Latent asymmetric intraocular pressure as a predictor of visual field defects.
OBJECTIVE
To investigate the association of latent asymmetric intraocular pressure (IOP) (IOP asymmetry between fellow eyes when patients were in the supine position but not when sitting) with visual field (VF) defects in patients with open-angle glaucoma.


METHODS
Fifty-three patients with open-angle glaucoma, who were receiving the same topical medication in both eyes, were enrolled and were housed in a sleep laboratory for 24 hours. Intraocular pressures were measured when the patients with open-angle glaucoma were in the supine position or were sitting. A group of patients with latent asymmetric IOP was identified. Intraocular pressure asymmetry, monocular diurnal IOP fluctuation, and VF indexes were compared between the groups with and without latent asymmetric IOP.


RESULTS
Among the study population, 16 patients had latent asymmetric IOP. Compared with fellow eyes, their hypertensive eyes demonstrated greater IOP fluctuations in the sitting and supine positions and had more aggressive VF defects. In addition, the eyes in patients having latent symmetric IOP showed significantly greater diurnal IOP fluctuations in the sitting and supine positions and more severe VF defects compared with the eyes in patients having symmetric sitting and supine position IOPs.


CONCLUSIONS
Patients with latent asymmetric IOP are at increased risk of VF deterioration. Latent asymmetric IOP may be a predictor of glaucomatous VF defects. Further investigation in a larger, more diverse group of patients is needed to assess the diagnostic implications of latent asymmetric IOP relative to glaucoma therapy.
Hong
Samin
S
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul 120-752, Korea.
Kang
Sung Yong
SY
Ma
Kyoung Tak
KT
Seong
Gong Je
GJ
Kim
Chan Yun
CY
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002940:Circadian Rhythm; D005260:Female; D007839:Functional Laterality; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016683:Supine Position; D014065:Tonometry, Ocular; D014786:Vision Disorders / Q000175:diagnosis* / Q000503:physiopathology; D058609:Visual Field Tests; D014794:Visual Fields
D000959:Antihypertensive Agents