Do Patients with Low Tension Glaucoma Have Particular Cardiovascular Characteristics?

Abstract

It has been suggested that low tension glaucoma (LTG) could be the consequence of a hemodynamic crisis or chronic occlusive disease. The purpose of the present study was to test this hypothesis by comparing three groups of patients matched for age and sex: 51 patients with LTG, 51 patients with open angle glaucoma (OAG) and 46 control patients. Clinical symptoms and history of occlusive arterial disease and conditions which could be associated with or were the consequence of acute blood pressure lowering were not more frequent in the LTG group. The prevalence of rhythm and conduction abnormalities on the ECG was two times more frequent in the glaucoma groups, but the differences were not statistically significant. Mean cardiovascular risk factor levels were not higher in the LTG group than in the two other groups. But the mean difference of blood pressure between the standing and lying positions was significantly greater in the LTG group (systolic blood pressure: ––6.9mmHg) than in the OAG group (––1.2 mm HG) and the control group (––1.5mmHg). These results suggest that postural hypotension could play a role in the pathogenesis of LTG.

Silent Myocardial Ischemia in Glaucoma Patients

“…The striking observation, however, was that the frequency of silent ischemic episodes was even doubled in the normal-tension group. Although the number of patients is too small to draw definite conclusions, the find ings are well in line with previous reports, demonstrating that cardiovascular abnormal ities are more often observed in glaucoma pa tients than in normals [10,11]. These abnor malities seem to occur even more frequently in patients with normal-tension glaucoma.…”

24-h blood pressure monitoring in normal tension glaucoma: night-time blood pressure variability

“…17,45,46 Interestingly, all studies on patients with glaucoma, including the studies that reported significant differences to control subjects found a mean nighttime blood pressure reduction in this physiological range. 12,16,28,34,36,41,[43][44][45][46][47] In the presented study, the prevalence of treated arterial hypertension and cardiovascular risk factors was not significantly different in patients with NTG and controls based on the patient's medical history ( Table 2). The medications and systemic diseases other than the named cardiovascular risk factors were not analysed in this study.…”

Relationship between Diastolic Perfusion Pressure and Progressive Optic Neuropathy as Determined by Heidelberg Retinal Tomography Topographic Change Analysis

“…First, an increased risk of glaucoma with calcium channel blocker use has been shown, 16 and second, suppression of the autoregulatory response has been shown with the use of calcium channel blockers. 41 The importance of monitoring blood pressure and not ''overtreating'' hypertension has also been mentioned elsewhere in terms of avoiding low perfusion pressures in diagnosed OAG cases. 17 This research represents a significant step forward in confirming the relationship between lower perfusion pressure and increased progression rates in OAG using relatively stringent imaging criteria.…”