Clinical factors associated with progression of glaucomatous optic disc damage in treated patients

Gülgün Tezel, Kim D. Siegmund, Kathryn Trinkaus, Martin B. Wax, Michael A. Kass, Allan E. Kolker

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Background: Reducing intraocular pressure (IOP) in glaucomatous eyes does not always prevent disease progression. Objective: To determine the clinical factors associated with progressive optic disc damage in glaucomatous eyes receiving treatment to reduce IOP. Methods: Baseline and follow-up optic disc photographs as well as demographic and clinical data were retrospectively studied in 186 eyes of 93 patients with primary open-angle glaucoma, and in 138 eyes of 69 patients with normal-pressure glaucoma. The patients with primary open-angle glaucoma were included in the study only if their treated IOPs during a follow-up period of 5 years were less than 21 mm Hg. The patients with normal-pressure glaucoma were included only if their IOPs were reduced by at least 20% during the follow-up period. The association of progressive optic disc damage with patient- and eye-specific characteristics was examined using multivariate analysis. Results: During the 5-year study period, 141 (43.5%) of the 324 eyes exhibited progressive optic disc damage defined by at least a 5% decrease in the neural rim area-to-disc area ratio. Using multivariate analysis, the following were found to be strongly associated with progressive neural rim damage: a baseline smaller neural rim area-disc area ratio (P<.001); a baseline larger zone β area-disc area ratio (P = .04); a baseline larger parapapillary atrophy length-disc circumference ratio (P = .05); a diagnosis of normal-pressure glaucoma (P = .01); and combined medical and surgical treatment prior to the study period (P = .01). Conclusions: Clinical factors other than IOP may be important indicators of subsequent progression of glaucomatous optic disc damage. Our findings suggest that eyes with advanced glaucomatous optic disc damage and normal-pressure glaucoma are more likely to progress despite receiving treatment to reduce IOP.

Original languageEnglish (US)
Pages (from-to)813-818
Number of pages6
JournalArchives of Ophthalmology
Volume119
Issue number6
StatePublished - 2001

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Optic Disk
Intraocular Pressure
Glaucoma
Pressure
Multivariate Analysis
Atrophy
Disease Progression
Therapeutics
Demography

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Tezel, G., Siegmund, K. D., Trinkaus, K., Wax, M. B., Kass, M. A., & Kolker, A. E. (2001). Clinical factors associated with progression of glaucomatous optic disc damage in treated patients. Archives of Ophthalmology, 119(6), 813-818.

Clinical factors associated with progression of glaucomatous optic disc damage in treated patients. / Tezel, Gülgün; Siegmund, Kim D.; Trinkaus, Kathryn; Wax, Martin B.; Kass, Michael A.; Kolker, Allan E.

In: Archives of Ophthalmology, Vol. 119, No. 6, 2001, p. 813-818.

Research output: Contribution to journalArticle

Tezel, G, Siegmund, KD, Trinkaus, K, Wax, MB, Kass, MA & Kolker, AE 2001, 'Clinical factors associated with progression of glaucomatous optic disc damage in treated patients', Archives of Ophthalmology, vol. 119, no. 6, pp. 813-818.
Tezel G, Siegmund KD, Trinkaus K, Wax MB, Kass MA, Kolker AE. Clinical factors associated with progression of glaucomatous optic disc damage in treated patients. Archives of Ophthalmology. 2001;119(6):813-818.
Tezel, Gülgün ; Siegmund, Kim D. ; Trinkaus, Kathryn ; Wax, Martin B. ; Kass, Michael A. ; Kolker, Allan E. / Clinical factors associated with progression of glaucomatous optic disc damage in treated patients. In: Archives of Ophthalmology. 2001 ; Vol. 119, No. 6. pp. 813-818.
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AB - Background: Reducing intraocular pressure (IOP) in glaucomatous eyes does not always prevent disease progression. Objective: To determine the clinical factors associated with progressive optic disc damage in glaucomatous eyes receiving treatment to reduce IOP. Methods: Baseline and follow-up optic disc photographs as well as demographic and clinical data were retrospectively studied in 186 eyes of 93 patients with primary open-angle glaucoma, and in 138 eyes of 69 patients with normal-pressure glaucoma. The patients with primary open-angle glaucoma were included in the study only if their treated IOPs during a follow-up period of 5 years were less than 21 mm Hg. The patients with normal-pressure glaucoma were included only if their IOPs were reduced by at least 20% during the follow-up period. The association of progressive optic disc damage with patient- and eye-specific characteristics was examined using multivariate analysis. Results: During the 5-year study period, 141 (43.5%) of the 324 eyes exhibited progressive optic disc damage defined by at least a 5% decrease in the neural rim area-to-disc area ratio. Using multivariate analysis, the following were found to be strongly associated with progressive neural rim damage: a baseline smaller neural rim area-disc area ratio (P<.001); a baseline larger zone β area-disc area ratio (P = .04); a baseline larger parapapillary atrophy length-disc circumference ratio (P = .05); a diagnosis of normal-pressure glaucoma (P = .01); and combined medical and surgical treatment prior to the study period (P = .01). Conclusions: Clinical factors other than IOP may be important indicators of subsequent progression of glaucomatous optic disc damage. Our findings suggest that eyes with advanced glaucomatous optic disc damage and normal-pressure glaucoma are more likely to progress despite receiving treatment to reduce IOP.

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