June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Changes in blood pressure and ocular perfusion pressure are associated with functional progression in open-angle glaucoma patients with diabetes mellitus after 5 years
Author Affiliations & Notes
  • Colin Ridenour
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Alon Harris
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Brent A Siesky
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Alice Chandra Verticchio Vercellin
    University Eye Clinic, IRCCS Policlinico San Matteo, Pavia, Italy
  • Tyler Knight
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Aaditya Shah
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Christian P. Jonescu-Cuypers
    Neurosciences Cliniques, Ophthalmology, Hôpitaux Universitaires de Genève, Genève, Switzerland
  • Josh C Gross
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Footnotes
    Commercial Relationships   Colin Ridenour, None; Alon Harris, AdOM (C), AdOM (I), Biolight (C), Isarna Therapeutics (C), Nano Retina (C), Nano Retina (I), Ono Pharmaceuticals (C), Oxymap (I), Science Based Health (C), Stemnion Inc. (C); Brent Siesky, None; Alice Chandra Verticchio Vercellin, None; Tyler Knight, None; Aaditya Shah, None; Christian Jonescu-Cuypers, None; Josh Gross, None
  • Footnotes
    Support  American Diabetes Association Grant 1-12-IN-20, Research to Prevent Blindness NY, NY
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 742. doi:
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      Colin Ridenour, Alon Harris, Brent A Siesky, Alice Chandra Verticchio Vercellin, Tyler Knight, Aaditya Shah, Christian P. Jonescu-Cuypers, Josh C Gross; Changes in blood pressure and ocular perfusion pressure are associated with functional progression in open-angle glaucoma patients with diabetes mellitus after 5 years. Invest. Ophthalmol. Vis. Sci. 2017;58(8):742.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To examine the relationship between blood pressure and ocular perfusion pressure and functional progression in open-angle glaucoma (OAG) patients with and without diabetes mellitus (DM) over 5 years.

Methods : 111 patients with intraocular pressure (IOP) controlled OAG (21 with DM, 90 without DM) were evaluated for baseline blood pressure (BP) and systolic and diastolic ocular perfusion pressure (SPP, DPP) every 6 months for 5 years. Functional progression, evaluated by 24-2 Swedish interactive threshold algorithm visual field (VF) (Humphrey), was defined as 2 consecutive visits with a mean deviation decrease ≥ 2 compared to baseline and/or advanced glaucoma intervention study (AGIS) increase ≥ 2 compared to baseline. Mixed-model ANCOVA was used to test for statistically significance changes from baseline to 5-year follow-up. Time to functional progression was analyzed using Cox proportional hazards survival analysis. Interactions were tested to determine if the effects of the factors on progression time differed by diabetic status.

Results : Systolic BP decreased -9.41 (95% CI=-19.73, 0.92)(p=0.07) in patients with DM and significantly decreased -5.93 (-10.68, -1.18)(p=0.01) in patients without DM over 5 years. IOP (mmHg) significantly decreased -3.36 (-5.59, -1.13)(p<0.01) in DM patients and decreased -0.94 (-1.97, 0.10)(p=0.08) in patients without DM over 5 years. In DM patients, changes in systolic BP (Hazard Ratio (HR)=1.07) (1.01, 1.12) and SPP (HR=1.08) (1.01, 1.15) were associated with shorter time to functional progression. Hazard ratios were higher and significantly different for patients with DM compared to patients without DM (systolic BP: p=0.01; SPP: p=0.02). There were no significant differences regarding diastolic BP between patients with and without DM.

Conclusions : In OAG patients with DM, changes in systolic BP and SPP are associated with a shorter time to functional progression after 5 years.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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