Comparison of Risk Factors for Bilateral and Unilateral Eye Involvement in Normal-Tension Glaucoma

Cinoo Kim, Tae-Woo Kim
2009 Investigative Ophthalmology and Visual Science  
PURPOSE. To compare the risk factors for bilateral and unilateral disease in normal-tension glaucoma (NTG). METHODS. The study analyzed data from consecutive NTG patients with either bilateral (n ϭ 194) or unilateral (n ϭ 193) disease. Multivariate regression models were used to evaluate the following potential risk factors for bilateral eye involvement: age, sex, central corneal thickness, mean deviation in standard automated perimetry, mean and fluctuation of diurnal intraocular pressure
more » ... cular pressure (IOP) without glaucoma medication, spherical equivalent, family history of glaucoma, and underlying systemic disease such as diabetes mellitus, hypertension, hypercholesterolemia, ischemic heart disease, previous cerebrovascular accident, migraine, and cold extremities. RESULTS. Multivariate analysis showed that worse mean deviation in the first affected eye (odds ratio [OR], 1.19/1 dB decrease; P Ͻ 0.001), diabetes mellitus (OR, 2.31; P ϭ 0.004), previous cerebrovascular accident (OR, 4.27; P ϭ 0.039), and mean IOP greater than 14 mm Hg in the less affected eye (OR, 1.66; P ϭ 0.030) were significantly associated with bilateral eye involvement in NTG. CONCLUSIONS. Besides being an indicator of disease severity (worse mean deviation), diabetes mellitus, previous cerebrovascular accident, and IOP were associated with bilateral eye involvement. These data suggest that systemic vascular factors and IOP play significant roles in the pathogenesis of NTG. It appears that although systemic vascular factors increase the susceptibility of the optic nerve, a certain level of pressureinduced stress is also required to cause glaucomatous optic neuropathy. (Invest Ophthalmol Vis Sci.
doi:10.1167/iovs.08-1886 pmid:18836170 fatcat:tcq33ismcnfppirgtkvqxj5ouy