Cardiovascular risk factors and events in glaucoma patients with peripapillary focal arteriolar narrowing.

PURPOSE: To evaluate cardiovascular risk factors and events in glaucoma patients with and without peripapillary focal arteriolar narrowing of retinal vessels.

METHODS

We examined the fundus photographs of 325 consecutive glaucoma patients for evidence of focal arteriolar narrowing of retinal vessels adjacent to the optic disc. Cases and controls were matched for age, race, sex and mean deviation on Humphrey visual field. Medical information regarding cardiovascular risk factors and events was collected from patients' primary care physicians, and this information was confirmed by questionnaires sent to the patients themselves.

RESULTS

A total of 58 pairs of cases and controls were matched. The prevalence of hypertension and diabetes was exactly equal in both groups, 65.5% and 27.6%, respectively. Similarly, the prevalences of myocardial infarction, cardiac surgery, angioplasty, family history of heart disease and smoking were nearly identical in both groups. There was no significant difference in the prevalence of strokes or transient ischaemic attacks. The prevalence of hypercholesterolemia and mortality was greater in the case group (mean differences of 8.6, p = 0.42 and 5.2, p = 0.25, respectively), however, these differences were not statistically significant.

CONCLUSION

There is no significant relationship between peripapillary focal arteriolar narrowing of retinal vessels and cardiovascular risk factors or events in patients with glaucoma. Proximal narrowing does not appear to be a marker of systemic vascular disease.