Systemic blood pressure in open-angle glaucoma, low tension glaucoma, and the normal eye.

Abstract

The object of the present study was to investigate the hypothesis that a low systemic blood pressure might be associated with so-called low tension glaucoma: the rather unexpected result was an association between open-angle glaucoma and vascular hypertension. Theoretically, the pressure in the ophthalmic artery as shown by ophthalmodynamometry is likely to be a better index of blood pressure in arteries in the eyeball than the systemic blood pressure measured at the upper arm; however, in practice, we have the impression that the latter estimate has less observer error and so it has been chosen for this study. A good correlation seems to exist between ophthalmic artery and brachial artery pressure (Smith and Cogan, I959; Johnson and Drance, i 968a). I'he relationship between ischaemia of the optic nerve and retina, blood pressure, and glaucoma has been studied by several authors in various ways:(a) Optic nerve ischaemia and glaucoma Schnabel (i885) introduced the term "cavernous optic atrophy" and Wolff (1947) agreed that the condition was the result of ischaemia. Duke-Elder (i962) also considers arteriosclerosis, etc., to be important in open-angle glaucoma.(b) Low tension glaucoma and low blood pressure Weekers (1942) and Sjogren (1946) noted that patients with low tension glaucoma often have low blood pressure.(c) Lowering of blood pressure and increasedfield loss These have been observed in glaucoma by several authors, for example Harrington (I959) and Lobstein, Bronner, and Nordmann (i960).(d) Glaucoma, blood pressure (including perfusion pressure), and atherosclerosis (i) LOW BLOOD PRESSURE Sachsenweger (I963) and Ebner (I967) found a more rapid deterioration in the visual fields in glaucoma patients with low blood pressure than in those with either high or normal blood pressure. Lobstein and Herr ( i 966) showed that, in glaucoma, field loss was greater the lower the blood pressure.

Fluctuations of Intraocular Pressure during the Day in Open-Angle Glaucoma, Normal-Tension Glaucoma and Normal Subjects

“…The NTG patients had a slightly higher IOP and more evident fluctuations if compared with the normal subjects. Other authors have already reported a difference in IOP between normal subjects and NTG patients [8, 9]. …”

Decreased intraocular pressure in dogs with one-kidney, one wrapped hypertension.

“…13 A correlation has also been reported between the occurrence of hypertension and glaucoma. 16 Watson and Greenwood 17 and Gafter et al 18 reported slightly elevated arterial pressure and low IOP in azotemic patients that did not change with hemodialysis. Low IOP has also been reported in azotemic dogs; blood pressure was not measured.…”

High prevalence of sleep‐disordered breathing in patients with primary open‐angle glaucoma

“…Strong associations with low diastolic blood pressure (Drance et al 1981;Morgan & Drance 1975;Richler et al 1982) and also systemic hypertension (Dielemans et al 1995;Leighton & Philips 1972;Nagin & Schwartz 1985;Wilson et al 1987) has been reported in glaucoma patients. Some authors postulated that physiologic nocturnal hypotension, in the presence of other vascular risk factors, may reduce the optic nerve head blood flow below a critical level, and thereby may play a role in the pathogenesis of anterior ischemic optic neuropathy and glaucoma (Graham et al 1995;Hayreh et al 1994).…”