Circadian Fluctuation of Mean Ocular Perfusion Pressure Is a Consistent Risk Factor for Normal-Tension Glaucoma

Abstract

Of the functional and anatomic outcome variables, circadian MOPP fluctuation was the most consistent clinical risk factor for glaucoma severity in eyes with NTG. This finding may suggest an etiology of NTG as a chronic ischemic end organ disease.

Twenty-four-hour intraocular pressure and ocular perfusion pressure characteristics in newly diagnosed patients with normal tension glaucoma

“…In the present study, B20% of our NTG patients exhibited a normal nocturnal SBP reduction (5-10%), while 48% showed a marked SBP reduction (410%). These results are in agreement with those reported by Choi et al 23 in Korean NTG patients. In this study, non-dippers (defined as patients with nighttime SBP reduction o5%) and reverse dippers (showing a nighttime elevation of SBP) were collectively classified as non-physiological dippers and constituted 31% of the NTG cohort under investigation.…”

“…Our BP data concur with those reported in a NTG cohort of 132 Korean patients. 23 Furthermore, the 24-h MAP documented in our cohort (93.2 mmHg) is fairly similar to the 24-h MAP (94.7 mmHg) reported by Renard et al 34 in another group of Caucasian NTG patients.…”

“…In this study, non-dippers (defined as patients with nighttime SBP reduction o5%) and reverse dippers (showing a nighttime elevation of SBP) were collectively classified as non-physiological dippers and constituted 31% of the NTG cohort under investigation. 23 Equally in our NTG group, the cumulative percentage of mild dippers and non-dippers was 32%. As different cutoffs have been used by some investigators 27,34 for the classification of dipping status in NTG, comparisons across studies should be drawn with caution.…”

“…[15][16][17][18][19][20][21][22] More specifically, evidence has highlighted the role of reduced OPP in the incidence, 16 prevalence, [17][18][19][20][21][22] and progression of glaucomatous neuropathy 15 in several ethnic groups. Particularly in NTG, increased OPP fluctuation has been linked to the severity of disease at diagnosis 23 and the subsequent risk of progression. [24][25][26][27] At present there is lack of consensus on the 24-h IOP characteristics of NTG patients.…”

Weighing in Ocular Perfusion Pressure in Managing Glaucoma

“…Ocular hemodynamics in young healthy individuals, are autoregulated to maintain constant blood supply to ocular tissues, despite changes in PP [5]. However in glaucoma, there is the hypothesis of a defective autoregulation, resulting in ischemic damage and reperfusion injury [6]. In a case-control study by Gherghel et al , lower ocular PP was associated with hemodynamic alterations in progressive glaucoma patients [7].…”