Abstract
Low ocular perfusion pressure (OPP) may increase the risk of optic neuropathy. This study investigated the effects of OPP on the ganglion cell complex (GCC) and optic nerve head-retinal nerve fibre layer (ONH-RNFL) thickness in presumed systemic hypotensives (PSH). Fifteen participants with PSH and 14 controls underwent automated sphygmomanometry and Icare tonometry to calculate OPP: mean OPP (MOPP), systolic OPP (SOPP), and diastolic OPP (DOPP). ONH-RNFL and macula GCC thickness were evaluated using the Optovue iVue optical coherence tomographer. Statistical analysis comprised independent t-tests, the Mann–Whitney U test and binary logistic regression analysis. There was no significant difference when comparing ONH-RNFL and macula GCC thickness between both groups. Increased MOPP (OR = 0.51; 95% CI: 0.27–0.97; p = 0.039) and SOPP (OR = 0.79; 95% CI: 0.64–0.98; p = 0.035) were significantly associated with a decreased risk of reductions in GCC total thickness. Increased SOPP (OR = 0.11; 95% CI: 0.01–0.89; p = 0.027) was significantly associated with a decreased risk of reductions in the average ONH-RNFL thickness. The study found no significant retinal thickness changes in PSH’s, in comparison to the controls. The study established that, by increasing MOPP and SOPP, there was a decreased risk of reductions in the total GCC thickness and average ONH-RNFL thickness. Higher SOPP may decrease the possibility of retinal thinning of the GCC and ONH-RNFL. However, higher MOPP may decrease the odds of thinning of the GCC before ONH-RNFL changes.
Highlights
Glaucoma is the leading cause of irreversible blindness worldwide [1]
P, mean systemic blood pressure (BP), and ocular perfusion pressure (OPP) for bothTgarboleup1s.sAhonwinsdaepceonmdepnatrti-stoesnt sbheotwedenthtahtethmereeawnaIsOaPs,tamtiesatincasllyyssteigmnifcicBaPn,t arendducO- PP fotirobnoitnhthgeroeuxpes.riAmnenitnadl egproeunpdewnhtetn-tceosmt sphaorwededtotthhaetctohnetrreolwgarosuapsftoartibstoitchalMlyOsPigPnaifindcant reSdOuPcPti.on in the experimental group when compared to the control group for both mean OPP (MOPP)
The study found that a reduced OPP as a result of presumed systemic hypotensives (PSH) has proven to be significant, no significant changes in retinal thickness were found in comparison to the control group
Summary
Glaucoma is the leading cause of irreversible blindness worldwide [1]. The estimated global prevalence of glaucoma is 3.54%, with the highest prevalence in Africa [1]. Glaucoma is defined as a heterogeneous group of chronic neurodegenerative disorders It is a selective and progressive optic neuropathy that is characterised by the accelerated death of retinal ganglion cells (RGC) and their retinal nerve fibre layer (RNFL) axons leading to visual field loss [3,4,5]. It is chronic, imperceptible and is difficult to diagnose, especially in asymptomatic patients, making timely diagnosis and evaluation of the disease through structural and functional analysis significant [6]. The mechanism of glaucoma is not clearly understood, with extraretinal neurodegeneration [7]
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