Indian journal of ophthalmology · 2014
Relationship between systemic hypertension, perfusion pressure and glaucoma: a comparative study in an adult Indian population.
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Deb Amit K, Kaliaperumal Subashini, Rao Vasudev A, Sengupta Sabyasachi
Аннотация
AIMS: To study the relationship between blood pressure (BP), intraocular pressure (IOP), mean ocular perfusion pressure (MOPP) and primary open angle glaucoma (POAG) in patients with hypertension and compare it to a control group of normotensives.
DESIGN: Cross-sectional observational study.
MATERIALS AND METHODS: A total of 108 subjects with primary hypertension and 100 age-matched controls without hypertension were enrolled for the study. IOP measurement using Noncontact Tonometer and dilated fundus evaluation using + 90 D lens were done for all cases. Single recording of BP was taken. Gonioscopy, Humphrey's central visual fields, optical coherence tomography and pachymetry were done for all subjects with IOP > 21 mm Hg or C: D ratio ≥ 0.5 or asymmetry of > 0.2.
STATISTICAL ANALYSIS: Univariate and multivariate multinomial regression models were used to determine the association between covariates and risk of glaucoma or glaucoma suspect.
RESULTS: There was no difference in the glaucoma status between subjects with and without hypertension. Subjects on antihypertensive medications were 1 times more likely to have suspicious glaucoma (odds ratio [OR] =1.56] and nearly twice as likely to have POAG (OR = 1.85). In addition, we found a 31% and 12% reduction in risk of having POAG (95% confidence interval [CI] =13-45%, P = 0.001) and glaucoma suspect (95% CI = 2-21%, P = 0.03) respectively with every 1 mm Hg increment in MOPP.
CONCLUSION: Subjects on antihypertensive medications are more likely to have either glaucoma or glaucoma suspect, and higher ocular perfusion pressure offers relative protection from glaucomatous damage.
DESIGN: Cross-sectional observational study.
MATERIALS AND METHODS: A total of 108 subjects with primary hypertension and 100 age-matched controls without hypertension were enrolled for the study. IOP measurement using Noncontact Tonometer and dilated fundus evaluation using + 90 D lens were done for all cases. Single recording of BP was taken. Gonioscopy, Humphrey's central visual fields, optical coherence tomography and pachymetry were done for all subjects with IOP > 21 mm Hg or C: D ratio ≥ 0.5 or asymmetry of > 0.2.
STATISTICAL ANALYSIS: Univariate and multivariate multinomial regression models were used to determine the association between covariates and risk of glaucoma or glaucoma suspect.
RESULTS: There was no difference in the glaucoma status between subjects with and without hypertension. Subjects on antihypertensive medications were 1 times more likely to have suspicious glaucoma (odds ratio [OR] =1.56] and nearly twice as likely to have POAG (OR = 1.85). In addition, we found a 31% and 12% reduction in risk of having POAG (95% confidence interval [CI] =13-45%, P = 0.001) and glaucoma suspect (95% CI = 2-21%, P = 0.03) respectively with every 1 mm Hg increment in MOPP.
CONCLUSION: Subjects on antihypertensive medications are more likely to have either glaucoma or glaucoma suspect, and higher ocular perfusion pressure offers relative protection from glaucomatous damage.