Skip to main content
Journal cover image

Corneal Biomechanics and Visual Field Progression in Eyes with Seemingly Well-Controlled Intraocular Pressure.

Publication ,  Journal Article
Susanna, BN; Ogata, NG; Jammal, AA; Susanna, CN; Berchuck, SI; Medeiros, FA
Published in: Ophthalmology
December 2019

PURPOSE: To investigate the incidence and risk factors for glaucomatous visual field progression in eyes with well-controlled intraocular pressure (IOP). DESIGN: Prospective cohort. PARTICIPANTS: A total of 460 eyes of 334 patients with glaucoma under treatment. METHODS: Study subjects had a mean follow-up of 4.3±0.8 years. Patients were classified as well controlled if all IOP measurements were less than 18 mmHg. Rates of visual field progression were calculated using ordinary least-squares linear regression of standard automated perimetry (SAP) mean deviation (MD) values over time. Progression was defined as a significantly negative MD slope (alpha = 0.05). MAIN OUTCOME MEASURES: Rates of SAP MD change; mean and peak IOP, and IOP fluctuation; and corneal biomechanics: corneal hysteresis (CH), central corneal thickness (CCT), and corneal index. RESULTS: Of the 179 eyes with well-controlled IOP, 42 (23.5%) demonstrated visual field progression. There was no significant difference between progressing and stable patients in baseline MD (-6.4±7.1 decibels [dB] vs. -6.0±6.2 dB; P = 0.346), mean IOP (11.7±2.0 mmHg vs. 12.1±2.3 mmHg; P = 0.405), IOP fluctuation (1.6±0.6 mmHg vs. 1.6±0.5 mmHg; P = 0.402), or peak IOP (14.3±1.9 mmHg vs. 14.6±2.1 mmHg; P = 0.926). Progressing eyes had significantly lower CH (8.6±1.3 mmHg vs. 9.4±1.6 mmHg; P = 0.014) and thinner CCT (515.1±33.1 μm vs. 531.1±42.4 μm; P = 0.018, respectively) compared with stable eyes. In the multivariate analysis, a 1 standard deviation lower corneal index, a summation of normalized versions of CH and CCT, resulted in a 68% higher risk of progression (odds ratio, 1.68; 95% confidence interval, 1.08-2.62; P = 0.021). CONCLUSIONS: Approximately one-quarter of eyes with well-controlled IOP may show visual field progression over time. Thin cornea and low CH are main risk factors.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

December 2019

Volume

126

Issue

12

Start / End Page

1640 / 1646

Location

United States

Related Subject Headings

  • Visual Fields
  • Vision Disorders
  • Risk Factors
  • Prospective Studies
  • Optic Nerve Diseases
  • Ophthalmology & Optometry
  • Middle Aged
  • Male
  • Intraocular Pressure
  • Incidence
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Susanna, B. N., Ogata, N. G., Jammal, A. A., Susanna, C. N., Berchuck, S. I., & Medeiros, F. A. (2019). Corneal Biomechanics and Visual Field Progression in Eyes with Seemingly Well-Controlled Intraocular Pressure. Ophthalmology, 126(12), 1640–1646. https://doi.org/10.1016/j.ophtha.2019.07.023
Susanna, Bianca N., Nara G. Ogata, Alessandro A. Jammal, Carolina N. Susanna, Samuel I. Berchuck, and Felipe A. Medeiros. “Corneal Biomechanics and Visual Field Progression in Eyes with Seemingly Well-Controlled Intraocular Pressure.Ophthalmology 126, no. 12 (December 2019): 1640–46. https://doi.org/10.1016/j.ophtha.2019.07.023.
Susanna BN, Ogata NG, Jammal AA, Susanna CN, Berchuck SI, Medeiros FA. Corneal Biomechanics and Visual Field Progression in Eyes with Seemingly Well-Controlled Intraocular Pressure. Ophthalmology. 2019 Dec;126(12):1640–6.
Susanna, Bianca N., et al. “Corneal Biomechanics and Visual Field Progression in Eyes with Seemingly Well-Controlled Intraocular Pressure.Ophthalmology, vol. 126, no. 12, Dec. 2019, pp. 1640–46. Pubmed, doi:10.1016/j.ophtha.2019.07.023.
Susanna BN, Ogata NG, Jammal AA, Susanna CN, Berchuck SI, Medeiros FA. Corneal Biomechanics and Visual Field Progression in Eyes with Seemingly Well-Controlled Intraocular Pressure. Ophthalmology. 2019 Dec;126(12):1640–1646.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

December 2019

Volume

126

Issue

12

Start / End Page

1640 / 1646

Location

United States

Related Subject Headings

  • Visual Fields
  • Vision Disorders
  • Risk Factors
  • Prospective Studies
  • Optic Nerve Diseases
  • Ophthalmology & Optometry
  • Middle Aged
  • Male
  • Intraocular Pressure
  • Incidence