Evidence map›Paper›PMID 38035974›Full record

ArticleAmerican journal of ophthalmology2024

The Impact of Achieving Target Intraocular Pressure on Glaucomatous Retinal Nerve Fiber Layer Thinning in a Treated Clinical Population.

Alex T Pham, Chris Bradley, Kaihua Hou, Patrick Herbert, Michael V Boland, Pradeep Y Ramulu, Jithin Yohannan

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of ophthalmology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Alex T PhamFrom the Wilmer Eye Institute, Johns Hopkins University School of Medicine (A.T.P., C.B., P.Y.R., J.Y.), Baltimore, Maryland.
Chris BradleyFrom the Wilmer Eye Institute, Johns Hopkins University School of Medicine (A.T.P., C.B., P.Y.R., J.Y.), Baltimore, Maryland.
Kaihua HouMalone Center for Engineering in Healthcare, Johns Hopkins University (K.H., P.H., J.Y.), Baltimore, Maryland.
Patrick HerbertMalone Center for Engineering in Healthcare, Johns Hopkins University (K.H., P.H., J.Y.), Baltimore, Maryland.
Michael V BolandMassachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts (M. V. B.), USA.
Pradeep Y RamuluFrom the Wilmer Eye Institute, Johns Hopkins University School of Medicine (A.T.P., C.B., P.Y.R., J.Y.), Baltimore, Maryland.
Jithin YohannanFrom the Wilmer Eye Institute, Johns Hopkins University School of Medicine (A.T.P., C.B., P.Y.R., J.Y.), Baltimore, Maryland; Malone Center for Engineering in Healthcare, Johns Hopkins University (K.H., P.H., J.Y.), Baltimore, Maryland. Electronic address: jithin@jhmi.edu.
Johns Hopkins University · USMassachusetts Eye and Ear Infirmary · US

Funding

A Comprehensive Strategy to Detect Glaucoma Worsening Earlier and With Fewer TestsK23EY032204 · NEI · JOHNS HOPKINS UNIVERSITY · PI YOHANNAN, JITHIN · 2021 to 2025
$956k
NEI NIH HHS K23 EY032204
6 · The paper itself

Abstract

purposeTo estimate the effect of being below and above the clinician-set target intraocular pressure (IOP) on rates of glaucomatous retinal nerve fiber layer (RNFL) thinning in a treated real-world clinical population.

designRetrospective cohort study.

methodsA total of 3256 eyes (1923 patients) with ≥5 reliable optical coherence tomography scans and 1 baseline visual field test were included. Linear mixed-effects modeling estimated the effects of the primary independent variables (mean target difference [measured IOP - target IOP] and mean IOP, mm Hg) on the primary dependent variable (RNFL slope, µm/y) while accounting for additional confounding variables (age, biological sex, race, baseline RNFL, baseline pachymetry, and disease severity). A spline term accounted for differential effects when above (target difference >0 mm Hg) and below (target difference ≤0 mm Hg) target pressure.

resultsEyes below and above target had significantly different mean RNFL slopes (-0.44 vs -0.71 µm/y, P < .001). Each 1 mm Hg increase above target had a 0.143 µm/y faster rate of RNFL thinning (P < .001). Separating by disease severity, suspect, mild, moderate, and advanced glaucoma had 0.135 (P = .002), 0.116 (P = .009), 0.203 (P = .02), and 0.65 (P = .22) µm/y faster rates of RNFL thinning per 1 mm Hg increase, respectively.

conclusionsBeing above the clinician-set target pressure is associated with more rapid RNFL thinning in suspect, mild, and moderate glaucoma. Faster rates of thinning were also present in advanced glaucoma, but statistical significance was limited by the lower sample size of eyes above target and the optical coherence tomography floor effect.

Indexed as

Intraocular PressureNerve FibersRetinal Ganglion CellsTomography, Optical CoherenceTonometry, OcularVisual FieldsAgedAntihypertensive AgentsFemaleGlaucomaGlaucoma, Open-AngleHumansMaleMiddle AgedOptic DiskOptic Nerve DiseasesAntihypertensive Agents

Identifiers

PMID38035974
PMCPMC12956044
OpenAlexW4389093278

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.