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V. P. Costa, J. Jimenez-Roman, F. G. Carrasco, A. P. C. Lupinacci, A. Harris; 24h Diurnal Ocular Perfusion Pressure in Primary Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5857.
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To compare the 24-hour IOP, blood pressure (BP), and perfusion pressure (PP) of primary open-angle glaucoma (POAG) patients and healthy individuals.
24 healthy individuals and 29 POAG patients were prospectively recruited. Exclusion criteria for both groups were: a) previous intraocular surgery or laser procedure; b) systemic hypertension, diabetes mellitus, or any other disease that may affect arterial BP; c) use of vasoactive medications that could influence BP measurements; d) presence of other ophthalmic diseases. Individuals were admitted at the Hospital and underwent IOP and BP measurements every 2 hours, starting at 8:00 AM until 6:00 AM of the next morning. IOP measurements were made by a masked observer with a Goldmann tonometer at the slit-lamp from 8:00 AM to 10:00 PM and with the Perkins tonometer, with the patient lying in a horizontal position, from 12:00AM to 6:00 AM. Systolic and diastolic BP (SDP and DBP) measurements were performed with an automated device, which remained on the right arm of the patient.
Mean age, race and gender distributions did not differ significantly between the groups (P>0.05). Mean IOP measurements in POAG patients were significantly higher than those obtained in controls at all time intervals (P<0.001). Mean SBP was significantly higher in POAG patients from 4:00 AM to 10:00 AM, and also at 2:00PM and 6:00 PM (p<0.05). Mean DBP was significantly higher in POAG patients at 8:00 AM and 10:00 AM (p<0.01), but was significantly lower in POAG patients at 4:00 AM (p=0.025). Mean SPP was significantly higher in POAG patients at 8:00 AM and 10:00 AM (p<0.01). Mean DPP was significantly lower in POAG patients at night, from 12:00 AM to 6:00 AM (p<0.05).
POAG patients show a distinct diurnal behavior of PP. Although higher SPPs are observed in POAG patients during the morning, lower DPPs are found during the night.
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