Glaucomatous damage in normotensive fellow eyes of patients with unilateral hypertensive pseudoexfoliation glaucoma: normotensive pseudoexfoliation glaucoma?

Abstract

Background: The objective of the study was to investigate the prevalence of glaucomatous damage in normotensive fellow eyes of patients with unilateral high-tension pseudoexfoliation (PX) glaucoma.

Methods: Initial examination records of 111 patients with unilateral PX glaucoma with intraocular pressure (IOP) > or = 22 mmHg in the hypertensive eye and IOP < or = 21 mmHg in the normotensive fellow eye without any prior antiglaucomatous treatment were retrospectively studied. Visual field and optic disc examination results were evaluated for glaucomatous damage in the normotensive eyes.

Results: Glaucomatous changes were detected in 45 of the 111 fellow eyes (40%). The damage was mild in 25 eyes (22%), moderate in 18 eyes (16%), and severe in 2 (2%). The factors significantly associated with glaucomatous findings in the normotensive eyes were clinical detection of PX, higher age (> or =70 years), higher maximal IOP (> or =18 mmHg) and wider IOP fluctuation (> or =6 mmHg) in the univariate analyses. In the multivariate analysis, associated factors remained as higher maximal IOP (odds ratio = 7.92, confidence interval = 2.82-22.23, P < 0.001) and wider IOP fluctuation (odds ratio = 5.67, confidence interval = 2.05-15.74, P = 0.001).

Conclusion: Normotensive fellow eyes of patients with unilateral high-tension PX glaucoma are under significant risk of glaucomatous damage, related with the level and the fluctuation range of IOP.