Intraocular pressure and progression of visual field damage

Contradicting results concerning IOP control and visual field deterioration are presented. Some of these inconsistencies may be due to the statistical method of analysis. Sixty POAG patients with a perimetric follow-up over 3 years were selected. Mean and maximum IOPs were considered during the same period. The patients were divided into two groups according to the IOP control (well controlled or poorly controlled). Visual field progression was defined as a reduction in sensitivity over the fifth percentile in more than four points. Mean IOPs were not significantly different in the group of patients with a visual field deterioration compared to the stable ones, but the percentage of patients with a visual field deterioration was significantly higher in patients with higher IOPs. This holds especially true if IOP below 16 mmHg (G) is considered the 'target pressure'. IOP reduction seems to play an essential role in visual field progression. In glaucomatous patients, a strict (<16 mmHg (G)) might be necessary.