Glaucomatous Optic Nerve Head Progression and its Risk Factor in Glaucoma:Longitudinal Study of Heidelberg Retina Tomograph

ABSTRACT

This study evaluated the risk factor of glaucoma progression despite of adequate intraocular pressure[IOP]and that of glaucomatous optic nerve head progression before visual field progression with minimum treatment regimen. Inclusion criteria included subjects with elevated intraocular pressure and glaucomatous optic nerve head in fundus examination. Patients were main-tained their IOP by medication or filtering surgery. Baseline assessment included routine ocular examination, Heidelberg Retina Tomograph[HRT]and visual field. All patients were reexamined 6 months after the first examina-tion. We review the results of 61 patients[118 eyes]. In multiple logistic regression analysis, the risk factors of glaucoma progression were age[p=0.027] and the intraocular pressure at the first HRT examination[p=0.0216]. Glaucomatous visual field progression correlated significantly with HRT progres-sion[p=0.0216]. If the early glaucoma progression is detected with HRT, progression of glaucoma can be prevented. In the groups with the risk factors, the target pressure should be lower to prevent further loss or blindness with agressive treatment. In groups without risk factor, the quality of patient's life can be improved with minimum treatment. We may be able to prevent the progression of glaucomatous field defect, if we can recognize the early change of their optic nerve head morphology. Their findings may help us to differentiate non-risk group from risk group. We hope that we would improve our patient's life quality by minimizing glaucoma treatment especially in the non-risk group.