Association of blood and ocular perfusion pressure with structural glaucomatous progression by flicker chronoscopy

McGlynn, Margaret M.; Ehrlich, Joshua R.; Marlow, Elizabeth; Chee, Ru Ik; Silva, Fabiana Q.; Tassel, Sarah H. Van; Radcliffe, Nathan M.

doi:10.1136/bjophthalmol-2013-303655

Cited by 8 publications

(4 citation statements)

References 20 publications

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“…Systemic HT, even when treated with anti-hypertensive medications, has been shown to be a risk factor for progressive RNFL thinning in subjects with glaucoma. 21 Our findings of a higher DBP inducing greater RNFL thinning were in contrast to those reported by McGlynn et al 26 who reported that a lower DBP was associated with more progressive RNFL loss (OR = 0.2 per 10 mmHg, 95% CI 0.1–0.6, P < 0.006). As previously mentioned, from the Los Angeles Latino Eye Study, it was demonstrated that the relationship between DBP and glaucoma prevalence is in a “U-shape” signifying that extremes of DBP (too high or too low) were detrimental for glaucoma since a high DBP can cause vascular dysregulation, whereas a low DBP can result in a low ocular perfusion pressure.…”

Section: Discussioncontrasting

confidence: 99%

The Correlation of Retinal Nerve Fiber Layer Thickness With Blood Pressure in a Chinese Hypertensive Population

Gangwani

Lee

et al. 2015

Medicine

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To investigate the association between retinal nerve fiber layer (RNFL) thickness and blood pressure (BP) in subjects with systemic hypertension.Subjects with systemic hypertension on anti-hypertensive medications were screened by fundus photography and referred for glaucoma work-up if there was enlarged vertical cup-to-disc (VCDR) ratio ≥0.6, VCDR asymmetry ≥0.2, or optic disc hemorrhage. Workup included a complete ophthalmological examination, Humphrey visual field test, and RNFL thickness measurement by optical coherence tomography. The intraocular pressure (IOP) and RNFL thicknesses (global and quadrant) were averaged from both eyes and the means were correlated with: the systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) using Pearson correlation.Among 4000 screened hypertensive subjects, 133 were referred for glaucoma workup and 110 completed the workup. Of the 4000 screened subjects, 1.3% had glaucoma (0.9% had normal tension glaucoma [NTG], 0.2% had primary open angle glaucoma, and 0.2% had primary angle closure glaucoma), whereas 0.3% were NTG suspects. The SBP was negatively correlated with the mean superior RNFL thickness (P = 0.01). The DBP was negatively correlated with the mean global (P = 0.03), superior (P = 0.02), and nasal (P = 0.003) RNFL thickness. The MAP was negatively correlated with the mean global (P = 0.01), superior (P = 0.002), and nasal (P = 0.004) RNFL thickness while positively correlated with the mean IOP (P = 0.02).In medically treated hypertensive subjects, glaucoma was present in 1.3%, with NTG being most prevalent. MAP control may help with IOP lowering and RNFL preservation, although future prospective studies will be needed.

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Section: Discussioncontrasting

confidence: 99%

The Correlation of Retinal Nerve Fiber Layer Thickness With Blood Pressure in a Chinese Hypertensive Population

Gangwani

Lee

et al. 2015

Medicine

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“…The present study found that a history of systemic hypertension is not a risk factor for visual field progression, since fewer patients in the progression group had systemic hypertension. Consistent with this result, previous studies showed that a lower diastolic blood pressure was associated with glaucomatous progression [ 8 , 9 ]. Comparisons of other characteristics demonstrated that the use of β -blocker or carbonic anhydrase inhibitor eyedrops was more common in the visual field progression group.…”

Section: Discussionsupporting

confidence: 87%

A Small Disc Area Is a Risk Factor for Visual Field Loss Progression in Primary Open-Angle Glaucoma: The Glaucoma Stereo Analysis Study

Kitaoka

Tanito

Yokoyama

et al. 2018

Journal of Ophthalmology

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Purpose The Glaucoma Stereo Analysis Study, a cross-sectional multicenter collaborative study, used a stereo fundus camera (nonmyd WX) to assess various morphological parameters of the optic nerve head (ONH) in glaucoma patients. We compared the associations of each parameter between the visual field loss progression group and no-progression group. Methods The study included 187 eyes of 187 patients with primary open-angle glaucoma or normal-tension glaucoma. We divided the mean deviation (MD) slope values of all patients into the progression group (<−0.3 dB/year) and no-progression group (≧−0.3 dB/year). ONH morphological parameters were calculated with prototype analysis software. The correlations between glaucomatous visual field progression and patient characteristics or each ONH parameter were analyzed with Spearman's rank correlation coefficient. Results The MD slope averages in the progression group and no-progression group were −0.58 ± 0.28 dB/year and 0.05 ± 0.26 dB/year, respectively. Among disc parameters, vertical disc width (diameter), disc area, cup area, and cup volume in the progression group were significantly less than those in the no-progression group. Logistic regression analysis revealed a significant association between the visual field progression and disc area (odds ratio 0.49/mm2 disc area). Conclusion A smaller disc area may be associated with more rapid glaucomatous visual field progression.

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“…A similar proportion of patients with RNFL progression and neuroretinal rim loss had lower diastolic blood pressure compared to those without these structural changes. This study therefore used flicker to reveal a correlation that may have significant implications for glaucoma management [23]. Similarly, Chee et al performed a study in which two glaucoma specialists assessed serial flicker chronoscopy images for features of structural progression, and found that age was significantly associated with global (OR = 1.8 per year, p \ 0.001) and PPA progression (OR = 1.7 per year, p = 0.002), and lower corneal hysteresis was associated with global progression (OR = 0.78 per mmHg, p = 0.049) and RNFL loss (OR = 0.5 per mmHg, p = 0.02) [24 • ].…”

Section: Using Automated Flicker To Identify Other Glaucoma Risk Factorsmentioning

confidence: 99%

Detection of Glaucoma Progression with Alternation Flicker

Syed

Marlow

Radcliffe

2014

Curr Ophthalmol Rep

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Glaucoma is a progressive optic neuropathy characterized by functional visual loss and underlying optic nerve deterioration. Optic nerve imaging, achieved using photography and scanning ophthalmic laser diagnostic imaging techniques, is an important aspect of glaucoma diagnosis and management. Alternation flicker is a technique in which serial optic nerve photographs, typically taken one or more years apart, are aligned and alternated in order to allow the observer to easily detect change over time. Alternation flicker has been shown to improve several aspects of optic nerve evaluation and has been demonstrated to correlate with traditional glaucoma risk factors, with some limitations. In this review, we consider the literature with respect to flicker for the evaluation and monitoring of glaucomatous optic neuropathy.

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Association of blood and ocular perfusion pressure with structural glaucomatous progression by flicker chronoscopy

Cited by 8 publications

References 20 publications

The Correlation of Retinal Nerve Fiber Layer Thickness With Blood Pressure in a Chinese Hypertensive Population

The Correlation of Retinal Nerve Fiber Layer Thickness With Blood Pressure in a Chinese Hypertensive Population

A Small Disc Area Is a Risk Factor for Visual Field Loss Progression in Primary Open-Angle Glaucoma: The Glaucoma Stereo Analysis Study

Detection of Glaucoma Progression with Alternation Flicker

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