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Abstract #8460 Published in IGR 5-1
Using the arteriolar Pressure Attenuation Index to predict ocular hypertension progression to open-angle glaucoma
Cohen SL; Lee PP; Herndon LW; Challa P; Overbury O; Allingham RRArchives of Ophthalmology 2003; 121: 33-38
BACKGROUND: Vascular phenomena are considered important to optic nerve and visual field progression in open-angle glaucoma (OAG). A recently described formulation, the Pressure Attenuation Index (PAI), links arteriolar caliber variations to pressure loss along the retinal arteriolar system. OBJECTIVE: To examine whether the PAI could predict ocular hypertension (OHT) progression to OAG. METHODS: The PAI was calculated for 27 eyes of 14 patients with OHT using initial and final digitized optic disc photographs taken during a follow-up interval of five to 18 years. Serial stereo color disc photographs and visual fields were analyzed to determine progression. RESULTS: At baseline, the arteriolar tree of eight subjects with OHT that progressed to OAG (n = 8 eyes) demonstrated a 45.8% greater mean PAI value than that of seven subjects who did not progress (n = 7 eyes) (mean ± SEM, 5.31 ± 0.93 versus 3.64 ± 0.34; r = 0.83). Progression was independent of baseline cup-disc ratio. The PAI values of subjects with stable OHT remained stable after a median follow-up interval of 12.0 years. The PAI values of subjects with OHT that progressed demonstrated a further increase of 19.97 ± 11.24% during a median follow-up period of 6.0 years. CONCLUSIONS: The results support the hypothesis that low end-arteriolar pressure predicts the progression from OHT to OAG. The PAI provides a new, early, reproducible, and physiological method to study vascular phenomena in glaucoma.
Dr. S.L. Cohen, Department of Ophthalmology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada. v.cohen@sympatico.ca
Classification:
9.2.2 Other risk factors for glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
