A Population-Based Assessment of 24-Hour Ocular Perfusion Pressure Among Patients With Primary Open Angle Glaucoma: The Handan Eye Study

PurposeTo compare the 24-hour ocular perfusion pressure (OPP) among patients with primary open angle glaucoma (POAG) and those with suspected POAG identified in a population-based study in China. MethodsForty-seven patients with POAG and 35 with suspected POAG attended the 24-hour OPP study. Intraocular pressure (IOP) and blood pressure (BP) were measured at 2, 6, and 10 AM and 2, 6, and 10 PM. Subjects were not taking any medications to lower IOP, which was measured with Goldmann applanation in an upright sitting position. Blood pressure was measured in a supine position using a digital automatic BP monitor (OMRON, model HEM-907). Mean arterial pressure was calculated as diastolic BP + 1[Fraction Slash]3 × (systolic BP – diastolic BP). Mean OPP (MOPP) was defined as 2[Fraction Slash]3 × mean arterial pressure – IOP, systolic OPP (SOPP) was defined as 2[Fraction Slash]3 × systolic BP – IOP, and diastolic OPP (DOPP) was defined as 2[Fraction Slash]3 × diastolic BP – IOP. ResultsAfter adjustment for age, sex, and IOP, the maximum, mean, and minimum SOPP, DOPP, and MOPP were statistically significantly lower in subjects with POAG than in those with suspected POAG (P < 0.05). The minimum MOPP, SOPP, and DOPP occurred from 10 AM to 2 PM in approximately 60% of eyes with POAG and between 20% and 30% of minimum MOPP, SOPP, and DOPP occurred around 10 PM. ConclusionsSystolic OPP, DOPP, and MOPP were consistently lower in eyes with POAG than in those with suspected POAG, providing further evidence that OPP plays a role in the development of glaucoma.

[1]  R. Klein,et al.  Diabetic retinopathy in a multi-ethnic cohort in the United States. , 2006, American journal of ophthalmology.

[2]  M. C. Leske,et al.  Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. , 2003, Archives of ophthalmology.

[3]  A. Sommer,et al.  Hypertension, perfusion pressure, and primary open-angle glaucoma. A population-based assessment. , 1995, Archives of ophthalmology.

[4]  P. Mitchell,et al.  Open-Angle Glaucoma and Systemic Hypertension: The Blue Mountains Eye Study , 2004, Journal of glaucoma.

[5]  P. Sarafidis,et al.  24-Hour Intraocular Pressure and Blood Pressure Levels with Latanoprost/Timolol Fixed Combination Versus Timolol , 2009, Current eye research.

[6]  S. Yun,et al.  Twenty-four hour ocular perfusion pressure fluctuation and risk of normal-tension glaucoma progression. , 2009, Investigative ophthalmology & visual science.

[7]  A. Fleming,et al.  Penicillin and streptomycin. , 1947, Lancet.

[8]  Ning Li Wang,et al.  Prevalence and characteristics of primary angle-closure diseases in a rural adult Chinese population: the Handan Eye Study. , 2011, Investigative ophthalmology & visual science.

[9]  E. O’Brien,et al.  DIPPERS AND NON-DIPPERS , 1988, The Lancet.

[10]  E. E. Hartmann,et al.  The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. , 2002, Archives of ophthalmology.

[11]  A. Iwase,et al.  The prevalence of primary open-angle glaucoma in Japanese: the Tajimi Study. , 2004, Ophthalmology.

[12]  D. Friedman,et al.  Prevalence and causes of amblyopia in a rural adult population of Chinese the Handan Eye Study. , 2011, Ophthalmology.

[13]  A. Sommer,et al.  Risk factors for open-angle glaucoma: the Barbados Eye Study. , 1996, Archives of ophthalmology.

[14]  K. Sung,et al.  Twenty-Four Hour Blood Pressure Pattern in Patients With Normal Tension Glaucoma in the Habitual Position , 2009, Korean journal of ophthalmology : KJO.

[15]  P. Linkowski,et al.  Effects of wake and sleep stages on the 24-h autonomic control of blood pressure and heart rate in recumbent men. , 1994, The American journal of physiology.

[16]  D. Friedman,et al.  A population-based assessment of 24-hour intraocular pressure among subjects with primary open-angle glaucoma: the handan eye study. , 2010, Investigative ophthalmology & visual science.

[17]  A. Investigators The Advanced Glaucoma Intervention Study (AGIS): 12. Baseline risk factors for sustained loss of visual field and visual acuity in patients with advanced glaucoma. , 2002, American journal of ophthalmology.

[18]  Douglas R. Anderson,et al.  The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma. Collaborative Normal-Tension Glaucoma Study Group. , 1998, American journal of ophthalmology.

[19]  J. Staessen,et al.  Is Isolated Nocturnal Hypertension a Novel Clinical Entity?: Findings From a Chinese Population Study , 2007, Hypertension.

[20]  M. C. Leske,et al.  The Barbados Eye Study. Prevalence of open angle glaucoma. , 1994, Archives of ophthalmology.

[21]  G. Schillaci,et al.  Dippers versus non-dippers. , 1991, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[22]  M. C. Leske,et al.  Risk factors for open-angle glaucoma. The Barbados Eye Study. , 1995, Archives of ophthalmology.

[23]  Francesco Portaluppi,et al.  Role of sleep-wake cycle on blood pressure circadian rhythms and hypertension. , 2007, Sleep medicine.

[24]  Jaewan Choi,et al.  Circadian fluctuation of mean ocular perfusion pressure is a consistent risk factor for normal-tension glaucoma. , 2007, Investigative ophthalmology & visual science.

[25]  D. Friedman,et al.  Prevalence and causes of low vision and blindness in a rural chinese adult population: the Handan Eye Study. , 2008, Ophthalmology.

[26]  P. Mitchell,et al.  Prevalence of open-angle glaucoma in Australia. The Blue Mountains Eye Study. , 1996, Ophthalmology.

[27]  S. Hayreh The Blood Supply of the Optic Nerve Head and the Evaluation of it — Myth and Reality , 2001, Progress in Retinal and Eye Research.

[28]  Tin Aung,et al.  The prevalence and types of glaucoma in malay people: the Singapore Malay eye study. , 2008, Investigative ophthalmology & visual science.

[29]  Yuan Bo Liang,et al.  Prevalence of primary open angle glaucoma in a rural adult Chinese population: the Handan eye study. , 2011, Investigative ophthalmology & visual science.

[30]  G. Marchini,et al.  Vascular risk factors for primary open angle glaucoma: the Egna-Neumarkt Study. , 2000, Ophthalmology.

[31]  A. Sit,et al.  Pathophysiology of glaucoma and continuous measurements of intraocular pressure. , 2009, Molecular & cellular biomechanics : MCB.

[32]  S. Drance,et al.  Risk factors for progression of visual field abnormalities in normal-tension glaucoma. , 2001, American journal of ophthalmology.

[33]  D. Kass,et al.  Advanced glycation endproduct crosslink breaker (alagebrium) improves endothelial function in patients with isolated systolic hypertension , 2007, Journal of hypertension.

[34]  M. C. Leske,et al.  Predictors of long-term progression in the early manifest glaucoma trial. , 2007, Ophthalmology.

[35]  A. Hofman,et al.  Primary open-angle glaucoma, intraocular pressure, and systemic blood pressure in the general elderly population. The Rotterdam Study. , 1995, Ophthalmology.

[36]  D. Friedman,et al.  Rationale, Design, Methodology, and Baseline Data of a Population-Based Study in Rural China: The Handan Eye Study , 2009, Ophthalmic epidemiology.

[37]  A. Sommer,et al.  Relationship between intraocular pressure and primary open angle glaucoma among white and black Americans. The Baltimore Eye Survey. , 1991, Archives of ophthalmology.

[38]  J. Jonas,et al.  Ocular perfusion pressure and glaucoma: the Beijing Eye Study , 2009, Eye.

[39]  A. Harris,et al.  The role of optic nerve blood flow in the pathogenesis of glaucoma. , 2005, Ophthalmology clinics of North America.

[40]  D. Friedman,et al.  Distribution of ocular perfusion pressure and its relationship with open-angle glaucoma: the singapore malay eye study. , 2010, Investigative ophthalmology & visual science.

[41]  E. Stefánsson,et al.  The impact of ocular blood flow in glaucoma , 2002, Progress in Retinal and Eye Research.

[42]  M. C. Leske,et al.  Risk factors for incident open-angle glaucoma: the Barbados Eye Studies. , 2008, Ophthalmology.

[43]  M. C. Leske,et al.  Risk Factors for Open-angle Glaucoma: The Barbados Eye Study-Reply , 1996 .

[44]  G. Schillaci,et al.  Quantitative assessment of day-to-day spontaneous variability in non-invasive ambulatory blood pressure measurements in essential hypertension. , 1991, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[45]  D. Martinez,et al.  Awakenings change results of nighttime ambulatory blood pressure monitoring , 2007, Blood pressure monitoring.