Long-term relationship between intraocular pressure and visual field loss in primary open-angle glaucoma.
OBJECTIVE
To investigate the dependence upon intraocular pressure (IOP) of the progression of visual field defects in eyes with primary open-angle glaucoma (POAG), in which the mean IOP was maintained at < or =21 mm Hg.


METHODS
This study involved 100 eyes with POAG, which were followed up for > or =5 years. The mean IOP levels were maintained at < or =21 mm Hg during the follow-up period. The relationship between the IOP and the progression of visual field defects, which was scored using the Advanced Glaucoma Intervention Study criteria, was investigated retrospectively.


RESULTS
Compared with the baseline scores, the visual field defect scores had significantly worsened by the end of the follow-up period (P<0.0001, Wilcoxon paired signed rank test). The change in the visual field defect score (2.5+/-0.5) in eyes with average IOP levels of > or =16 mm Hg (n=36) was significantly greater (P=0.031, Mann-Whitney U test) than the change (1.3+/-0.3) in eyes with average IOP levels of <16 mm Hg (n=64). Moreover, IOP of > or =18 mm Hg made a major contribution to the aggravation of visual field defects in eyes with POAG.


CONCLUSIONS
Eyes with POAG and with mean IOP levels maintained at < or =21 mm Hg underwent IOP-dependent progression of their visual field defects. Our results suggest that further IOP lowering would be beneficial in such cases.
Inatani
Masaru
M
Department of Ophthalmology and Visual Science, Kumamoto University Graduate School of Medical Sciences, Japan. inatani@fc.kuh.kumamoto-u.ac.jp
Iwao
Keiichiro
K
Inoue
Toshihiro
T
Awai
Maiko
M
Muto
Takahito
T
Koga
Takahisa
T
Ogata-Iwao
Minako
M
Hara
Ryuhei
R
Futa
Ryusuke
R
Tanihara
Hidenobu
H
D000959:Antihypertensive Agents / Q000627:therapeutic use; D018450:Disease Progression; D018463:Filtering Surgery; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000503:physiopathology*; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014786:Vision Disorders / Q000503:physiopathology*; D014794:Visual Fields
D000959:Antihypertensive Agents