| Relationship among Water-Shed Zone, Nocturnal Dip and Visual Field Progression in Open Angle Glaucoma. |
|
Hong Ryung Seo, Nam Yeong Kim, Sae Heun Rho |
1Department of Ophthalmology, Wallace Memorial Baptist Hospital, Busan, Korea.
2Department of Ophthalmology, Dong-A University College of Medicine, Busan, Korea. shrho@dau.ac.kr |
| 개방각녹내장에서 맥락막분수계역, 야간 혈압하강 및 녹내장성 시야결손의 상관관계 |
|
서홍융1⋅김남영2⋅노세현2 |
|
Department of Ophthalmology, Wallace Memorial Baptist Hospital1, Busan, Korea Department of Ophthalmology, Dong-A University College of Medicine2, Busan, Korea |
|
|
| Abstract |
PURPOSE
To investigate the influence of water-shed zone (WSZ) and nocturnal dip (ND) on the progression of the glaucomatous visual field (V/F) defects in open-angle glaucoma (OAG) patients when the intraocular pressure (IOP) was maintained under the target pressure. METHODS: We performed fluorescence angiography (FAG), 24-hour ambulatory blood pressure monitoring (24-hr ABPM), and V/F tests. We examined the relationships among WSZ in early-FAG, ND over 10% (dip), and the progression of the glaucomatous V/F defects using chi-square, Fisher's exact, and multivariate logistic regression tests. A p-value < 0.05 was considered statistically significant. RESULTS: When considering the correlation between WSZ and dip, statistical significance was found in OAG (p = 0.024, odds ratio (OR) = 3.308) and normal tension glaucoma (NTG) (p = 0.029, OR = 4.364) patients. In patients with dip, glaucomatous V/F defects significantly progressed (OAG: p = 0.003, OR = 5.938, NTG: p = 0.005, OR = 13.929). In patients with WSZ, the glaucomatous V/F defects progressed in all groups (OAG: p = 0.002, OR = 5.156, NTG: p = 0.024, OR = 4.750, primary open angle glaucoma (POAG): p = 0.021, OR = 8.750). In the patients with WSZ involving optic nerve head, the glaucomatous V/F defects had progressed in OAG (p = 0.004, OR = 5.958) and NTG (p = 0.009, OR = 8.333) groups. Based on binary logistic regression analysis, dip (p = 0.010, OR = 6.227) significantly affected V/F progression only in OAG patients. CONCLUSIONS: In the OAG and NTG groups, ND over 10% influenced the progression of the glaucomatous V/F defects. The patients with WSZ tended to have ND over 10% in OAG and NTG groups and glaucomatous V/F defects progressed in all patients. Therefore, performing early FAG and 24-hr ambulatory blood pressure monitoring may be helpful for glaucoma patients with progressing glaucomatous V/F defects even when the IOP was maintained under the target pressure. |
| Key Words:
Nocturnal dip;Progression of the glaucomatous visual field defects;Twenty-four-hour blood pressure monitoring;Vascular dysregulation;Water-shed zone |
|
PDF Links
Full text via DOI
Download Citation
