正常眼压型青光眼患者中心视野快速进展与夜间血压下降。

IF 4.2 1区 医学 Q1 OPHTHALMOLOGY
Jimin Park,Woo Keun Song,Jooyoung Yoon,Ko Eun Kim,Michael S Kook
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引用次数: 0

摘要

目的探讨早至中度正常眼压型青光眼(NTG)患者夜间血压(BP)下降与中央视野(VF)快速进展的关系。设计前瞻性队列研究参与者:共199例未经治疗的NTG患者参加了本研究。方法199例未经治疗的NTG患者在习惯体位接受24小时动态血压监测(ABPM),随访至少2年。根据患者夜间血压下降情况,将患者分为不下沉、下沉和过度下沉。使用线性混合模型分析比较各组中央VF随时间的变化率。快速中心VF进展被定义为12个中心点的平均总偏差(MTD10)值以< -0.5 dB/年的速率下降。逻辑回归分析确定了临床因素,包括夜间血压下降,有助于加速中枢性室颤进展。主要观察指标:中央性VF进展率和中央性VF快速进展率结果:在平均随访4.9年期间,MTD10下降表明,过度倾斜者中央性VF进展率明显快于非倾斜者和倾斜者(非倾斜者:-0.23 dB/年;倾斜者:-0.27 dB/年;过度倾斜者:-0.53 dB/年;P = 0.007)。过度倾斜者中枢性VF快速进展的患病率明显更高(非倾斜者:19.8%;倾斜者:23.5%;过度倾斜者:60.0%;P < 0.001)。较高的夜间平均动脉压(MAP)下降百分比被认为是中心性VF快速进展的重要危险因素(优势比:1.062,P < 0.05)。结论过度倾斜的NTG患者中枢性VF进展明显快于非倾斜者和倾斜者,超过50%的过度倾斜患者进展迅速。中央性VF的快速进展与早期至中度NTG患者眼部夜间MAP下降的百分比显著相关。这些发现强调了密切监测夜间血压明显下降的NTG患者中枢性VF变化的重要性,以防止中枢性VF快速丧失引起的功能损害。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fast Central Visual Field Progression in Patients with Normal-Tension Glaucoma and Nocturnal Blood Pressure Dip.
PURPOSE This study aimed to investigate the relationship between nocturnal blood pressure (BP) dip and rapid central visual field (VF) progression in patients with early-to-moderate stage normal-tension glaucoma (NTG). DESIGN Prospective cohort study PARTICIPANTS: : In total, 199 untreated NTG patients participated in this study. METHODS In total, 199 untreated NTG patients underwent 24-h ambulatory BP monitoring (ABPM) in their habitual position, with a minimum 2-year follow-up. Patients were classified as non-dippers, dippers, and over-dippers based on their nocturnal BP dip. The rates of central VF changes over time among these groups were compared using linear mixed model analysis. Fast central VF progression was defined as a decline in the mean total deviation (MTD10) values of 12 central points at a rate of < -0.5 dB/year. Logistic regression analysis identified clinical factors, including nocturnal BP dip, that contribute to accelerated central VF progression. MAIN OUTCOME MEASURES Rate of central VF progression and prevalence of fast central VF progression RESULTS: : Over-dippers showed a significantly faster rate of central VF progression than non-dippers and dippers, as indicated by the MTD10 decline over an average follow-up of 4.9 years (non-dippers: -0.23 dB/year; dippers: -0.27 dB/year; over-dippers: -0.53 dB/year; P = 0.007). The prevalence of fast central VF progression was significantly higher in over-dippers (non-dippers: 19.8%; dippers: 23.5%; over-dippers: 60.0%; P < 0.001). A higher percentage of nocturnal mean arterial pressure (MAP) dip was identified as a significant risk factor for fast central VF progression (odds ratio: 1.062, P < 0.05). CONCLUSIONS Patients with NTG classified as over-dippers showed significantly faster central VF progression than non-dippers and dippers, with over 50% of over-dippers experiencing fast progression. Rapid central VF progression was significantly associated with the percentage of nocturnal MAP dip in eyes with early-to-moderate stage NTG. These findings highlight the importance of closely monitoring central VF changes in NTG patients with pronounced nocturnal BP dips to prevent functional impairment caused by rapid central VF loss.
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来源期刊
CiteScore
9.20
自引率
7.10%
发文量
406
审稿时长
36 days
期刊介绍: The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.
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