The retinal venous pressure ‐ A new measurable parameter in glaucoma risk assessment

Abstract

AbstractLow ocular perfusion pressure (OPP) is a risk factor for the progression of glaucoma. OPP is calculated as the difference between mean ophthalmic artery pressure and the venous pressure in the eye which is assumed being equal to the intraocular pressure (IOP). Thus lowering IOP lowers the ocular venous pressure and increases the OPP. This view, however, needs a modification because in the past 25 years it has been shown that the retinal venous pressure (RVP) may be considerably higher in approximately one third of glaucoma patients. In an own series of 50 glaucoma patients 16 patients could be identified just because of a lacking spontaneous pulsation of the central retinal vein. These patients had an IOP of 15(4)mmHg (median (interquartile range) and a RVP of 31(12)mmHg. Also other study groups reported on patients with a high RVP despite an inconspicuous IOP. In a long‐term study of 82 months the RVP was strongly predictive for an increased excavation of the optic disc (odds ratio 1.3/mmHg RVP). We hypothesize that the RVP may be a more potent risk factor than the IOP. Until now, the RVP has been measured by the Dynoptor or by contact lens dynamometry. Due to the hesitant acceptance of these measurement techniques a new method has been developed in which the cornea is no longer touched. By including the RVP in glaucoma diagnostics a new parameter may be available for the risk assessment of this disease.