Study, Intraocular Pressure Control Predicts Retinal Nerve F
A Study was conducted to determine the relationship of intraocular pressure (IOP) control with subsequent retinal nerve fiber layer (RNFL) thinning in patients with primary angle closure disease (PACD).

517 treated PACD eyes from 280 Chinese subjects were followed up at least 24 months. IOP was measured every 3-month using Goldmann applanation tonometry, and RNFL were measured by SD-OCT every 6-month. IOP mean and fluctuation were calculated as the average and the coefficient of variation (CoV) of IOP measurements during the first 18-month of study period.

--IOP mean and IOP fluctuation were independently negatively associated with subsequent progressive global RNFL changes, after adjustment for age, sex, and baseline RNFL thickness.

--In the sectoral analysis, both higher mean IOP and IOP fluctuation predicted progressive RNFL thinning in the inferotemporal, superotemporal, superonasal, and temporal sectors in the order of strength of association.

--In the subgroup analysis by disease category, IOP fluctuation showed greater association with global RNFL thinning in eyes with PACG than eyes without glaucomatous changes.

Finally, in treated PACD eyes, substantial IOP variation, in addition to high mean IOP throughout follow-up, is an independent predictor of eventual progressive RNFL thinning.