Impact of glaucoma medications on IOP, blood pressure and perfusion pressure: relevance for the daily practice

Abstract

AbstractHigher it will be the Perfusion pressure and higher it will be the blood flow in a determined body district. How it has been determined by several population‐based studies, low levels of diastolic ocular perfusion pressure (DOPP) are associated with an increased prevalence and incidence of POAG. As a matter of fact, the Baltimore eye study has shown that when DOPP decreases below 50 mm Hg the prevalence of POAG increases; similar results were obtained in the Egna‐Neumarkt in Europe, in the Projecto VER in Mexico, and in the Barbados Eye Study in Caribbean. In the Barbados eye study DOPP was 63 ± 14.9 mmHg in healthy subjects, and 53.8 ± 14.9 mmHg in POAG patients. As a general indication, it can be concluded that when DOPP is lower than 55 mm Hg there is an increased risk to develop POAG. In the present lecture it will analyzed the relationship between BF and POAG, and the correlation between circadian fluctuation of BF and the extent of damage in POAG patients. Twenty‐four hour Blood pressure and IOP will be detailed evaluated in the study of pathogenesis of glaucoma. Moreover it twill be analyzed the behavior of 24‐hour IOP and blood pressure in normal‐tension glaucoma patients. It will be also analyzed the influence of hypotensive drugs for glaucoma on BF and circadian IOP and blood pressure. The mean aim of the present lecture will be to give a comprehensive evaluation of the importance of the monitoring of blood pressure and IOP over the twenty‐four hour, in order to evaluate the risk of progression of each POAG patients, but also to know the effect of hypotensive glaucoma therapy not only on IOP but also on diastolic ocular perfusion pressure.