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Abstract #10508 Published in IGR 6-1
Five-year risk of progression of ocular hypertension to primary open angle glaucoma: a population-based study
Thomas R; Parikh R; George R; Kumar RS; Muliyil JIndian Journal of Ophthalmology 2003; 51: 329-333
PURPOSE: To report the progression of ocular hypertension (OHT) to primary open angle glaucoma (POAG) during a five-year follow up of a population-based sample. METHODS: Twenty-nine patients diagnosed to have OHT and 110 randomly selected normals from a population-based study in 1995 were invited for ocular examination in 2000. All patients underwent a complete ophthalmic examination; including the daytime diurnal variation of intraocular pressure (IOP) and measurement of central corneal thickness (CCT). The 'corrected' IOP was used for analysis. Progression to POAG was based on typical optic disc changes with corresponding field defects on automated perimetry. RESULTS: Twenty-five of the 29 persons with OHT who could be contacted were examined. After correcting for CCT, two persons were reclassified as normal. Four of 23 (17.4%; 95% CI: 1.95-32.75) had progressed to POAG. One person among the 110 normals progressed to normal tension glaucoma (NTG). The relative risk of progression amongst OHT was 19.1 (95% CI: 2.2-163.4). All those who progressed had bilateral OHT. The mean and peak IOP in those who progressed was 25.4 and 29.3 mmHg compared to 23.9 and 25.7 mmHg in those who did not. Those who progressed had more than 8 mmHg diurnal variation. The diurnal variation was less than 6 mmHg in those who did not progress. No patient developed blindness due to glaucoma. CONCLUSIONS: The five-year incidence of POAG amongst OHT in this population was 17.4% (3.5% per year). Bilateral OHT, higher peak IOP and large diurnal variation may be the risk factors for progression.
Dr. R. Thomas, LV Prasad Eye Institute, Vellore, India. ravithomas@lvpei.org
Classification:
9.2.1 Ocular hypertension (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
