Risk Factors for Progression of Glaucoma Confirmed

Brian Hoyle

October 31, 2011

October 31, 2011 (Orlando, Florida) — Patients with glaucoma and elevated intraocular pressure (IOP) and splinter-type disc hemorrhage are more apt to experience progressive worsening of their condition. The confirmation of these risk factors could be valuable in designing interventions to help reduce progression of glaucoma in these patients, Spanish researchers announced here at the American Academy for Ophthalmology (AAO) 2011 Annual Meeting.

The poster presenter was José Martinez de la Casa, MD, Department of Ophthalmology, Hospital Clínico San Carlos in Madrid, Spain.

"Evaluating progression of glaucoma and estimating the rate of change are some of the most important challenges in the care of patients with glaucoma. It is still unclear whether fluctuations in IOP and central corneal thickness are related to progression. Myopia and optic disc haemorrhages may be associated with the progression of glaucoma," the researchers report in the poster.

PROGREX, an epidemiologic, cross-sectional, descriptive study, was undertaken at several medical centers in Spain to evaluate the rate of disease progression from diagnosis in 1318 patients (662 women, 656 men) age 18 years or older (mean age, 64 years) with open-angle glaucoma (n = 977) or ocular hypertension (n = 341) and to assess the correlation of risk factors with progression.

Glaucoma was predominantly the single primary open-angle variety (n = 879 [67%]). Progression according to Early Manifest Glaucoma Trial criteria occurred in 44% of patients with glaucoma and 21% of those with ocular hypertension.

The major factors associated with progression were an IOP of 21 mm Hg or higher at the time of diagnosis (P < .04) and presence of splinter-type hemorrhage (P < .01). Age and sex were not significant.

Patients who progressed were also more likely to have high blood pressure (33%) and elevated lipids in the blood (15%).

"Identifying risk factors and achieving adequate target IOP for each patient may help to reduce the high rates of progression of patients with glaucoma and ocular hypertension," the researchers concluded in their poster.

"This is a well-done study. While it adds nothing novel to the collective knowledge concerning glaucoma and ocular hypertension, it confirms previous information, which makes these findings important," Herbert Kaufman, MD, professor of ophthalmology, pharmacology, and microbiology emeritus, Louisiana State Medical School, New Orleans, told Medscape Medical News.

Funding for the study was provided by Pfizer. Dr. Martinez de la Casa and Dr. Kaufman have not disclosed any relevant financial relationships.

American Academy for Ophthalmology (AAO) 2011 Annual Meeting; Abstract PO124. Presented on October 23, 2011.