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Karin Pillunat, Cosima Hermann, Olga Furashova, Eberhard Spoerl, Lutz Pillunat; Nonphysiologic nocturnal blood pressure dipping in Primary Open Angle Glaucoma (POAG) and Normal Pressure Glaucoma (NPG) patients. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4454.
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In order to evaluate whether nonphysiologic nocturnal blood pressure dipping is associated with visual field indices in POAG and NPG patients.
29 patients suffering from POWG (IOP> 22 mmHg) and 22 patients suffering from NTG (IOP < 21mmHg) were included in a prospective clinical trial. 24 hour blood pressure was measured (Bosch&Sohn GmbH). According to WHO criteria a mean arterial blood pressure (MAP) dipping less than 10% and more than 20% was considered as nonphysiologic dipping, a MAP-dipping between 10% and 20% was considered as physiologic dipping. Visual field tests were only taken from right eyes with the Humphrey 30-2 SST program. A mean deviation (MD) of more than -6 dB was considered as early, a MD between -6 dB and -12 dB as moderate and a MD of less than -12 dB as severe glaucomatous loss. For statistical analysis the Chi2-test was used. A p-value less than 0,05 was considered as statistically significant.
45% of the patients showed nonphysiologic MAP dipping. MD of less than -6 dB was seen in 57% of these cases. 55% however showed physiologic MAP dipping. MD of less than -6 dB was seen only in 35% of physiological dippers. The difference between visual field indices between nonphysiological and physiological dippers was statistically significant (p=0,05). 58% of POAG patients and 27% of NTG patients were nonphysiologic MAP dippers.
Nonphysiologic nocturnal blood pressure dipping is associated with more advanced visual field defects especially in POAG but also in NPG patients. Therefore also in POAG patients diurnal blood pressure monitoring has to be regarded as an important diagnostic tool.
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