Intraocular pressure reflects as glaucomatous damage to macula: Study

USA: Structural and functional characteristics of the macula are more responsive to intraocular pressure (IOP) in terms of glaucomatous development, says an article published in the Journal of Glaucoma.

Angela Y. BA Chang and colleagues conducted this study with the goal of examining the correlations between intraocular pressure, self-reported systemic hypertension (HTN), and glaucoma development utilizing structural testing using optical coherence tomography (OCT) and functional testing with visual field analysis (VF).

A total of 191 eyes from 119 individuals with glaucoma who were engaged in a prospective, longitudinal research (Structural and Functional Progression of Glaucomatous Damage to the Macula Study) were studied. Patients were examined at 4 to 6-month intervals with 10-2 and 24-2 VF and spectral-domain OCT. IOP was collected at each visit. In the included patients, 72 eyes (37 percent) had self-reported HTN diagnoses. The connection between summary data from VF and OCT and HTN diagnosis was tested using linear mixed-effects regression. The Bayesian information criteria were used to measure the goodness-of-fit of relationships.

The key findings of this study were as follows:

1. The following OCT parameters were most related to mean follow-up IOP: inferior macula GCL, global macular ganglion cell layer (GCL), mean less vulnerable zone macula GCL, and mean macular vulnerability zone GCL, as well as the following VF parameters: 10-2 PSD and 10-2 MD.

2. There was no statistically significant difference in advancement rates between HTN and non-HTN patients for any OCT or VF measure.

3. The best goodness-of-fit models for the link between HTN and advancement were the same as those found for IOP.

In conclusion, macular structural and functional factors were shown to be more closely associated to pressure-dependent glaucoma than traditional parameters. HTN was not linked with structural or functional progression, while it was not connected with advancement using any measure, macular structural and functional metrics showed a higher goodness-of-fit to predict progression.

Reference:

Chang, A. Y., Tsamis, E., Blumberg, D. M., Al-Aswad, L. A., Cioffi, G. A., Hood, D. C., Liebmann, J. M., & De Moraes, C. G. (2022). The Role of Intraocular Pressure and Systemic Hypertension in the Progression of Glaucomatous Damage to the Macula. In Journal of Glaucoma (Vol. 31, Issue 5, pp. 317–321). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/ijg.0000000000002018