Abstract
AbstractPurposeGlaucoma is one of the leading causes of blindness worldwide, and as the proportion of those over age 40 increases, so will the prevalence of glaucoma. The pathogenesis of primary open angle glaucoma (POAG) is unclear and multiple ocular risk factors have been proposed, including intraocular pressure, ocular perfusion pressure, ocular blood flow, myopia, central corneal thickness, and disc hemorrhages. The purpose of this review was to analyse the correlation between systemic vascular risk factors and POAG pathogenesis based on major epidemiological studies.MethodologyWe used the PubMed database to identify studies including the term glaucoma in association with the following keywords: vascular risk factors, systemic risk factors, blood pressure, systemic hypertension, systemic hypotension, diabetes, dipping, vasospasm, age and migraine.ResultsThe search identified 270 unique articles. After including only relevant English‐language articles only 66 studies were reported in the analysis. Reports presenting the association between POAG and systemic vascular risk factors included a total of over 50,000 patients. Several epidemiological studies confirmed the importance of vascular risk factors in the pathogenesis and progression of glaucomatous optic neuropathy, including hypertension, blood pressure dipping. The pooled analysis confirmed hypertension as the most significant risk factor for primary open angle glaucoma.ConclusionsVascular risk factors play a significant role in the pathogenesis and progression of glaucoma. The association between POAG and diabetes mellitus type 2 or migraine still needs to be evaluated in future studies.
Highlights
Glaucoma is one of the leading causes of blindness worldwide [1]
Genetic abnormalities are believed to initiate a cascade of events that lead to glaucomatous optic nerve injury and remodeling
The purpose of this study was to analyze the association of systemic vascular risk factors and Primary open angle glaucoma (POAG), based on major epidemiological studies
Summary
Glaucoma is one of the leading causes of blindness worldwide [1]. As the proportion of those over age 40 increases, so will the prevalence of glaucoma. Primary open angle glaucoma (POAG) is the most common form of the disease worldwide, in Africa and in the Western countries [3,4,5]. Multiple ocular risk factors have been proposed, including IOP, ocular perfusion pressure, ocular blood flow, myopia, central corneal thickness, and optic disc hemorrhages. Systemic risk factors include age, smoking, African ancestry, family history, genetic factors, systemic hypertension (HTN), low blood pressure (BP) ( a nocturnal drop in BP), atherosclerosis, lipid dysregulation, type 2 diabetes mellitus (DM), glucose intolerance, obesity, vasospasm, migraine, Raynaud syndrome, stress, and primary vascular dysregulation [5,6,7,8,9,10,11,12]. Notwithstanding the role of genetic mutations and variations on glaucoma onset, the role of different systemic risk factors remains debatable
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