Using the arteriolar Pressure Attenuation Index to predict ocular hypertension progression to open-angle glaucoma.

Journal Article (Journal Article)

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 5 to 18 years. Serial stereo color disc photographs and visual fields were analyzed to determine progression. RESULTS: At baseline, the arteriolar tree of 8 subjects with OHT that progressed to OAG (n = 8 eyes) demonstrated a 45.8% greater mean PAI value than that of 7 subjects who did not progress (n = 7 eyes) (mean +/- SEM, 5.31 +/- 0.93 vs 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.

Full Text

Duke Authors

Cited Authors

  • Cohen, SL; Lee, PP; Herndon, LW; Challa, P; Overbury, O; Allingham, RR

Published Date

  • January 2003

Published In

Volume / Issue

  • 121 / 1

Start / End Page

  • 33 - 38

PubMed ID

  • 12523882

International Standard Serial Number (ISSN)

  • 0003-9950

Digital Object Identifier (DOI)

  • 10.1001/archopht.121.1.33


  • eng

Conference Location

  • United States