Reversal of optic disc cupping in glaucoma.
OBJECTIVE
To study whether reversal of optic disc cupping after intraocular pressure (IOP) reduction is related to risk of glaucoma progression.


METHODS
In this prospective follow-up study, where 51 patients with exfoliation glaucoma and five with ocular hypertension combined with exfoliation syndrome were followed for 6 years after IOP reduction, 24 showed progression of glaucoma in visual fields or optic nerve head (ONH) stereophotographs. ONH topography was measured with the Heidelberg Retina Tomograph (HRT). A decrease in HRT parameter cup volume of more than 5% was considered cup reversal. Multiple logistic regression was used to model progression of glaucoma.


RESULTS
Cup reversal (OR 0.226; 95% CI 0.055 to 0.918, p = 0.037), final IOP (OR 1.216; 95% CI 1.000 to 1.479, p = 0.050) and visual field mean defect at entry (OR 1.158; 95% CI 1.034 to 1.296, p = 0.011) were associated with progression. IOP change from study entry to 6-year control visit was not associated with progression (OR 0.964, 95% CI 0.850 to 1.092, p = 0.56).


CONCLUSIONS
Cup reversal seemed to be an independent protective factor for progression of glaucoma.
Harju
M
M
Helsinki University Eye Hospital, Haartmaninkatu 4 C, PO Box 220, 00029 Hus, Finland. mika.harju@aad.fi
Saari
J
J
Kurvinen
L
L
Vesti
E
E
D018450:Disease Progression; D004812:Epidemiologic Methods; D017889:Exfoliation Syndrome / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D005901:Glaucoma / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D009798:Ocular Hypertension / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D009898:Optic Disk / Q000473:pathology*; D011379:Prognosis; D014054:Tomography; D014794:Visual Fields