Abstract
Primary open angle glaucoma is the most common form of glaucoma and it remains asymptomatic until the late stage of the disease. The purpose of this study is to compare the mean ocular perfusion pressure with the primary open angle glaucoma. A total of 60 study subjects were divided into two following groups: a) newly diagnosed patients with primary open angle glaucoma (case) and b) age and sex-matched healthy volunteers (control). The intraocular pressure and blood pressure were measured 3 hourly from 8:00 am to 11:00 pm. The mean ocular perfusion pressure of the right eyes in untreated primary open angle glaucoma was 39.9 ± 7.5 mm Hg whereas it was 47.7 ± 7.7 mm Hg in the control. The odds ratio was 6.6 (95% CI, 2.1-20.5; p=0.002). The right eyes of untreated primary open angle glaucoma had 6.6 times more risk compared to the control group. The mean ocular perfusion pressure of left eyes in untreated primary open angle glaucoma was 39.9 ± 7.5 mm Hg and 48.6 ± 4.0 mm Hg in the control group. The odds ratio was 5.7 (95% CI, 1.8-17.5; p=0.004). The left eyes of untreated primary open angle glaucoma had 5.7 times more risk compared to control group. The findings revealed the evidence of vascular mechanism in glaucoma pathogenesis: Reduction of mean ocular perfusion pressure ≤48 mm Hg, may lead to daily repetitive ischemic insult to the optic nerve.
Highlights
Glaucoma is a multifactorial disease characterized by a loss of retinal ganglion cells that leads to typical damage of the optic nerve and visual field
Blood flow in any tissue is generated by the perfusion pressure that is defined as the difference between mean arterial blood pressure and venous pressure.[10]
The mean intraocular pressure and ocular perfusion pressure in both eyes of untreated primary open angle glaucoma were higher than the normal control (Table II)
Summary
Glaucoma is a multifactorial disease characterized by a loss of retinal ganglion cells that leads to typical damage of the optic nerve and visual field. Poor perfusion of tissues can occur in the context of either hypertension or hypotension. Treatment or overtreatment of systemic hypertension may cause a marked decrease in systemic blood pressure this, in turn, causes decrease in systolic and diastolic perfusion pressure leading to chronic decrease of ocular blood flow, loss of retinal ganglion cells.[9] Blood flow in any tissue is generated by the perfusion pressure that is defined as the difference between mean arterial blood pressure and venous pressure.[10] In the resting position, mean arterial blood pressure is calculated as: MAP = DBP + 1/3(SBP-DBP)
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