title: Influence of intraocular pressure reduction on progression of normal-tension glaucoma with myopic tilted disc and associated risk factors.
abstract: Purpose To evaluate the influence of intraocular pressure (IOP) reduction on progression of normal-tension glaucoma (NTG) with myopic tilted disc and to demonstrate the associated risk factors.
  
  
  METHODS
  The medical records on 109 eyes of 109 NTG patients with myopic tilted discs who were followed up for more than 5 years and treated with topical medications were reviewed. Glaucoma progression was defined according to either structural or functional deterioration. Patients were divided into tertile groups according to the percent IOP reduction from the baseline, and the cumulative probability of NTG nonprogression of the upper- and lower-tertile groups was compared using Kaplan-Meier survival analysis. The multivariate Cox proportional hazards model was used to identify the risk factors for glaucoma progression.
  
  
  RESULTS
  Forty-nine of 109 eyes (45.0%) showed glaucoma progression after the average follow-up period of 7.55 ± 1.79 years. The Kaplan-Meier analysis revealed a greater cumulative probability of nonprogression for the upper-tertile group (percent IOP reduction >20.9%) than for the lower-tertile group (percent IOP reduction<12.9%; P = 0.016). The Cox proportional hazards model indicated that presence of disc hemorrhage was a factor associated with glaucoma progression (HR = 3.664; P = 0.001).
  
  
  CONCLUSIONS
  Lower-percent reduction in IOP was associated with NTG progression in eyes with myopic tilted discs, and the presence of disc hemorrhage was a risk factor for NTG progression.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.|Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Bo Ram
authors.initials: BR
authors.lastname: Seol
authors.affiliation: Department of Ophthalmology, Gyeonggi Province Medical Center Suwon Hospital, Suwon, Gyeonggi Province, Korea.
authors.forename: Soa
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.|Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Dong Myung
authors.initials: DM
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.|Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Ki Ho
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.|Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Jeoung
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. xcski@hanmail.net.|Department of Ophthalmology, Seoul National University Boramae Hospital, #425 Shindaebang-dong, Dongjak-gu, Seoul, 156-707, Korea. xcski@hanmail.net.
authors.forename: Seok Hwan
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D057066:Low Tension Glaucoma / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications* / Q000473:pathology; D009887:Ophthalmoscopy; D009898:Optic Disk / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D058609:Visual Field Tests; D014794:Visual Fields
chemical_list: D000959:Antihypertensive Agents
keywords: Glaucoma progression; Intraocular pressure; Myopic tilted disc; Normal-tension glaucoma; Risk factors