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K. Gugleta, A. Kochkorov, D. Kavroulaki, R. Katamay, J. Flammer, S. Orgul; Analysis of Vascular Risk Factors in Untreated Primary Open Angle Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5861.
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To investigate the association between the known and assumed risk factors for glaucoma and the actual morphological and functional glaucomatous damage in untreated primary open angle glaucoma patients.
Twenty-five consecutive primary open angle glaucoma patients were recruited. They were without treatment for at least 4 weeks and never underwent any ocular surgery in the past apart from cataract operation (at lest 6 months prior to recruitment). Intraocular pressure profile with Goldmann applanation tonometry, shortterm IOP variability, oscillometric blood pressure measurement (mean BP), ocular pulse amplitude (OPA) with dynamic contour tonometry, pachymetry, retinal vessel response to flicker light stimulation with Retinal Vessel Analyzer, Octopus visual field (MD) and peripapillary nerve fiber layer (RNFL) with ocular coherence tomography were recorded. The association of damage (MD and RNFL separately) with risk factors was done by means of forward stepwise multiple regression analysis.
The worse eye in terms of MD and/or RNFL of nine male and 16 female POAG patients, age 62.3±8.3 years, entered the analysis. For MD, with F-to-enter 1.0, the model including retinal arteriolar and venous dilation, OPA and mean BP explained 39.2% of MD variability. The only significant individual contributor was arteriolar dilation, beta=-0.66, p=0.004. For RNFL, 20.2% of variability was explained by arteriolar dilation (individual beta=0.44, p=0.027), pachymetry and mean BP.
Impairment of neurovascular coupling in the retina is strongly associated with both morphological and functional damage in glaucoma. The pathogenetic significance of this association deserves further investigation.
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