Abstract
Purpose:
To analyze 24-hours Arterial Blood Pressure (ABP) recordings in elderly patients with Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) compared with other retinal vascular diseases.
Methods:
Over a 7-year period, 49 NAION patients and 27 control subjects with sudden visual loss due to arterial, venous or diabetic retinal vascular acute episodes, all aged 70 or more, underwent 24-hours ABP recordings. Our main outcome was the number of patients with one or more nocturnal diastolic ABP fall under 50 mmHg. Number of patients with one or more nighttime systolic ABP fall under 90 mmHg, mean systolic and diastolic ABP during 24-hours, daytime and nighttime, as well as standard NAION risk factor were also studied.
Results:
Nocturnal diastolic ABP values ≤50 mmHg were observed in 20 (41%) NAION and 4 (15%) control subjects (P=0.02). Nocturnal systolic ABP values ≤90 mmHg were observed in 5 (10%) NAION and 4 (15%) control subjects (p=0,55). Mean systolic(SD)/diastolic(SD) 24-hour ABP was 134(17)/70(9) mmHg in NAION and 135(20)/71(10) mmHg in control subjects (P=0.78). No statistic difference was observed regards of mean systolic and mean diastolic ABP whether in daytime or nighttime recordings. 23 (46%) NAION and 19 (70%) control subjects took hypotensive drug therapy (p=0.04). Sex ratio, body mass index, and the frequency of diabetes and dyslipidemia were not different.
Conclusions:
Nocturnal diastolic ABP fall under 50mmHg, a risk factor for cerebral hypoperfusion, is significantly more frequent in elderly patients with acute visual loss due to NAION compared with other vascular retinal etiologies, and appears to be a specific risk factor for this disease.