To evaluate the association of mean intraocular pressure (IOP) and IOP variability (IOP fluctuation [SD of IOP] and the IOP range) with the rate of ganglion cell complex (GCC) layer thinning over time in patients with glaucoma. Prospective cohort study. Participants with at least 4 visits and 2 years of follow-up of optical coherence tomography tests were included. A linear mixed-effect model was used to investigate the association of IOP parameters with the rates of GCC thinning. Subgroup analyses were conducted for eyes with early (MD ≥ −6 dB), and moderate to advanced stage (MD < −6 dB) at baseline. The cohort consisted of 369 eyes of 249 glaucoma patients (282 early glaucoma and 87 moderate to advanced glaucoma) with mean (standard deviation [SD]) age of 68.2 (10.7) years over 5.1 years of follow-up. The mean rate of GCC change was −0.59 (95% confidence interval [CI], −0.67 to −0.52) µm per year. In multivariable models, faster annual rate of GCC thinning was associated with a higher IOP fluctuation (−0.17 [95% CI, −0.23 to −0.11] µm per 1-mmHg higher, < .001) or higher IOP range (−0.07 [95% CI, −0.09 to −0.05] µm per 1-mmHg higher, < .001) after adjustment for mean IOP and other confounding factors. Similar results were found for early and moderate to advanced stages of glaucoma. IOP variability showed an independent association with macular change in patients with glaucoma regardless of severity at baseline, even after adjustment for mean IOP, supporting its potential value as a therapeutic target for clinical decision-making.

中文翻译：

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青光眼患者长期眼压变异与神经节复合体变薄率的关系

评估青光眼患者平均眼压 (IOP) 和 IOP 变异性（IOP 波动 [IOP 的 SD] 和 IOP 范围）与神经节细胞复合体 (GCC) 层随时间变薄的速率之间的关系。前瞻性队列研究。至少进行过 4 次就诊并进行了 2 年光学相干断层扫描测试随访的参与者均被纳入其中。使用线性混合效应模型研究 IOP 参数与 GCC 变薄率的关联。对基线时早期（MD ≥ -6 dB）和中晚期（MD < -6 dB）的眼睛进行亚组分析。该队列由 249 名青光眼患者（282 名早期青光眼和 87 名中度至晚期青光眼）的 369 只眼睛组成，在 5.1 年的随访中，平均（标准差 [SD]）年龄为 68.2 (10.7) 岁。 GCC 变化的平均率为每年 -0.59（95% 置信区间 [CI]，-0.67 至 -0.52）μm。在多变量模型中，GCC 每年变薄速度较快与较高的 IOP 波动（每升高 1 mmHg，−0.17 [95% CI，−0.23 至 −0.11] µm，< .001）或较高的 IOP 范围（−0.07 [95% CI，−0.23 至 −0.11] µm，< .001）相关。调整平均 IOP 和其他混杂因素后，95% CI，每升高 1 mmHg，-0.09 至 -0.05] µm，< .001）。对于青光眼的早期和中晚期阶段也发现了类似的结果。无论基线时的严重程度如何，眼压变异性都与青光眼患者的黄斑变化存在独立相关性，即使在调整平均眼压后也是如此，这支持了其作为临床决策治疗目标的潜在价值。