Abstract
Purpose
To analyse short-term variability of systemic blood pressure and choroidal blood flow in glaucoma patients, and compare them with ocular hypertensive patients and controls.
Subjects and methods
Thirty untreated patients with primary open-angle glaucoma (POAG), 25 untreated patients with ocular hypertension (OHT) and 50 healthy controls without local therapy were included in the study. Continuous 5-minute measurements of arterial systemic blood pressure (SBP) by Finometer and choroidal blood flow (CBF) by laser Doppler flowmetry were obtained. Variability of SBP and CBF was analysed by means of coefficient of variation and analyzed in ANOVA model. Linear regression analysis was performed on parameters of morphological (nerve fiber layer thickness) and functional glaucomatous damage (visual field) on one side, and between SBP and CBF on the other side.
Results
ANOVA model demonstrated significant differences in variability between the groups (p = 0.003); post-hoc analysis specified a significantly higher short-term variability of both the blood pressure and choroidal blood flow in POAG patients (coefficients of variation: 3.33% ± 1.05% and 3.90% ± 2.17% respectively) than in healthy controls (coefficient of variation: 2.57% ± 0.80% and 2.94% ± 1.52% respectively). No significant differences were found for OHT patients.
Conclusions
POAG patients without local therapy demonstrate an increased short-term BP and CBF variability.
Similar content being viewed by others
References
Flammer J, Orgul S, Costa VP, Orzalesi N, Krieglstein GK, Serra LM, Renard JP, Stefansson E (2002) The impact of ocular blood flow in glaucoma. Prog Retin Eye Res 21:359–393
Bonomi L, Marchini G, Marraffa M, Bernardi P, Morbio R, Varotto A (2000) Vascular risk factors for primary open angle glaucoma: the Egna-Neumarkt study. Ophthalmology 107:1287–1293
Kaiser HJ, Flammer J (1991) Systemic hypotension: a risk factor for glaucomatous damage? Ophthalmologica 203:105–108
Kashiwagi K, Hosaka O, Kashiwagi F, Taguchi K, Mochizuki J, Ishii H, Ijiri H, Tamura K, Tsukahara S (2001) Systemic circulatory parameters. Comparison between patients with normal tension glaucoma and normal subjects using ambulatory monitoring. Jpn J Ophthalmol 45:388–396
Detry M, Boschi A, Ellinghaus G, De Plaen JF (1996) Simultaneous 24-hour monitoring of intraocular pressure and arterial blood pressure in patients with progressive and non-progressive primary open-angle glaucoma. Eur J Ophthalmol 6:273–278
Kaiser HJ, Flammer J, Graf T, Stumpfig D (1993) Systemic blood pressure in glaucoma patients. Graefes Arch Clin Exp Ophthalmol 231:677–680
Flammer J (2001) Die glaukomatose Optikusneuropathie: Ein Reperfusionsschaden. Klin Monatsbl Augenheilkd 218:290–291
Pemp B, Georgopoulos M, Vass C, Fuchsjager-Mayrl G, Luksch A, Rainer G, Schmetterer L (2009) Diurnal fluctuation of ocular blood flow parameters in patients with primary open-angle glaucoma and healthy subjects. Br J Ophthalmol 93:486–491
Plange N, Kaup M, Daneljan L, Predel HG, Remky A, Arend O (2006) 24-h blood pressure monitoring in normal tension glaucoma: night-time blood pressure variability. J Hum Hypertens 20:137–142
Bechetoille A, Bresson-Dumont H (1994) Diurnal and nocturnal blood pressure drops in patients with focal ischemic glaucoma. Graefes Arch Clin Exp Ophthalmol 232:675–679
Choi J, Kim KH, Jeong J, Cho HS, Lee CH, Kook MS (2007) Circadian fluctuation of mean ocular perfusion pressure is a consistent risk factor for normal-tension glaucoma. Invest Ophthalmol Vis Sci 48:104–111
Medeiros FA, Weinreb RN, Zangwill LM, Alencar LM, Sample PA, Vasile C, Bowd C (2008) Long-term intraocular pressure fluctuations and risk of conversion from ocular hypertension to glaucoma. Ophthalmology 115:934–940
Nouri-Mahdavi K, Hoffman D, Coleman AL, Liu G, Li G, Gaasterland D, Caprioli J (2004) Predictive factors for glaucomatous visual field progression in the advanced glaucoma intervention study. Ophthalmology 111:1627–1635
Chiselita D, Motoc I, Danielescu C (2008) Daily and nightly fluctuation of intraocular pressure and blood pressure in glaucoma and non-glaucoma patients. Oftalmologia 52:119–125
Choi J, Jeong J, Cho HS, Kook MS (2006) Effect of nocturnal blood pressure reduction on circadian fluctuation of mean ocular perfusion pressure: a risk factor for normal tension glaucoma. Invest Ophthalmol Vis Sci 47:831–836
Joe SG, Choi J, Sung KR, Park SB, Kook MS (2009) Twenty-four hour blood pressure pattern in patients with normal tension glaucoma in the habitual position. Korean J Ophthalmol 23:32–39
Graham SL, Drance SM, Wijsman K, Douglas GR, Mikelberg FS (1995) Ambulatory blood pressure monitoring in glaucoma. The nocturnal dip. Ophthalmology 102:61–69
Graham SL, Drance SM (1999) Nocturnal hypotension: role in glaucoma progression. Surv Ophthalmol 43(Suppl 1):S10–S16
Leske MC, Wu SY, Hennis A, Honkanen R, Nemesure B (2008) Risk factors for incident open-angle glaucoma: the barbados eye studies. Ophthalmology 115:85–93
Osusky R, Schoetzau A, Flammer J (1997) Variations in the blood flow of the human optic nerve head. Eur J Ophthalmol 7:364–369
Riva CE (2006) Sub-foveal choroidal blood flow by LDF: Measurement and application to the physiology and pathology of the choroidal circulation. Bull Soc Belge Ophtalmol 302:185–194
Emre M, Orgul S, Gugleta K, Flammer J (2004) Ocular blood flow alteration in glaucoma is related to systemic vascular dysregulation. Br J Ophthalmol 88:662–666
European Glaucoma Society (2008) Perimetry; in: Terminology and guidelines for glaucoma. Dogma, Savona, pp 82–87
Guelen I, Westerhof BE, Van Der Sar GL, Van Montfrans GA, Kiemeneij F, Wesseling KH, Bos WJ (2003) Finometer, finger pressure measurements with the possibility to reconstruct brachial pressure. Blood Press Monit 8:27–30
Geiser M, Diermann U, Riva CE (1999) Compact laser doppler choroidal flowmeter. J Biomed Opt 4:459–464
Gugleta K, Orgul S, Flammer I, Gherghel D, Flammer J (2002) Reliability of confocal choroidal laser doppler flowmetry. Invest Ophthalmol Vis Sci 43:723–728
Galang N, Sasaki H, Maulik N (2000) Apoptotic cell death during ischemia/reperfusion and its attenuation by antioxidant therapy. Toxicology 148:111–118
Haefliger IO, Dettmann E, Liu R, Meyer P, Prunte C, Messerli J, Flammer J (1999) Potential role of nitric oxide and endothelin in the pathogenesis of glaucoma. Surv Ophthalmol 43(Suppl 1):S51–S58
Author information
Authors and Affiliations
Corresponding author
Additional information
Asan Kochkorov and Konstantin Gugleta contributed equally.
Swiss National Foundation Grant 3200B0-113685, Velux Stiftung Grant, Freie Akademische Gesellschaft (FAG) Grant, Pfizer Inc. Grant
Rights and permissions
About this article
Cite this article
Kochkorov, A., Gugleta, K., Katamay, R. et al. Short-term variability of systemic blood pressure and submacular choroidal blood flow in eyes of patients with primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 248, 833–837 (2010). https://doi.org/10.1007/s00417-009-1277-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-009-1277-1