scholarly journals Effect of mean ocular perfusion pressure on primary open angle glaucoma

2018 ◽  
Vol 11 (4) ◽  
pp. 286-290
Author(s):  
Pallab Kumar Sen ◽  
Nazneen Khan ◽  
Md. Shafiqul Islam

Primary open angle glaucoma is the most common form of glaucoma and it remains asymptomatic until the late stage of the disease. The purpose of this study is to compare the mean ocular perfusion pressure with the primary open angle glaucoma. A total of 60 study subjects were divided into two following groups: a) newly diagnosed patients with primary open angle glaucoma (case) and b) age and sex-matched healthy volunteers (control). The intraocular pressure and blood pressure were measured 3 hourly from 8:00 am to 11:00 pm. The mean ocular perfusion pressure of the right eyes in untreated primary open angle glaucoma was 39.9 ± 7.5 mm Hg whereas it was 47.7 ± 7.7 mm Hg in the control. The odds ratio was 6.6 (95% CI, 2.1-20.5; p=0.002). The right eyes of untreated primary open angle glaucoma had 6.6 times more risk compared to the control group. The mean ocular perfusion pressure of left eyes in untreated primary open angle glaucoma was 39.9 ± 7.5 mm Hg and 48.6 ± 4.0 mm Hg in the control group. The odds ratio was 5.7 (95% CI, 1.8-17.5; p=0.004). The left eyes of untreated primary open angle glaucoma had 5.7 times more risk compared to control group. The findings revealed the evidence of vascular mechanism in glaucoma pathogenesis: Reduction of mean ocular perfusion pressure ≤48 mm Hg, may lead to daily repetitive ischemic insult to the optic nerve.

Author(s):  
Raheeba Pakeer Muhammed ◽  
Neeta Sidhan ◽  
Beena Thankappan

Introduction: Various haemodynamic factors have been implicated as pathophysiological mechanisms in Primary Open Angle Glaucoma (POAG) other than raised Intraocular Pressure (IOP). However, the exact relationship still remains unclear. Aim: To examine the circadian pattern of Blood Pressure (BP), IOP and Ocular Perfusion Pressure (OPP) with the aim of understanding their relationships in a cohort of patients with POAG. Materials and Methods: A cross-sectional study was conducted in which 44 cases of newly diagnosed, non-hypertensive patients with POAG were enrolled and categorised based on the severity of glaucoma. Recording of BP and IOP were done every 4th hourly during a 24 hour hospital stay. The Mean OPP (MOPP) was calculated as 2/3×Mean Arterial Pressure (MAP)-IOP. Systolic OPP (SOPP) was calculated as Systolic BP-IOP and Diastolic OPP (DOPP) was calculated as Diastolic BP-IOP. The diurnal, nocturnal and 24 hour fluctuations were derived from the difference between the highest and lowest values within each period. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 16.0. Univariate and multivariate regression analysis of the variables with age and severity of POAG were performed Results: Significant positive correlation of the nocturnal fluctuations in MAP (r=0.533), SOPP (r=0.835), DOPP (r =0.768), MOPP (r=0.685) and 24 hour fluctuation in MOPP (r=0.636) were noted with severity of glaucoma on multivariate analysis. No significant correlation of these parameters with age was noted on multivariate analyses. Conclusion: Nocturnal dip in OPP was an important observation among patients with POAG, potentially contributing to its pathophysiology.


2018 ◽  
Vol 102 (10) ◽  
pp. 1402-1406 ◽  
Author(s):  
Yih-Chung Tham ◽  
Sing-Hui Lim ◽  
Preeti Gupta ◽  
Tin Aung ◽  
Tien Y Wong ◽  
...  

ObjectiveTo elucidate the inter-relationship between ocular perfusion pressure (OPP), blood pressure (BP), intraocular pressure (IOP) profiles and primary open-angle glaucoma (POAG) in a multiethnic Asian population.MethodsParticipants were recruited from the Singapore Epidemiology of Eye Diseases Study and underwent standardised ocular and systemic examinations. POAG was defined according to the International Society for Geographical and Epidemiological Ophthalmology criteria. Logistic regression analyses with generalised estimating equation models were performed and used to account for correlation between eyes.ResultsA total of 9877 participants (19 587 eyes), including 213 POAG cases (293 eyes) were included. Eyes with lowest quartile levels of systolic OPP (SOPP <110 mm Hg) were 1.85 times (95% CI 1.16 to 2.95) likely to have POAG, compared with eyes with mid-range SOPP levels (123–137 mm Hg; third quartile), after adjusting for relevant covariates and IOP. Consistently, we found that lowest quartile of systolic BP (SBP <124 mm Hg) was 1.69 times (95% CI 1.08 to 2.66) likely to have POAG, compared with mid-range SBP levels (138–153 mm Hg; third quartile). Furthermore, the effect of lower SBP on POAG was more pronounced in eyes with IOP ≥21 mm Hg (OR 3.90; 95% CI 1.24 to 12.30). Both the mean and diastolic profiles of OPP and BP were not significantly associated with POAG, after adjusting for relevant covariates and IOP.ConclusionsIn this population-based sample of nearly 10 000 Asian individuals, we showed that low SOPP was associated with POAG. This association was potentially in part secondary to low SBP and high IOP. Our findings provide further clarity on the roles of OPP surrogates and BP profiles in POAG.


2010 ◽  
Vol 94 (10) ◽  
pp. 1291-1294 ◽  
Author(s):  
V. P. Costa ◽  
J. Jimenez-Roman ◽  
F. G. Carrasco ◽  
A. Lupinacci ◽  
A. Harris

Sign in / Sign up

Export Citation Format

Share Document