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[Study on relationship between control of intraocular pressure and systemic risk factor for visual field progression
Takako Nakagami1, Yoshio Yamazaki, Fukuko Hayamizu
1Department of Ophthalmology, Division of Visual Science, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo 173-8610, Japan. nakagami@med.nihon-u.ac.jp
Purpose:
To study the relationship between the reduction of intraocular pressure (IOP) and visual field (VF) damage in normal-tension glaucoma (NTG) patients with or without systemic risk factors.
Methods:
Ninety-two eyes of 92 patients with NTG were enrolled in this study. All patients were followed up for more than 2 years of taking topical antiglaucoma medications. Personal history regarding migraine, diabetes mellitus, hypertension, cerebrovascular disease, cardiovascular disease, Raynaud's phenomenon, arrhythmia, and family history of glaucoma were collected from the medical records. The survival data were analyzed using regression analysis based on the Cox proportional hazards model. The relationship between the presence of each systemic factor and the effect of reduction of VF progression were evaluated using the life table analysis.
Results:
The progression of VF damage was significantly associated with IOP (p = 0.020). The eyes with larger IOP reduction showed significantly less VF progression than eyes with smaller IOP reduction both in patients with and without systemic diseases (with systemic diseases p = 0.027, without systemic diseases p = 0.025) and a family history of glaucoma (p = 0.019). In patients with a family history of glaucoma, the rate of VF progression did not show statistically differences between the eyes with larger IOP reduction and those with smaller IOP reduction.
Conclusions:
IOP reduction is beneficial in reducing the risk of VF progression regardless of the presence of systemic risk factors in patients with NTG.
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