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J. Choi, K.–H. Kim, M.S. Kook; Systemic Blood Pressure Fluctuation as a Consistent Risk Factor for Advanced Glaucomatous Damage in Normal Tension Glaucoma . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4780.
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© ARVO (1962-2015); The Authors (2016-present)
To determine both systemic and ocular risk factors for advanced glaucomatous damage in the eyes with normal tension glaucoma (NTG) at the initial examination.
The 76 eyes of 76 patients with NTG who visited our glaucoma clinic from 2004 to 2005 were consecutively evaluated. Each patient had 24–hour monitoring of intraocular pressure (IOP) and blood pressure (BP), scanning laser polarimetric examination with variable corneal compensation (SLP–VCC), and Humphrey visual field examination. Each patient's age, spherical equivalent, central corneal thickness (CCT), mean office IOP, mean in–hospital IOP, peak in–hospital IOP, 24–hour IOP fluctuation, systolic (SBP) and diastolic BP (DBP) fluctuation were analyzed by a multivariate regression model. IOP was compensated arbitrarily for CCT. Functional outcome variables for glaucomatous damage were mean deviation (MD) on Humphrey Field Analyzer and Advanced Glaucoma Intervention Study (AGIS) score. Anatomical outcome variables were TSNIT average, superior and inferior average, nerve fiber indicator (NFI) on SLP–VCC.
Larger IOP fluctuation was significantly associated with worsened MD and AGIS score among functional outcome variables. Larger SBP fluctuation was significantly associated with worsened MD among functional outcome variables and with reduced TSNIT average, superior and inferior average among anatomical outcome variables. Larger DBP fluctuation was significantly associated with reduced TSNIT average and inferior average among anatomical outcome variables. CCT was not associated with any outcome variable.
Systemic blood pressure fluctuation was the most consistent clinical risk factor in determining glaucoma severity of NTG in terms of functional and anatomical outcome variables. However, the degree of glaucomatous damage was independent of CCT at the initial presentation in our series of NTG eyes.
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