Central visual field progression in normal-tension glaucoma patients with autonomic dysfunction

To investigate the characteristics of visual field (VF) progression in normal-tension glaucoma (NTG) patients with autonomic dysfunction. Forty-eight NTG eyes with more than seven VF tests during at least 5 years of follow-up were analyzed retrospectively. All participants were referred to rheumatol...

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Veröffentlicht in:Investigative ophthalmology & visual science 2014-04, Vol.55 (4), p.2557-2563
Hauptverfasser: Park, Hae-Young Lopilly, Park, Sung-Hwan, Park, Chan Kee
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Park, Chan Kee
description To investigate the characteristics of visual field (VF) progression in normal-tension glaucoma (NTG) patients with autonomic dysfunction. Forty-eight NTG eyes with more than seven VF tests during at least 5 years of follow-up were analyzed retrospectively. All participants were referred to rheumatology, where they were subjected to heart-rate variability assessment. Patients were classified into the lowest and highest heart-rate variability groups according to the SD value of the qualified normal-to-normal intervals of the heart-rate-variability assessment. The VF was divided into central and peripheral regions and further classified into superior and inferior regions. Groups in the lowest and highest heart-rate variability groups were compared in terms of rates of change in the mean thresholds of each designated region by using a linear mixed model. Potential clinical factors associated with central VF progression were also investigated. The baseline VF showed similar stages of glaucoma damage between the lowest and highest heart-rate variability groups. The mean global rate of VF changes was similar between the two groups. Only the rate of VF changes in the central and superior central regions were significantly different between the lowest heart-rate variability group (-1.16 dB/year in the central region and -1.48 dB/year in the superior central region) and highest heart-rate variability group (-0.52 dB/year in the central region and -0.64 dB/year in the superior central region). Baseline VF pattern SD (β = -1.160, P = 0.008), migraine (β = 1.380, P = 0.040), orthostatic hypotension (β = 1.146, P = 0.023), and lower heart-rate variability (β = -1.516, P = 0.010) were significantly associated with central VF progression. NTG patients with lower heart-rate variability, which reflects autonomic dysfunction with sympathetic predominance, presented faster rate of central VF progression than patients with higher heart-rate variability. Intraocular pressure-independent risk factors, such as migraine, orthostatic hypotension, and autonomic dysfunction, were related to central VF progression.
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Forty-eight NTG eyes with more than seven VF tests during at least 5 years of follow-up were analyzed retrospectively. All participants were referred to rheumatology, where they were subjected to heart-rate variability assessment. Patients were classified into the lowest and highest heart-rate variability groups according to the SD value of the qualified normal-to-normal intervals of the heart-rate-variability assessment. The VF was divided into central and peripheral regions and further classified into superior and inferior regions. Groups in the lowest and highest heart-rate variability groups were compared in terms of rates of change in the mean thresholds of each designated region by using a linear mixed model. Potential clinical factors associated with central VF progression were also investigated. The baseline VF showed similar stages of glaucoma damage between the lowest and highest heart-rate variability groups. The mean global rate of VF changes was similar between the two groups. Only the rate of VF changes in the central and superior central regions were significantly different between the lowest heart-rate variability group (-1.16 dB/year in the central region and -1.48 dB/year in the superior central region) and highest heart-rate variability group (-0.52 dB/year in the central region and -0.64 dB/year in the superior central region). Baseline VF pattern SD (β = -1.160, P = 0.008), migraine (β = 1.380, P = 0.040), orthostatic hypotension (β = 1.146, P = 0.023), and lower heart-rate variability (β = -1.516, P = 0.010) were significantly associated with central VF progression. NTG patients with lower heart-rate variability, which reflects autonomic dysfunction with sympathetic predominance, presented faster rate of central VF progression than patients with higher heart-rate variability. 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Forty-eight NTG eyes with more than seven VF tests during at least 5 years of follow-up were analyzed retrospectively. All participants were referred to rheumatology, where they were subjected to heart-rate variability assessment. Patients were classified into the lowest and highest heart-rate variability groups according to the SD value of the qualified normal-to-normal intervals of the heart-rate-variability assessment. The VF was divided into central and peripheral regions and further classified into superior and inferior regions. Groups in the lowest and highest heart-rate variability groups were compared in terms of rates of change in the mean thresholds of each designated region by using a linear mixed model. Potential clinical factors associated with central VF progression were also investigated. The baseline VF showed similar stages of glaucoma damage between the lowest and highest heart-rate variability groups. The mean global rate of VF changes was similar between the two groups. Only the rate of VF changes in the central and superior central regions were significantly different between the lowest heart-rate variability group (-1.16 dB/year in the central region and -1.48 dB/year in the superior central region) and highest heart-rate variability group (-0.52 dB/year in the central region and -0.64 dB/year in the superior central region). Baseline VF pattern SD (β = -1.160, P = 0.008), migraine (β = 1.380, P = 0.040), orthostatic hypotension (β = 1.146, P = 0.023), and lower heart-rate variability (β = -1.516, P = 0.010) were significantly associated with central VF progression. NTG patients with lower heart-rate variability, which reflects autonomic dysfunction with sympathetic predominance, presented faster rate of central VF progression than patients with higher heart-rate variability. Intraocular pressure-independent risk factors, such as migraine, orthostatic hypotension, and autonomic dysfunction, were related to central VF progression.</description><subject>Autonomic Nervous System Diseases - complications</subject><subject>Autonomic Nervous System Diseases - physiopathology</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Intraocular Pressure</subject><subject>Low Tension Glaucoma - complications</subject><subject>Low Tension Glaucoma - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><subject>Visual Field Tests</subject><subject>Visual Fields - physiology</subject><issn>1552-5783</issn><issn>1552-5783</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkE1PwzAMhiMEYmNw5Ipy5NIRO23THdHElzSJC5yjJEtHUJuMJh3av6f7AHF6LfuxZT2EXAObApTizoVNnALPgIscT8gYigKzQlT89F89IhcxfjKGAMjOyQjzcoaA5ZjIufWpUw3duNgPUTvbLOm6C6vOxuiCp85TH7pWNVmyft9ZNao3oVV0rZIb1iP9dumDqj4FH1pn6HIb696bNMCX5KxWTbRXx5yQ98eHt_lztnh9epnfLzKDM54yKwzXdaGsBgVaMVbkAniltGZ1MRO5Rg5oKysQBAoLyI02jNc5MjaMFZ-Q28Pd4fWv3sYkWxeNbRrlbeijhAKqEpHPYECzA2q6EGNna7nuXKu6rQQmd07lzqkELvdOB_7meLrXrV3-0b8S-Q9tynRm</recordid><startdate>20140421</startdate><enddate>20140421</enddate><creator>Park, Hae-Young Lopilly</creator><creator>Park, Sung-Hwan</creator><creator>Park, Chan Kee</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140421</creationdate><title>Central visual field progression in normal-tension glaucoma patients with autonomic dysfunction</title><author>Park, Hae-Young Lopilly ; Park, Sung-Hwan ; Park, Chan Kee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c293t-e7c3bf5aeb1a1ba00547138abb0f5974b2312e8e721727e123cbc03f4200974a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Autonomic Nervous System Diseases - complications</topic><topic>Autonomic Nervous System Diseases - physiopathology</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Intraocular Pressure</topic><topic>Low Tension Glaucoma - complications</topic><topic>Low Tension Glaucoma - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><topic>Visual Field Tests</topic><topic>Visual Fields - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Hae-Young Lopilly</creatorcontrib><creatorcontrib>Park, Sung-Hwan</creatorcontrib><creatorcontrib>Park, Chan Kee</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Investigative ophthalmology &amp; visual science</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Hae-Young Lopilly</au><au>Park, Sung-Hwan</au><au>Park, Chan Kee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Central visual field progression in normal-tension glaucoma patients with autonomic dysfunction</atitle><jtitle>Investigative ophthalmology &amp; visual science</jtitle><addtitle>Invest Ophthalmol Vis Sci</addtitle><date>2014-04-21</date><risdate>2014</risdate><volume>55</volume><issue>4</issue><spage>2557</spage><epage>2563</epage><pages>2557-2563</pages><issn>1552-5783</issn><eissn>1552-5783</eissn><abstract>To investigate the characteristics of visual field (VF) progression in normal-tension glaucoma (NTG) patients with autonomic dysfunction. Forty-eight NTG eyes with more than seven VF tests during at least 5 years of follow-up were analyzed retrospectively. All participants were referred to rheumatology, where they were subjected to heart-rate variability assessment. Patients were classified into the lowest and highest heart-rate variability groups according to the SD value of the qualified normal-to-normal intervals of the heart-rate-variability assessment. The VF was divided into central and peripheral regions and further classified into superior and inferior regions. Groups in the lowest and highest heart-rate variability groups were compared in terms of rates of change in the mean thresholds of each designated region by using a linear mixed model. Potential clinical factors associated with central VF progression were also investigated. The baseline VF showed similar stages of glaucoma damage between the lowest and highest heart-rate variability groups. The mean global rate of VF changes was similar between the two groups. Only the rate of VF changes in the central and superior central regions were significantly different between the lowest heart-rate variability group (-1.16 dB/year in the central region and -1.48 dB/year in the superior central region) and highest heart-rate variability group (-0.52 dB/year in the central region and -0.64 dB/year in the superior central region). Baseline VF pattern SD (β = -1.160, P = 0.008), migraine (β = 1.380, P = 0.040), orthostatic hypotension (β = 1.146, P = 0.023), and lower heart-rate variability (β = -1.516, P = 0.010) were significantly associated with central VF progression. NTG patients with lower heart-rate variability, which reflects autonomic dysfunction with sympathetic predominance, presented faster rate of central VF progression than patients with higher heart-rate variability. Intraocular pressure-independent risk factors, such as migraine, orthostatic hypotension, and autonomic dysfunction, were related to central VF progression.</abstract><cop>United States</cop><pmid>24692126</pmid><doi>10.1167/iovs.13-13742</doi><tpages>7</tpages></addata></record>
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subjects Autonomic Nervous System Diseases - complications
Autonomic Nervous System Diseases - physiopathology
Disease Progression
Female
Follow-Up Studies
Heart Rate - physiology
Humans
Intraocular Pressure
Low Tension Glaucoma - complications
Low Tension Glaucoma - physiopathology
Male
Middle Aged
Prognosis
Retrospective Studies
Time Factors
Visual Field Tests
Visual Fields - physiology
title Central visual field progression in normal-tension glaucoma patients with autonomic dysfunction
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