increased intraocular pressure (IOP)
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Etiology
- either over-production or impaired drainage of aqueous humor
- pharmacologic causes:
Pathology
- significant &/or prolonged increases in IOP may lead to open-angle glaucoma
Management
- treatment is cost effective if life-expectency is >= 18 years[5]
- prognosis
- 85% of patients with elevated IOP (> 22 mm Hg) do NOT have glaucoma & will NOT develop glaucoma within the next 5 years
- at 5 years, reducing IOP by 20% in patients with IOP of 24-32 mm Hg, reduces risk of visual field abnormality or optic disc deterioration from 9.5 to 4.4%[3]
- number needed to treat: 12 patients to prevent one case of visual field defects of optic nerve changes consistent with glaucoma[4]
- see open angle glaucoma
More general terms
Additional terms
References
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 66
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, 16. American College of Physicians, Philadelphia 1998, 2012
- ↑ 3.0 3.1 Journal Watch 22(15):115, 2002
Kass MA et al The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delay or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol 120:701, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12049574
Gordon MO et al The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol 120:714, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12049574
Palmberg P Answers from the ocular hypertension treatment study. Arch Ophthalmol 120:829, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12049591 - ↑ 4.0 4.1 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016 - ↑ 5.0 5.1 Kymes SM, Plotzke MR, Kass MA, Boland MV, Gordon MO. Effect of patient's life expectancy on the cost-effectiveness of treatment for ocular hypertension. Arch Ophthalmol. 2010 May;128(5):613-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20457984
- ↑ Boey PY, Mansberger SL. Ocular hypertension: an approach to assessment and management. Can J Ophthalmol. 2014 Dec;49(6):489-96. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25433737