No abstract

Both high and low BP has been linked glaucoma. Low BP is particularly associated with glaucoma progression in normal-tension glaucoma (NTG) patients. Patients who have low nighttime BP readings are at highest risk of progression of their glaucoma. Internal medicine specialists and ophthalmologists should consider the relationship between BP and glaucoma when treating patients with concomitant disease. Too-low nighttime BP should be avoided. Ambulatory blood pressure monitoring is a useful tool to identify patients at greatest risk for progression.

Objective:To identify relationships between idiopathic intracranial hypertension (IIH) and other socioeconomic determinants of health, such as low-income status and proximity to healthy food.Methods:This retrospective case-control study of adult female neuro-ophthalmology patients from one institution identified 223 women with and 4,783 women without IIH. Street addresses were geocoded and merged with U.S. census data to obtain census tract-level information on income and food access. Choropleth maps visualized IIH clusters within certain neighborhoods. Logistic regression compared the proportion of IIH patients from racial and ethnic minority backgrounds, low-income census tracts, and food deserts and swamps to non-IIH controls.Results:In our cohort, when adjusted for age, women with IIH were more likely to be Black (OR 3.96; 95% CI 2.98-5.25), Hispanic (OR 2.23; 95% CI 1.14-4.36) and live in low-income tracts (OR 2.24; 95 % CI 1.71-2.95) or food swamps (OR 1.54; 95 % CI 1.15-2.07). IIH patients were less likely to live in food deserts than controls (OR 0.61, 95% CI: 0.45-0.83). The association between Black race and IIH remained significant even after adjusting for other variables.Conclusion:IIH is more common among Black and Hispanic women than expected even when accounting for the demographics of a metropolitan city. Some of this relationship is driven by the association of obesity and IIH incidence with low income and proximity to unhealthy foods.