Symptoms of Autonomic Dysfunction in Primary Open-Angle Glaucoma (POAG)

Abstract

 

Purpose:

 

Though autonomic dysfunction is implicated in the pathogenesis of POAG, the prevalence of autonomic symptoms is not known. This study was designed to determine the autonomic symptom profile in POAG as well as the differences in symptoms between stable and unstable POAG.

 

Methods:

 

In this prospective, non-randomized study, 34 subjects with mild or moderate controlled POAG, were recruited. Eighteen subjects had stable and 16 subjects had unstable glaucoma despite clinical control.Autonomic symptom profile (ASP) was assessed in each patient using a validated self-report instrument. Questions were designed to assess symptoms in ten different domains of autonomic dysfunction. Accompanying systemic conditions were also recorded. The binomial test was performed to compare the scores between historical controls and subjects with POAG. The stable and unstable groups were compared with the Fisher Exact test.

 

Results:

 

The mean age was 69 years (range 48-83) and the prevalence of co-existing systemic autonomic conditions in POAG subjects was: hypertension (76.5%), hypercholesterolemia (55.9%), coronary artery disease (50.0%), and diabetes mellitus (26.5%). As shown in the table, subjects with POAG exhibited greater prevalence of autonomic symptoms compared to historical normals. However, the difference in symptoms between stable and unstable POAG was not statistically significant.* Percent of subjects with the ASP domain score > 0. p-value compared to historical controls (Ref. Suarez et al. Neurology,1999), binomial test.  

 

Conclusions:

 

This study found a higher prevalence of autonomic symptoms and related systemic diseases in patients with POAG. This close association needs to be further investigated for better control of glaucoma.

 

Keywords: intraocular pressure • clinical (human) or epidemiologic studies: risk factor assessment • visual fields