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  • Title: Relationship between 24-hour mean ocular perfusion pressure fluctuation and rate of paracentral visual field progression in normal-tension glaucoma.
    Author: Choi J, Lee JR, Lee Y, Lee KS, Na JH, Han S, Kook MS.
    Journal: Invest Ophthalmol Vis Sci; 2013 Sep 11; 54(9):6150-7. PubMed ID: 23963166.
    Abstract:
    PURPOSE: To investigate the relationship between unstable mean ocular perfusion pressure (MOPP) and the rate of paracentral visual field (PVF) progression in patients with medically treated normal-tension glaucoma (NTG). METHODS: The data of 157 eyes of 122 patients with NTG who were followed for more than 6 years (mean follow-up, 8.7 years ± 12.6 months) and had more than 5 reliable standard visual field (VF) tests were analyzed retrospectively. Groups in the highest, middle, and lowest tertiles of 24-hour MOPP fluctuation (HMF, MMF, and LMF, respectively) were compared in terms of rates of change of mean thresholds in the central 10° (PVF), 10° to 24°, and global areas by using a linear mixed model. Clinical factors associated with rapid PVF progression were also investigated. RESULTS: The LMF and HMF groups did not differ significantly in the mean global rate of VF changes (-0.52 vs. -0.71 dB/y; P = 0.07). The HMF group had a significantly faster progression of VF defects in the central 10° area than the LMF group (-1.02 vs. -0.54 dB/y; P < 0.001) but did not differ in terms of progression of VF defects in the peripheral 10° to 24° area (-0.39 vs. -0.495 dB/y; P = 0.425). PVF progression was significantly associated with 24-hour MOPP fluctuation (β = -0.31, P < 0.001) and VF damage severity at initial presentation (β = 0.134, P = 0.011). CONCLUSIONS: Medically treated NTG eyes with greater 24-hour MOPP fluctuations (HMF) had faster PVF defect progression than eyes with stable 24-hour MOPP (LMF). Twenty-four hour MOPP fluctuation associated significantly with PVF progression velocity.
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