG) patients over a 5 year period.
111 OAG patients (Mean age 65 yr; 44 male) were assessed for IOP by Goldmann applanation tonometry, for visual function by 24-2 Swedish interactive threshold algorithm with the Humphrey visual field machine, for optic nerve head (ONH) morphology by Heidelberg retina tomograph 3 (HRT3), and for macular thickness by optical coherence tomography every 6 months for 5 years. Structural progression was defined as two consecutive visits with retinal nerve fiber layer thickness decrease by at least 8% and/or horizontal or vertical cup/disk ratio increase by at least 0.2 compared to baseline. Mixed-model ANCOVA was used to test for statistically significant changes from baseline to 5-year follow-up. Time to structural progression was analyzed using Cox proportional hazards survival analysis.
Baseline IOP 16.68 (confidence interval 95%: 15.52, 17.84) statistically decreased at 5 years to 15.28 (14.01, 16.54), mean change -1.41 (-2.36, -0.45). Baseline mean deviation (MD) -3.38 (confidence interval 95%: -4.43, -2.34) statistically decreased at 5 years to -4.88 (-6.18, -3.57), mean change -1.49 (-2.35, -0.63). Baseline advanced glaucoma intervention study score (AGIS) 1.41 (0.86, 2.12) statistically increased to 2.14 (1.37, 3.16), mean change 0.56 (0.28, 0.81). Measurements of cup volume, cup/disk area ratio, mean cup depth, cup shape, and height variation contour showed significant increases over five years when analyzing all patients (p<0.05). Macular thickness measured in the outer/inner superior, outer/inner inferior, outer/inner nasal, outer/inner temporal, and macular volume significantly decreased in all sectors (p<0.05). Lower baseline MD and/or higher AGIS scores were predictive of structural progression (p<0.05) after 5 years.
In OAG patients monitored from baseline to 5 years, despite IOP decreasing over time, structural and functional progression occurred. Visual function at baseline was predictive of structural progression after 5 years.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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