Vascular risk factors for open angle glaucoma in African eyes

Abstract

Context:The exact patho physiological mechanizm of optic nerve damage in glaucoma is not fully understood.Aim:To assess the vascular risk factors in open angle glaucoma in African eyes.Settings and Design:Prospective multicenter hospital-based study in Edo State, Nigeria.Materials and Methods:Three hundred and twenty-two glaucoma patients and 184 control subjects were included in the study comprising 200 male glaucoma patients (62.11%) and 122 females (37.89%). A cohort of consecutive patients with a diagnosis of primary open angle glaucoma and age and sex matched control subjects were included in this prospective, cross-sectional, and multicenter hospital-based study conducted during the period January-June 2008. Blood pressure (BP), pulse and intraocular pressure findings were recorded and mean BP, pulse and perfusion pressure for each eye calculated.Statistical Analysis Used:Mean, standard deviations, 95% confidence intervals, Welch's t test, and Fisher's exact test were calculated.Results:The mean IOP in the 644 eyes of the 322 glaucoma patients was 22.65 mmHg (SD plus/minus 11.06). The systolic blood pressure (P < 0.0001), diastolic blood pressure (P < 0.0001), mean arterial blood pressure (P < 0.0001), pulse pressure (P < 0.01), systolic perfusion pressure (P < 0.01) were all significantly higher in glaucoma patients than in control.Conclusions:Higher systolic, diastolic, mean arterial BP and pulse pressure was found in Black African patients with open angle glaucoma.

Primary Open Angle Glaucoma and Vascular Risk Factors: A Review of Population Based Studies from 1990 to 2019

“…However, current evidence to support a direct relationship remains conflicting and is still not fully understood [6]. Seven population-based studies reported a statistically significant association between DM and POAG [34,38,41,46,48,49,51], but five studies Most of the analyzed studies identified an association of HTN with glaucoma and optic nerve damage [31,33,35,40,46,[48][49][50]52] (Table 1). The meta-analysis involving eight original studies on the prevalence of arterial HTN revealed a significant relationship with the occurrence of POAG (pooled OR = 1.67; 95% CI: 1.28-2.07) ( Figure 1).…”

“…However, current evidence to support a direct relationship remains conflicting and is still not fully understood [6]. Seven population-based studies reported a statistically significant association between DM and POAG [34,38,41,46,48,49,51], but five studies did not confirm an association [31,32,36,42,43]. In the pooled analysis comprising seven original studies no significant relationship between the prevalence of POAG and DM was identified (pooled OR = 1.37; 95% CI: 0.72-2.02), and heterogeneity was high (I² = 86.6%) (Figures 3 and 4).…”

Ocular perfusion pressure in glaucoma

“…Some other studies found a significant relation between higher SOPP and increase prevalence of OAG (Orzalesi et al 2007;Omoti et al 2009). In the Blue Mountains Study (Mitchell et al 2004), after adjusting for OAG risk factors, for each 10 mmHg increase in SOPP there was a 10% higher glaucoma prevalence.…”

“…There are several large epidemiological studies in which the relationship between OPP and OAG has been investigated (Tielsch et al 1995;Bonomi et al 2000b;Quigley et al 2001;Mitchell et al 2004; Leske et al Orzalesi et al 2007;Omoti et al 2009;Xu et al 2009;Memarzadeh et al 2010;Zheng et al 2010;Ramdas et al 2011). Most of them have shown that low OPP is a risk factor for the prevalence, incidence and progression of glaucoma.…”

Controversies in the vascular theory of glaucomatous optic nerve degeneration

“…These changes are correspondingly reflected in functional parameters, such as the visual fields, electroretinograms, and others. There is a plethora of knowledge regarding the structure–function changes and their management in glaucoma; however, the pathophysiologic mechanisms responsible for the development and progression of glaucoma remain unclear 12…”