Is there any difference in target intraocular pressure for exfoliative glaucoma patients with cardiovascular disease history?
OBJECTIVE
To investigate if patients with exfoliation glaucoma (XFG) with cardiovascular disease (CVD) require different target intraocular pressure (IOP) compared to patients with XFG with no CVD for long-term stability.


METHODS
A retrospective, multicenter, observational cohort analysis included consecutive patients with XFG from 9 European academic centers, with a minimum of 5 years follow-up.


RESULTS
In 201 patients, there was a statistical difference between progressed and non-progressed patients in mean (p=0.0049) and peak (p=0.015) IOP, variance of IOP (p=0.028), and number of medicine changes/year (p=0.0037). At a mean IOP ≥22 mmHg, patients progressed in 84% (32/38), between 14 and 21 mmHg in 54% (81/151), and at ≤13 mmHg in 33% (4/12). There was no difference in the rate of progression between groups based on CVD history (p=0.65). However, IOP that allowed ≤50% progression rate for patients with mild or no CVD was ≤20-21 mmHg and ≤18 mmHg for patients with severe disease. Further, at IOP ≥20 mmHg, 8% (1/12) of patients with severe CVD remained stable in contrast to 38% (16/42) of patients with mild and 21% (4/19) with no CVD history (p=0.0093). By multivariant regression analysis of the IOP and CVD measures, mean IOP was a risk factor for progression (p=0.0097).


CONCLUSIONS
Although IOP is the main determinant of progression in XFG under treatment, history of severe CVD should be further investigated as potential risk factor for glaucomatous progression.
Holló
Gábor
G
Semmelweis University, Budapest, Hungary.
Cvenkel
Barbara
B
Teus
Miguel A
MA
Irkec
Murat T
MT
Astakhov
Yuri S
YS
Chiselita
Dorin
D
Petkova
Nataliya
N
Liehneová
Ivana
I
Kaluzny
Bartlomiej J
BJ
Kóthy
Péter
P
Bozkurt
Banu
B
Akopov
Evgeny L
EL
Stewart
Jeanette A
JA
Kristoffersen
Michael S
MS
Kristoffersen
Caroline J
CJ
Stewart
William C
WC
D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D015331:Cohort Studies; D018450:Disease Progression; D017889:Exfoliation Syndrome / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects / Q000502:physiology*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
D000959:Antihypertensive Agents