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Visual field and intraocular pressure asymmetry in the low-pressure glaucoma treatment study.
Ophthalmology 2007; 114(3):460-5O

Abstract

OBJECTIVE

To explore the relationship between asymmetric baseline intraocular pressure (IOP) and asymmetric visual field (VF) loss in the Low-Pressure Glaucoma Treatment Study.

DESIGN

Randomized, multicenter, controlled clinical trial.

PARTICIPANTS

Low-pressure glaucoma (LPG) patients 30 years or older were identified. Exclusion criteria included an untreated pressure > 21 mmHg, advanced VF loss, and contraindications to study medications.

INTERVENTIONS

A baseline VF was created using the average of 2 reliable Humphrey full-threshold examinations. A baseline diurnal IOP curve was performed without IOP-lowering medication.

MAIN OUTCOME MEASURES

Mean diurnal, peak, trough, IOP range (peak - trough), and standard deviation (SD) of IOP measurements, and mean deviation (MD) and corrected pattern SD (CPSD) of VF examinations.

RESULTS

One hundred ninety patients were enrolled (mean age, 64.9+/-10.7 years). Mean deviation and CPSD were not correlated with mean, peak, trough, or peak minus trough (P - T) IOP (Ps = 0.2-0.9). Among patients with unilateral VF loss (n = 53 [27.9%]), there were no differences (Ps = 0.3-0.9) in any IOP parameter between the normal VF eye and fellow glaucomatous eyes. Among patients with bilateral VF loss (n = 137 [72.1%]), mean, peak, trough, and P - T IOPs were similar in eyes with a better VF MD compared with eyes with a worse VF MD (Ps = 0.2-0.7). Cross-classified contingency tables demonstrated no relationship (Ps = 0.1-0.3) between IOP and VF MD or CPSD using chi-square analysis.

CONCLUSIONS

Intraocular pressure asymmetry is unrelated to VF asymmetry in the Low-Pressure Glaucoma Treatment Study, suggesting an unclear pathogenic relationship between IOP and glaucomatous damage in eyes with LPG.

Authors+Show Affiliations

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida 33418, USA. dgreenfield@med.miami.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17141318

Citation

Greenfield, David S., et al. "Visual Field and Intraocular Pressure Asymmetry in the Low-pressure Glaucoma Treatment Study." Ophthalmology, vol. 114, no. 3, 2007, pp. 460-5.
Greenfield DS, Liebmann JM, Ritch R, et al. Visual field and intraocular pressure asymmetry in the low-pressure glaucoma treatment study. Ophthalmology. 2007;114(3):460-5.
Greenfield, D. S., Liebmann, J. M., Ritch, R., & Krupin, T. (2007). Visual field and intraocular pressure asymmetry in the low-pressure glaucoma treatment study. Ophthalmology, 114(3), pp. 460-5.
Greenfield DS, et al. Visual Field and Intraocular Pressure Asymmetry in the Low-pressure Glaucoma Treatment Study. Ophthalmology. 2007;114(3):460-5. PubMed PMID: 17141318.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Visual field and intraocular pressure asymmetry in the low-pressure glaucoma treatment study. AU - Greenfield,David S, AU - Liebmann,Jeffrey M, AU - Ritch,Robert, AU - Krupin,Theodore, AU - ,, Y1 - 2006/11/30/ PY - 2006/02/21/received PY - 2006/06/23/revised PY - 2006/06/27/accepted PY - 2006/12/5/pubmed PY - 2007/3/14/medline PY - 2006/12/5/entrez SP - 460 EP - 5 JF - Ophthalmology JO - Ophthalmology VL - 114 IS - 3 N2 - OBJECTIVE: To explore the relationship between asymmetric baseline intraocular pressure (IOP) and asymmetric visual field (VF) loss in the Low-Pressure Glaucoma Treatment Study. DESIGN: Randomized, multicenter, controlled clinical trial. PARTICIPANTS: Low-pressure glaucoma (LPG) patients 30 years or older were identified. Exclusion criteria included an untreated pressure > 21 mmHg, advanced VF loss, and contraindications to study medications. INTERVENTIONS: A baseline VF was created using the average of 2 reliable Humphrey full-threshold examinations. A baseline diurnal IOP curve was performed without IOP-lowering medication. MAIN OUTCOME MEASURES: Mean diurnal, peak, trough, IOP range (peak - trough), and standard deviation (SD) of IOP measurements, and mean deviation (MD) and corrected pattern SD (CPSD) of VF examinations. RESULTS: One hundred ninety patients were enrolled (mean age, 64.9+/-10.7 years). Mean deviation and CPSD were not correlated with mean, peak, trough, or peak minus trough (P - T) IOP (Ps = 0.2-0.9). Among patients with unilateral VF loss (n = 53 [27.9%]), there were no differences (Ps = 0.3-0.9) in any IOP parameter between the normal VF eye and fellow glaucomatous eyes. Among patients with bilateral VF loss (n = 137 [72.1%]), mean, peak, trough, and P - T IOPs were similar in eyes with a better VF MD compared with eyes with a worse VF MD (Ps = 0.2-0.7). Cross-classified contingency tables demonstrated no relationship (Ps = 0.1-0.3) between IOP and VF MD or CPSD using chi-square analysis. CONCLUSIONS: Intraocular pressure asymmetry is unrelated to VF asymmetry in the Low-Pressure Glaucoma Treatment Study, suggesting an unclear pathogenic relationship between IOP and glaucomatous damage in eyes with LPG. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/17141318/Visual_field_and_intraocular_pressure_asymmetry_in_the_low_pressure_glaucoma_treatment_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(06)01131-6 DB - PRIME DP - Unbound Medicine ER -