Optic nerve blood flow in glaucoma: effect of systemic hypertension

PURPOSE: To investigate optic nerve head blood flow in patients with glaucoma and to assess the effect of systemic hypertension. METHODS: This study included 24 eyes of 24 patients with primary open-angle glaucoma. Eleven of these patients had a history of systemic hypertension. Results in patients...

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Bibliographic Details
Published in:American journal of ophthalmology 1999-05, Vol.127 (5), p.516-522
Main Authors: Grunwald, Juan E, Piltz, Jody, Hariprasad, Seenu M, Dupont, Joan, Maguire, Maureen G
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Blood Flow Velocity
Blood Pressure
Female
Glaucoma and intraocular pressure
Glaucoma, Open-Angle - physiopathology
Humans
Hypertension - physiopathology
Intraocular Pressure
Laser-Doppler Flowmetry
Male
Medical sciences
Middle Aged
Ophthalmology
Optic Disk - blood supply
Optic Nerve - blood supply
Sphygmomanometers
Visual Acuity
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Summary:PURPOSE: To investigate optic nerve head blood flow in patients with glaucoma and to assess the effect of systemic hypertension. METHODS: This study included 24 eyes of 24 patients with primary open-angle glaucoma. Eleven of these patients had a history of systemic hypertension. Results in patients with glaucoma were compared with those of 13 eyes of 13 age-matched normal controls. Determinations of relative optic nerve head blood velocity, volume, and flow were obtained with laser Doppler flowmetry in the superotemporal and inferotemporal neuroretinal rim and also in the cup. Means of the velocity, volume, and flow of these three measurement sites were calculated for each subject. RESULTS: Mean overall optic nerve head blood flow was 29% lower in glaucoma patients than in normal controls ( t test, P < .001). This decrease in flow was mainly caused by a decrease of 23% in mean blood velocity ( P < .001). Mean flow in glaucoma patients without systemic hypertension was 26% lower than that of glaucoma patients with hypertension (Tukey honest significant difference test, P = .05). A significant direct correlation was observed between mean flow and mean blood pressure (R = 0.51, P < .02). CONCLUSIONS: Optic nerve blood flow is reduced in glaucoma patients. Glaucoma patients without systemic hypertension have lower optic nerve blood flow than those with hypertension. Our results raise concerns that treatment of systemic hypertension may further decrease optic nerve blood flow in glaucoma patients.
ISSN:0002-9394
1879-1891
DOI:10.1016/S0002-9394(99)00028-8