학술논문

Effect of quantitative intraocular pressure reduction on visual field defect progression in normal tension glaucoma under medical therapy applying Markov model
Document Type
article
Source
Clinical Ophthalmology, Vol Volume 12, Pp 1617-1624 (2018)
Subject
normal tension glaucoma
visual field defect (VFD) progression
long-term follow-up
intraocular pressure reduction
Markov model
Ophthalmology
RE1-994
Language
English
ISSN
1177-5483
Abstract
Keiji Yoshikawa,1 Kazunori Santo,2 Hiroko Hizaki,2 Masayo Hashimoto2 1Yoshikawa Eye Clinic, Machida, Tokyo, Japan; 2Japan Medical Affairs, Santen Pharmaceutical Co., Ltd, Osaka, Japan Purpose: To quantitatively evaluate the association of intraocular pressure (IOP) reduction with visual field defect (VFD) progression in normal tension glaucoma (NTG) under medical therapy. Patients and methods: Clinical data for 622 eyes of 311 primary open-angle glaucoma and NTG patients were collected from April 2006 to March 2016. Of these patients, those with normal IOP, glaucomatous VFD by Anderson’s criteria, corrected visual acuity ≥0.7, >5 years of medical therapy, ≥5 visual field tests at least five times at 12-month intervals, visual field testing reliability coefficients of ≤33%, and mean deviation (MD) exceeding below -20 dB in the initial visual field test were included in this retrospective data analysis. MD and IOP data were collected at baseline and after 5 years. Following MD categorization into stages I to IV, stage transition matrices were generated using a Markov model to evaluate VFD changes. Eyes were divided based on IOP reduction (0%, 10%, 15%, 20%, 25%, 30%) from baseline. VFD aggravations were compared using the Markov model and MD slopes with IOP reduction rates as cutoff values. Results: Overall, 132 eyes of 132 NTG patients fulfilled the eligibility criteria. MD decreased significantly (P