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IOP not a key factor in development of glaucomatous optic neuropathy

Invest Ophthalmol Vis Sci. 2011;52(11):7817-7821

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IOP is not a significant factor in the development of glaucomatous optic neuropathy in patients with primary open-angle glaucoma, according to a study.

"The present study adds further evidence that there is no obvious cutoff of IOP where glaucoma begins," the study authors wrote.

The randomized, population-based analysis examined 47 patients with untreated POAG in north China. All subjects were at least 30 years old. IOP was measured every 4 hours during the study.

Of the 47 subjects, 39 (83%) were found to have peak IOP 21 mm Hg or less. Peak IOP occurred between 6 a.m. and 10 a.m. in 76.5% of the subjects. Lowest IOP occurred between 10 p.m. and 2 a.m. in 70.2% of the patients.

In the 22 patients with unilateral POAG, there were no significant differences in the average IOP fluctuation and 24-hour, peak, and trough IOP between glaucomatous eyes and contralateral non-glaucomatous eyes.

"Factors other than IOP likely play an important role in the development of glaucomatous neuropathy," the study authors said.

The study was limited by the relative youth of the subjects as well as the fact that the IOP test was administered in a seated position during hours when people are normally asleep and that the study population came from a single, rural area of China.