Duration 5min, Q&A 3min
Seasonal Observations in Transient Elevation of Intraocular Pressure in Primary Open-Angle Glaucoma Patients after Automated Visual Field Examination
To evaluate seasonal fluctuations of transient intraocular pressure (IOP) elevation after automated visual field examination in patients with primary open-angle glaucoma (POAG), retrospectively.
We reviewed 53 consecutive patients, age 67.7±11.2 years, 21 males and 32 females, with POAG who visited at Kaimeido Ophthalmic and Dental Clinic. All patients enrolled in this study were required to have at least one reliable automated visual field examination from January 2011 to March 2013.
Both eyes of all patients were enrolled and the month of automated visual field examination was split into 4 seasonal groups , spring (April, May, June), summer (July, August), autumn (September, October, November), winter (December, January, February, March) according to the average outdoor air temperature in Sapporo Japan. IOP was measured immediately after automated visual field examination(vf IOP) and compared with the average IOP from previous 3 months (pre IOP) and with the average IOP from next 3 months (post IOP) in each season(paired t test). After IOP elevation rate was defined as (vf IOP-pre IOP)/pre IOP×100% and calculated, the relationship between mean deviation (MD) and IOP elevation rate was also evaluated (single regression analysis). All patients had stable IOP and were using same local medication to treat glaucoma without intervening changes in glaucoma therapy management during this study. Exclusion criteria were patients who received cataract surgery during this study and patients with a history of any previous glaucoma surgery. The automated visual field examination was performed with a Humphrey field analyzer and the Central 30-2 threshold program (FASTPAC).
Results and Conclusion
The average vf IOP was 14.5±2.5mmHg, higher than pre IOP 13.8±2.4mmHg(p<0.0001) and post IOP 13.8±2.2mmHg(p<0.0001) respectively. There was no statistically difference between pre IOP and post IOP (p=0.88). Only in the winter, there was statistically difference between pre IOP and vf IOP(n=38, p<0.0001), but not in other seasons, spring (n=22, p=0.18), summer (n=16, p=1.0), autumn (n=30. P=0.11). IOP elevation rate in each season was 4.1±11.6% in spring, 0.1±9.9% in summer, 5.0±13.8% in autumn, 10.6±8.8% in winter. There was no statistically significance between the MD and IOP elevation rate in each season (p=0.28, 0.31, 0.11, 0.63). In conclusion, this retrospective study suggests that patients with POAG show a transient IOP elevation after automated visual field examination, especially in the winter but not in other seasons.
[ Keyword ]
Primary open-angle glaucoma (POAG), Automated visual field examination, Transient IOP elevation, Seasonal fluctuations of IOP
[ Conflict of Interest ]