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Colin Ridenour, Alon Harris, Brent A Siesky, Alice Chandra Verticchio Vercellin, Tyler Knight, Aaditya Shah, Christian P. Jonescu-Cuypers, Josh C Gross; Changes in blood pressure and ocular perfusion pressure are associated with functional progression in open-angle glaucoma patients with diabetes mellitus after 5 years. Invest. Ophthalmol. Vis. Sci. 2017;58(8):742. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the relationship between blood pressure and ocular perfusion pressure and functional progression in open-angle glaucoma (OAG) patients with and without diabetes mellitus (DM) over 5 years.
111 patients with intraocular pressure (IOP) controlled OAG (21 with DM, 90 without DM) were evaluated for baseline blood pressure (BP) and systolic and diastolic ocular perfusion pressure (SPP, DPP) every 6 months for 5 years. Functional progression, evaluated by 24-2 Swedish interactive threshold algorithm visual field (VF) (Humphrey), was defined as 2 consecutive visits with a mean deviation decrease ≥ 2 compared to baseline and/or advanced glaucoma intervention study (AGIS) increase ≥ 2 compared to baseline. Mixed-model ANCOVA was used to test for statistically significance changes from baseline to 5-year follow-up. Time to functional progression was analyzed using Cox proportional hazards survival analysis. Interactions were tested to determine if the effects of the factors on progression time differed by diabetic status.
Systolic BP decreased -9.41 (95% CI=-19.73, 0.92)(p=0.07) in patients with DM and significantly decreased -5.93 (-10.68, -1.18)(p=0.01) in patients without DM over 5 years. IOP (mmHg) significantly decreased -3.36 (-5.59, -1.13)(p<0.01) in DM patients and decreased -0.94 (-1.97, 0.10)(p=0.08) in patients without DM over 5 years. In DM patients, changes in systolic BP (Hazard Ratio (HR)=1.07) (1.01, 1.12) and SPP (HR=1.08) (1.01, 1.15) were associated with shorter time to functional progression. Hazard ratios were higher and significantly different for patients with DM compared to patients without DM (systolic BP: p=0.01; SPP: p=0.02). There were no significant differences regarding diastolic BP between patients with and without DM.
In OAG patients with DM, changes in systolic BP and SPP are associated with a shorter time to functional progression after 5 years.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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