Seasonal Fluctuation in Intraocular Pressure and Retinal Nerve Fiber Layer Thinning in Primary Open-Angle Glaucoma.
Ophthalmol Glaucoma
; 4(4): 373-381, 2021.
Article
en En
| MEDLINE
| ID: mdl-33242683
ABSTRACT
PURPOSE:
To detect seasonal fluctuations in intraocular pressure (IOP) in healthy eyes and eyes with primary open-angle glaucoma (POAG) and to evaluate whether these seasonal fluctuations affect retinal nerve fiber layer (RNFL) thinning in eyes with POAG.DESIGN:
Observational, retrospective cohort study.PARTICIPANTS:
Healthy population who underwent a comprehensive health check-up and patients with POAG using only topical medications were enrolled.METHODS:
Kaplan-Meier survival analysis was used to compare the cumulative incidence probabilities of RNFL thinning between different seasonal IOP fluctuation groups. A Cox proportional hazards model, with adjustments for potential confounding factors, was used to evaluate the association between seasonal fluctuations in IOP and RNFL thinning. MAIN OUTCOMEMEASURES:
Intraocular pressure fluctuation rate calculated from winter and summer IOPs and RNFL thinning as determined by event-based analysis with high-definition OCT.RESULTS:
A total of 12 686 healthy eyes and 179 eyes of 179 POAG patients showed a significantly higher IOP in winter than in summer (healthy, 13.2 ± 3.0 mmHg vs. 12.5 ± 2.9 mmHg [P < 0.001]; POAG, 13.1 ± 2.7 mmHg vs. 11.8 ± 2.3 mmHg [P < 0.001]). In POAG patients, the mean age at initial OCT and follow-up duration were 55.1 ± 11.7 years and 98.4 ± 26.4 months, respectively. The mean deviation (MD) at first visit, MD slope, and RNFL thinning rate were -2.2 ± 3.4 dB, -0.07 ± 0.44 dB/year, and -0.44 ± 0.88 µm/year, respectively. During the study period, 85 eyes (47.5%) showed RNFL thinning progression. Kaplan-Meier analysis showed that a high seasonal IOP fluctuation rate significantly suppressed RNFL thinning (P < 0.05, log-rank test). After adjusting for confounders in the Cox analysis, the seasonal IOP fluctuation rate still showed a significantly negative association with RNFL thinning (hazard ratio, 0.98; 95% confidence interval, 0.96-0.99; P = 0.005).CONCLUSIONS:
Winter IOP was higher than summer IOP in both healthy and POAG eyes. The temporary IOP decline in summer, rather than a constant IOP throughout the year, may prevent glaucoma progression.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Disco Óptico
/
Glaucoma de Ángulo Abierto
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Ophthalmol Glaucoma
Año:
2021
Tipo del documento:
Article