title: Is there any difference in target intraocular pressure for exfoliative glaucoma patients with cardiovascular disease history?
abstract: 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.
authors.affiliation: Semmelweis University, Budapest, Hungary.
authors.forename: Gábor
authors.initials: G
authors.lastname: Holló
authors.forename: Barbara
authors.initials: B
authors.lastname: Cvenkel
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Teus
authors.forename: Murat T
authors.initials: MT
authors.lastname: Irkec
authors.forename: Yuri S
authors.initials: YS
authors.lastname: Astakhov
authors.forename: Dorin
authors.initials: D
authors.lastname: Chiselita
authors.forename: Nataliya
authors.initials: N
authors.lastname: Petkova
authors.forename: Ivana
authors.initials: I
authors.lastname: Liehneová
authors.forename: Bartlomiej J
authors.initials: BJ
authors.lastname: Kaluzny
authors.forename: Péter
authors.initials: P
authors.lastname: Kóthy
authors.forename: Banu
authors.initials: B
authors.lastname: Bozkurt
authors.forename: Evgeny L
authors.initials: EL
authors.lastname: Akopov
authors.forename: Jeanette A
authors.initials: JA
authors.lastname: Stewart
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kristoffersen
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Kristoffersen
authors.forename: William C
authors.initials: WC
authors.lastname: Stewart
mesh_terms: 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
chemical_list: D000959:Antihypertensive Agents