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Impact of IOP fluctuation on glaucoma progression still lacking proof
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COPENHAGEN, Denmark — Evidence is not yet sufficient to determine whether IOP fluctuations are an independent risk factor for glaucoma progression, according to two specialists speaking here.
At the European Glaucoma Society meeting, Anders Heijl, MD, said he is more inclined to believe that IOP fluctuations have no impact on glaucoma progression.
“Mean IOP is what matters,” he said. “IOP fluctuation may be related to progression, but only because it is higher in eyes with higher mean IOP.”
The opposite view was presented by Anastasios Konstas, MD, who said that IOP fluctuations have a role in glaucoma progression.
“Wide IOP fluctuations are seen more frequently in patients with ocular hypertension who eventually develop glaucoma,” Konstas said. “Also, patients with worse untreated 24-hour characteristics and untreated peak 24-hour IOP show greater visual field damage at diagnosis. … We should aim for less fluctuation, particularly in advanced glaucoma.”
Both physicians said that a long-term study investigating the prognostic impact and value of each 24-hour IOP parameter (mean, fluctuation and peak IOP) in glaucoma progression is needed.
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