Systemic Circulatory Parameters Comparison Between Patients with Normal Tension Glaucoma and Normal Subjects Using Ambulatory Monitoring

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

“…Arterial hypertension 7,8,11,[24][25][26][27] and hypotension 6,9,10,28-32 were reported to be relevant in normal tension and primary open-angle glaucoma, though other studies could not detect a significant difference to controls. [33][34][35][36] Diastolic perfusion pressures below 30 mmHg were related to a six-fold higher risk …”

“…19 Kashiwagi reported increased blood pressure variability in progressive NTG. 24 Béchetoille found higher systolic blood pressure variability in focal ischaemic glaucoma compared to POAG. 6 However, blood pressure measurements were only performed every 60 min at night, and no control subjects were included in this study.…”

“…28,36,43 In contrast, other investigators could find an even smaller dip in patients with progressive glaucoma. 24,44 The dip at night is considered to be physiological, and reaches 10-20% of daytime blood pressure values in a healthy population. 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.…”

“…Increased blood pressure fluctuations effect higher perfusion pressure variability, and may induce ischaemia of ocular tissues in glaucoma, if the autoregulatory capacity of ocular and optic nerve head blood flow is passed over. Maybe, not the absolute blood pressure level alone, 24,36,38,43,44,47 but fluctuations of night-time blood pressure may account for deficits of ocular perfusion pressure. In addition, ocular perfusion pressure is influenced by diurnal intraocular pressure fluctuations.…”

Short-term variability of systemic blood pressure and submacular choroidal blood flow in eyes of patients with primary open-angle glaucoma

“…Not only low mean ocular perfusion pressure [1][2][3][4][5][6], but also its variability play an important role in pathogenesis of GON [7][8][9][10][11]. Since OPP depends on intraocular pressure (IOP) and blood pressure in ocular vessels, their fluctuation could also be regarded as a risk factor for GON.…”