Etiology and Management of Referred Patients with Intraocular Pressure Elevation

Hyunkyu Hong; Sungjin Kim; Ko Eun Kim

doi:10.3341/jkos.2018.59.10.953

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Hong, Kim, and Kim: Etiology and Management of Referred Patients with Intraocular Pressure Elevation

Original Article

Journal of the Korean Ophthalmological Society 2018; 59(10): 953-959.

Published online: 17 October 2018

DOI: https://doi.org/10.3341/jkos.2018.59.10.953

Etiology and Management of Referred Patients with Intraocular Pressure Elevation

Hyunkyu Hong, MD, Sungjin Kim, MD, PhD, Ko Eun Kim, MD, PhD

Department of Ophthalmology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.

Address reprint requests to Ko Eun Kim, MD, PhD. Department of Ophthalmology, Eulji University Nowon Eulji Medical Center, #68 Hangeulbiseok-ro, Nowon-gu, Seoul 01830, Korea. Tel: 82-2-970-8270, Fax: 82-2-970-8872, csckek@gmail.com

Received 15 March 2018 Revised 18 July 2018 Accepted 28 September 2018

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the underlying causes and clinical characteristics of patients referred with intraocular pressure (IOP) elevation.

Methods

We retrospectively reviewed the medical records of patients who were referred with IOP elevation from July 2016 to July 2017. Patients with baseline IOP ≥ 22 mmHg and those who were treated and followed up for 6 months were included. The prevalence rates of the underlying diseases that caused IOP elevation were evaluated and the clinical characteristics were compared between patients with primary and secondary glaucoma.

Results

A total of 127 patients were included (mean age, 59.3 ± 16.8 years; baseline IOP, 31.7 ± 10.5 mmHg). Among the study participants, 22.0%, 31.5%, and 46.5% had been diagnosed with ocular hypertension, primary glaucoma, and secondary glaucoma, respectively. Among the causes of IOP elevation, open-angle glaucoma (20.5%) had the highest prevalence rate among those with primary glaucoma and inflammation-related glaucoma (12.6%) was the most prevalent cause among those with secondary glaucoma. In a comparison between patients with primary and secondary glaucoma, the percentage of IOP reduction was not significantly different at 6 months after treatment (52.1% vs. 53.9%, p = 0.603). However, the rate of patients treated with drugs other than IOP lowering agents or who underwent surgery was significantly higher in the secondary glaucoma group compared with the primary glaucoma group (all p < 0.05). At 6-month follow-up, the secondary glaucoma group showed significantly higher improvement rates of visual acuity (p = 0.004), but had a larger proportion of patients with a visual acuity of less than or equal to finger count (p = 0.027).

Conclusions

Treatment and visual outcome can vary depending on the underlying cause of IOP elevation. Therefore, a thorough examination for determining the cause of IOP elevation is recommended at the initial stage.

Keywords: Glaucoma, Intraocular pressure elevation, Primary glaucoma, Secondary glaucoma

Figures and Tables

Figure 1

Prevalence rate of underlying causes for intraocular pressure elevation. Open-angle glaucoma showed the highest prevalence rate (20.5%) among primary glaucoma and inflammation-related glaucoma (12.6%) among secondary glaucoma. G = glaucoma.

Table 1

Demographics of included patients (n = 127)

Values are presented as mean ± SD or n (%) unless otherwise indicated.

IOP = intraocular pressure.

Table 2

Diagnosis of referred patients with elevated intraocular pressure (n = 127)

Table 3

Causes of elevated intraocular pressure according to age groups (n = 127)

Table 4

Comparison of clinical characteristics between patients with primary and secondary glaucoma

Values are presented as mean ± SD (range) or n (%) unless otherwise indicated.

BCVA = best-corrected visual acuity; IOP = intraocular pressure; LPI = laser peripheral iridotomy; ALPI = argon laser peripheral iridoplasty.

^*Student t-test; ^†Chi-square test; ^‡Fisher's exact test.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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