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Long-term IOP fluctuation not definitively linked to glaucoma development

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Patients who demonstrate IOP fluctuations over a long period of time do not appear to be at a greater risk of developing glaucoma, researchers in California found.

Felipe A. Medeiros, MD, PhD, and colleagues evaluated the link between IOP fluctuation and glaucoma development in 252 eyes of 126 untreated ocular hypertension patients who were enrolled in the Diagnostic Innovations in Glaucoma Study. They published their results in the June issue of Ophthalmology.

All patients showed normal visual fields and optic discs at baseline, the authors noted.

"Glaucoma conversion was defined as development of reproducible [visual field] loss or optic disc damage," they said.

Overall, 41 eyes of 31 patients developed glaucoma during follow-up. In these eyes, IOP averaged 25.4 mm Hg and IOP fluctuation averaged 3.16 mm Hg, according to the study.

Eyes that did not develop glaucoma had an average IOP of 24.1 mm Hg and average IOP fluctuation of 2.77 mm Hg.

Neither univariable analysis nor multivariable analysis showed an association between IOP fluctuation and glaucoma development. However, average IOP appeared to be associated with glaucoma progression in both types of analyses.