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G. Gramer, B.H. F. Weber, E. Gramer; Vasospasm and Glaucoma – Age and Stage–Related Evaluation of 2015 Patients With Glaucoma or Ocular Hypertension . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3396.
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To evaluate in patients with glaucoma (GL) or ocular hypertension (OH) 1. whether there is a difference in the frequency of vasospasm (VA) in different types of GL compared to NTG and whether this frequency differs from the frequency of migraine (MI) 2. age related the collective risk to have MI or VA in NTG compared to POAG 3. the frequency of VA in two groups of patients with different stage of visual field loss (VFL) in NTG and POAG 4. the frequency of MI in patients with VA 5. gender differences in the frequency of VA and MI
By means of a questionnaire addressed to patients and their ophthalmologists, e.g. family history of GL, type of GL, stage of visual field loss (VFL), age at diagnosis, potential risk factors like heart disease, VA and MI were evaluated. Of 2015 patients who provided a yes or no answer on a history of VA, 1241 had POAG, 136 NTG, 50 PG, 62 PEX, 138 OH, 220 PACG. Patients were divided into two groups, with VFL up to stage II or III – V (classification of Aulhorn).
1. Of 2015 patients, 19.0% suffer from VA and 13.7% have MI. In contrast to MI, which was more frequent in NTG than in other types of GL, there was no significant difference between the overall frequency of VA in NTG with 22.8% vs. POAG with 18.3%, PG 16.0%, OH 15.9%, PEX 27.4% and PACG 18.2% 2. The probability of an NTG patient to have MI is 63,5% higher than of a POAG patient of same age (p=0.0070, Cochran–Mantel–Haenzel statistics; OR 1.80 (95% CI 1.16 – 2.79)), but there was no significant difference in the frequency of VA between NTG and POAG patients within same age groups (p=0.4939; OR 1.09 (95%CI 0.85–1.39)). 3. There was no significant difference in the frequency of VA between patients with beginning and severe VFL for NTG (21.1% vs. 27.8%, p = 0.4085 Fisher's Exact Test) and POAG (18.0% vs. 18.1%, p = 1.000). 4. Patients with VA had a twofold higher frequency of MI than patients without VA (22.95% vs. 11.73%, p < 0.0001, Mantel–Haenzel–Chi–square–test). 5. 73.3% of NTG and 62.2% of POAG patients with VA are female. Women had with 18.13% a twofold higher frequency of MI than men with 8.15% (p < 0.0001) and a twofold higher frequency of VA than men.
All types of GL were equally associated with VA in every fifth patient. This suggests that VA is a risk factor for all types of GL. Regarding the extent of VFL, VA alone does not seem to be a prognostic factor. There is an association between NTG and MI and between VA and MI. We suggest that the higher frequency of MI and VA in women could cause the female preponderance in NTG.
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