Intraocular Pressure Changes in Normal and Moderately Hypertensive Post Menopausal Women

Abstract

BACKGROUND: Elevated Intraocular Pressure (IOP) causes a mechanical stress situation, leading to damage of neurons in retina and their axons resulting in progressive loss of visual field and blindness seen in Glaucoma. Changes in IOP are directly and significantly associated with changes in systemic blood pressures. Blood pressure increases with age in most populations, especially so after menopause. Menopausal women with hypertension are at increased risk of developing elevated IOP. There are limited data about association of moderate changes in blood pressure that often go with treatment for hypertension with IOP. This work was undertaken to study the effect of moderate systemic hypertension on IOP in postmenopausal women. MATERIALS AND METHODS: 40 Normotensive and 40 Hypertensive postmenopausal women participated in the study. All participants satisfied inclusion and exclusion criteria and gave informed consent. Participants underwent detailed clinical and ophthalmologic examination and IOPs were measured using Schiotz Indentation Tonometer. RESULTS: Mean IOP was 15.28+/-2.54 mmHg in normotensive and 19.47+/-3.37 mmHg, in moderately Hypertensive women. IOP was significantly increased (P<0.001**) among the hypertensive post menopausal women compared to normotensives. Subjects with higher SBP had significantly higher IOP (p < 0.001). The mean IOP also showed a significant correlation (p value of 0.001**) to the total number of years after attainment of menopause. CONCLUSIONS: Elevated IOP was seen in postmenopausal women with moderate hypertension associated with treatment. It is therefore essential that postmenopausal hypertensive women are screened regularly for increases in IOP, the only modifiable risk factor for Glaucoma. KEY WORDS: Elevated Intraocular pressure, moderate hypertension, post menopausal women, Glaucoma, Schiotz Indentation Tonometer, systolic blood pressure and diastolic blood pressure (6) It is also seen that changes in IOP are directly and significantly associated with changes in systemic blood pressure. (7,8) In India more than 60 million women are in the age of 55 yrs because of aging population.(9) With women living longer than before, a majority would spend one third of their life in postmenopausal age. Blood pressure increases with age in most populations, especially after menopause there is a sharp increase in the prevalence of hypertension in women. (10) It is evident that postmenopausal women are at increased risk of developing elevated IOP and glaucoma because of presence of multiple risk factors mentioned above. It is seen that of those with glaucomatous visual field loss, less than 50% have received an appropriate diagnosis or treatment according to population surveys. (11,12) Cardiovascular disease is the leading cause of mortality and morbidity in women.(13) and medical intervention has been successful in lowering blood pressure and the subsequent risk of the systemic sequel of high blood pressure. There are limited data about association of IOP to moderate changes ...