Navigation Links
Fluctuating eye pressure associated with visual field deterioration in glaucoma patients
Date:8/13/2007

Fluctuations in eye pressure may be associated with a decreasing peripheral field of vision in patients with glaucoma, even if their eye pressure remains low overall, according to a report in the August issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Prevention of further visual field deterioration is a goal of glaucoma therapy, the authors write as background information in the article. Previous studies reported that lowering intraocular pressure (IOP) slowed the advancement of visual field damage in patients with glaucoma. However, even if the IOP can be substantially lowered, reduction of mean [average] and peak IOP does not always prevent progressive visual field deterioration.

Samin Hong, M.D., and colleagues at the Yonsei University College of Medicine, Seoul, Korea, studied 408 eyes of patients (average age 66.5 years) who had undergone a triple procedure to treat glaucoma: phacoemulsification, that involves dissolving and removing the lens; posterior chamber intraocular lens implantation; and trabeculectomy, also known as filtration surgery. All patients had a low IOP after surgery (below 18 milligrams of mercury). Measurements of IOP and visual field were taken for an average of 9.2 years following surgery. Based on the standard deviation (difference from the average) in IOP, the eyes were split into two groups, one with greater fluctuation and one with less.

Throughout the follow-up period, the two groups had the same average IOP, and their visual fields were the same after three months. However, after the last follow-up examination13 years laterthe visual field was significantly worse in the group with greater fluctuation in IOP. The number of patients with progressive visual field loss was significantly larger in the group with more fluctuation.

Our results suggest that glaucomatous visual field damage cannot be stabilized by only lowering the postoperative IOP but also requires reducing the long-term fluctuation of the post-operative IOP, the authors conclude.

(Arch Ophthalmol. 2007;125(8):1010-1013. Available pre-embargo to the media at www.jamamedia.org.)

Editors Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.


Editorial: Pressure Modulation May Help Preserve Vision Fluctuations in IOP have been pinpointed as a potential cause for glaucoma and a factor in worsening the eye damage caused by the disease, writes Joseph Caprioli, M.D., of the Jules Stein Eye Institute, UCLA, in an accompanying editorial.

Why should IOP fluctuation be damaging" Theories abound about the mechanisms of retinal ganglion cell damage in glaucoma, but no single cellular or molecular cause satisfactorily explains the condition in all patients, Dr. Caprioli writes. Long-term variability may disrupt homeostatic mechanisms. Irregular and large IOP fluctuations may cause a loading and unloading of stresses, and as opposed to conditions of static stress, the tissue is unable to compensate and damage occurs.

I would propose for your consideration IOP modulation rather than IOP reduction as appropriate treatment, he concludes. This would not only lead to robust IOP reduction in patients with advancing disease but also establish the goal of reducing IOP fluctuation, particularly in patients with disease progression even at lower pressures. Specific guidelines, however, must await a better understanding of the pathophysiologic consequences of IOP fluctuation in glaucoma.


'/>"/>
Contact: Young Jae Hong, M.D., Ph.D.
yjhong0815@yumc.yonsei.ac
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Fluctuating BP and Stroke Lowered Patient Survival Rate
2. Spouses and other partners lower blood pressure says new research
3. H2O - a cure for low blood pressure
4. Uncontrolled blood pressure
5. Nitric oxide involved in high blood pressure
6. Way to monitor blood pressure
7. Pressure on spine cause problems
8. Aggressive blood pressure treatment needed
9. Blood Pressure Drug may slow wasting in burn victims
10. Borderline blood pressure- possible health risk
11. Patients Pressure Would Result In Overprescription
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/22/2017)... ... May 22, 2017 , ... An inventor from Columbia, S.C., ... pen. "My wife’s hand was damaged in a firework accident, so she couldn’t grip ... with manual problems." , He then designed and created a prototype for the HELPEN ...
(Date:5/22/2017)... Peoria, IL (PRWEB) , ... May 22, 2017 ... ... HealthCare, is part of a larger group investing in InsightRX, an early stage ... a patient’s underlying biological and pharmacological characteristics. Greatpoint Ventures Innovation Fund ...
(Date:5/21/2017)... ... May 20, 2017 , ... Pot. Reefer. Grass. Mary Jane. No matter ... share its attributes like never before. More than a map, new social marketplace ... stores, strains, products – and for the first time – each other. A social ...
(Date:5/21/2017)... ... May 21, 2017 , ... Dental visits ... six months since you've seen a dentist, it's time for a dental checkup. ... x-rays once per year. , Dental checkups are a relatively easy procedure that ...
(Date:5/19/2017)... ... ... Springfield, Vermont-based law firm of Brady/Callahan has released a new Personal Injury law ... Personal Injury Attorney, " the article offers insight for people who have questions, concerns ... someone is injured due to another person's negligence, they may want to ...
Breaking Medicine News(10 mins):
(Date:5/4/2017)... 4, 2017  Fortuna Fix Inc. (" Fortuna "), ... first to eliminate the need for embryonic and fetal stem ... neurodegenerative diseases. Fortuna announced today the ... Michael Fehlings , MD, PhD; Father Kevin FitzGerald , ... and Professor James Giordano , PhD. "We ...
(Date:5/4/2017)... 4, 2017  A new tight-tolerance microextrusion medical ... highly-engineered materials, is being launched by Natvar, a ... developed in recent years to service a wide ... applications. More expensive materials such as glass and ... due to their ability to consistently hold tolerances. ...
(Date:5/3/2017)... 3, 2017  West Pharmaceutical Services, Inc. (NYSE: ... injectable drug administration, announced today that Fran ... Services, and Diane Paskiet , Director, Scientific ... focused on West,s expertise in the areas of ... as providing commentary on updated industry guidance. ...
Breaking Medicine Technology: