Anmeldung zur Tagung
Registration
Grußwort
Invitation
Themen
Topics
Allgemeiner Ablauf
General overview
Wissenschaftliches Programm
Scientific program
Kurse
Courses
Symposien
Symposiums
Frühstück mit Spezialisten
Breakfast with specialists
Arzthelferinnen-Fortbildung
Rahmenprogramm
Social program
DOG Information
DOG Information
Allgemeine Informationen
General Information
Autorenindex
Index of Authors
Ausstellerliste
Exhibitors
Sponsoren
Sponsors
Teilnahmegebühren
Registration fees
Impressum
Non-Morphological Risk Factors for Progressive Glaucomatous Optic Nerve Head Changes in Normal-Pressure Glaucoma
1Nestel A., 2Budde W. M., 2Hayler J., 3Martus P., 1Jonas J. B.
1Department of Ophthalmology and Eye Hospital, Faculty of Clinical Medicine Mannheim, University of Heidelberg, 68167 Mannheim, Germany; 2Department of Ophthalmology and Eye Hospital, University Erlangen- Nürnberg, Erlangen, Germany; 3Institute for Medical Informatics, Biometry, and Epidemiology, FU Berlin, Klinikum Benjamin Franklin, Berlin, Germany
Purpose: To evaluate which parameters besides morphologic feautures
of the optic disc are risk factors for progressive optic nerve head changes
in normal-pressure glaucoma.
Methods: The prospective clinical observational study included
94 eyes of 60 Caucasian patients with normal-pressure glaucoma. All patients
underwent repeated qualitative and morphometric evaluation of color stereo
optic disc photographs. Progression of glaucoma was defined as loss of
neuroretinal rim or, taken as a sperate subgroup, as presence of optic
disc hemorrhages. Mean follow-up time was 23.78 ± 15.92 months.
Results: Progression of glaucomatous optic nerve changes was detected
in 63 eyes (63/94=67.0%). At baseline of the study, mean minimal intraocular
pressure readings were significantly higher (P=0.002), age was significantly
(P=0.02) more advanced, and visual field loss variance was significantly
(P=0.02) more progressed. The group of eyes with eventual progression
and the group of eyes without progression did not vary significantly in
refractive error (P=0.30), mean maximal intraocular pressure (P=0.28),
the frequency of diabetes mellitus (P=1.00), arterial hypertension (P=0.77),
and a positive family history of glaucoma (P=0.82), and the mean visual
field loss (P=0.54).
Conclusions: Most important non-morphologic risk factors for progression
of the glaucomatous appearance of the optic nerve head in patients with
normal-pressure glaucoma are the minimal intraocular pressure measurements
and age. The minimal intraocular pressure readings may be more important
than the maximal intraopcular pressure measurements in determing the risk
for progression of normal-pressure glaucoma. Presence of diabetes mellitus,
artrrialhypertension and a positive family of glaucoma may not be major
risk factors for the progression of normal-pressure glaucoma.