Influence of automated visual field testing on intraocular pressure
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RESEARCH ARTICLE
Open Access
Influence of automated visual field testing on intraocular pressure Samuel Bertaud1* , Elisabeth Skarbek Borowski1, Rachid Abbas2, Christophe Baudouin1,3,4 and Antoine Labbé1,3,4
Abstract Background: To evaluate the influence of automated visual field (VF) testing on intraocular pressure (IOP) in patients with ocular hypertension (OHT) or glaucoma. Methods: We conducted a prospective observational study in the glaucoma department at Quinze-Vingts National Ophthalmology Hospital in Paris. Ninety-five right eyes of 95 patients followed for glaucoma or OHT were included. IOP was measured three times using a Nidek NT-510 non-contact tonometer within a maximum of 5 min before and after VF testing. Sub analyses using logistic regression analysis were performed to evaluate the impact of gender, age, central corneal thickness (CCT), mean deviation (MD) of the VF, VF test duration and filtration surgery on IOP fluctuations. Results: There was no significant change in IOP after VF testing, with IOP’s 15.14 ± 4.00 mmHg before and 14.98 ± 3.33 mmHg after the VF (P = 0.4). The average change in IOP was 0.15 ± 1.82 mmHg. Using multivariate analysis, no effect of the VF test on IOP was found (global model fit R2 = 0.12), whether based on duration of the VF test (P = 0.18) or the MD (P = 0.7) after adjustment for age, gender, CCT and history of glaucoma surgery. Similarly, there was no significant difference within different types of glaucoma, including open-angle glaucoma (P = 0.36), chronic angle closure glaucoma (P = 0.85) and OHT (P = 0.42). The subgroup of patients with an IOP elevation ≥2 mmHg had a significantly higher VF test duration (P = 0.002). Conclusion: VF testing does not influence IOP as measured with a non-contact tonometer. Keywords: Glaucoma, VF testing, intraocular pressure
Background Visual field (VF) testing and intraocular pressure (IOP) measurement are essentials for the diagnosis, monitoring and treatment of glaucoma [1, 2]. IOP reduction is the only evidence-based treatment that has been shown to slow glaucoma progression [3], and VF is the gold standard test for evaluation of glaucoma functional loss and progression [2, 4]. It has been demonstrated that IOP in healthy and glaucomatous eyes can be influenced by several factors, including accommodation [5–10]. During glaucoma or OHT patients follow-up, for logistical and * Correspondence: [email protected] 1 Quinze-Vingts National Ophthalmology Hospital, INSERM-DGOS CIC 1423, IHU FOReSIGHT, 28 rue de Charenton, 75012 Paris, France Full list of author information is available at the end of the article
organizational reasons, the VF is most often performed before clinical evaluation and IOP measurement. In daily practice, some ophthalmologists believe that VF testing might have an effect on IOP, in the form of a transient elevation. This potential IOP change might have a direct influence on glaucoma management, as the clinical decision to adjust glaucoma management is often based on the IOP. Some studies have already i
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