Ocular Blood Flow and Systemic Blood Pressure in Patients with Primary Open-Angle Glaucoma and Ocular Hypertension

Abstract

The present study indicates reduced ONH and choroidal blood flow and an abnormal association between blood pressure and ocular perfusion in patients with primary open-angle glaucoma or ocular hypertension, independent of topical antiglaucoma medication. Hence, vascular dysregulation appears to be an early manifestation in glaucoma that is not caused by pharmacologic intervention.

Circadian changes of intraocular pressure and ocular perfusion pressure after timolol or latanoprost in Caucasians with normal-tension glaucoma

“…These sideeffects have been reported from time to time [9,13,18,25,30,32], also indicating that timolol eyedrops reach a plasma concentration able to induce BP and HR drops similar to those observed after systemic drug administration [25]. However, the review of literature fails to give any unequivocal conclusion regarding an effectual correlation between ophthalmic β-blocker employment and detrimental BP-related modifications of ONH microcirculation [14,15,27,40]. In patients with POAG or ocular hypertension, Fuchsjager-Mayrl et al have documented an abnormal association between BP and ocular perfusion independently of anti-glaucoma drugs, but without verifying whether the re-administration of β-blockers was responsible for a further, iatrogenic worsening of ONH hemodynamics [14].…”

“…However, the review of literature fails to give any unequivocal conclusion regarding an effectual correlation between ophthalmic β-blocker employment and detrimental BP-related modifications of ONH microcirculation [14,15,27,40]. In patients with POAG or ocular hypertension, Fuchsjager-Mayrl et al have documented an abnormal association between BP and ocular perfusion independently of anti-glaucoma drugs, but without verifying whether the re-administration of β-blockers was responsible for a further, iatrogenic worsening of ONH hemodynamics [14]. The present investigation shows that latanoprost does not exert any cardiovascular modification in 24-hour-monitored NTG subjects, confirming the results of previous clinical trials conducted with similar [9,26], or more specific methodological approaches [45].…”

Paraoxonase 1 gene polymorphisms influence clinical features of open-angle glaucoma

“…Dysfunction of endothelial cells is known to contribute to the pathogenesis of OAG [8,9,13,36]. Thus, we considered the possibility that genetic factors associated with endothelial dysfunction might also be present in patients with OAG.…”

“…Many studies have shown that the ocular circulation is altered in OAG patients because of a breakdown of vascular regulation as opposed to the effects of arteriosclerosis [8,9,13]. Recently, cholesterol-lowering medications such as the statins were linked to reduced risk of having OAG [26].…”

Low Diastolic Blood Pressure Is Associated with the Progression of Normal-Tension Glaucoma

“…Several studies have implicated vascular risk factors such as blood pressure (BP) and perfusion pressure (PP) in the pathophysiology of open-angle glaucoma [2,5,6,7,8,9,10,11]. PP is defined as the difference between BP and IOP.…”