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Pan-Doh N, Guo X, Arsiwala-Scheppach LT, Walker KA, Sharrett AR, Abraham AG, Ramulu PY. Associations of Midlife and Late-Life Blood Pressure Status With Late-Life Retinal OCT Measures. Transl Vis Sci Technol 2023; 12:3. [PMID: 36729476 PMCID: PMC9907367 DOI: 10.1167/tvst.12.2.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Purpose To explore the relationship of long-term blood pressure (BP) patterns with late-life optical coherence tomography (OCT) structural measures reflecting optic nerve health. Methods Participants in this community-based cohort study of black and white individuals were part of the Atherosclerosis Risk in Communities study and the nested Eye Determinants of Cognition (EyeDOC) study. Participants had BP measured six times from 1987 to 2017 and were categorized into five BP patterns: sustained normotension; midlife normotension, late-life hypertension (systolic BP [SBP] >140 mmHg or diastolic BP [DBP] >90 mmHg or antihypertensive medication use); sustained hypertension; midlife normotension, late-life hypotension (SBP <90 mmHg or DBP <60 mmHg); and midlife hypertension, late-life hypotension. Multivariable linear regression modeling was used to evaluate associations between BP patterns and late-life OCT ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thickness. Results In total, 931 eyes of 931 participants (mean age at EyeDOC visit = 80 years; 63% female; 45% black) were included. Mean GCC and RNFL thicknesses in the sustained normotension pattern were 90.8 ± 10.3 µm and 89.9 ± 11.2 µm versus 89.4 ± 11.9 µm and 90.1 ± 12.2 µm in the sustained hypertension pattern (P > 0.05). Compared to the sustained normotension pattern, no significant differences in GCC or RNFL thickness were found for any anomalous BP pattern. Conclusions Assessment of long-term BP status showed no significant associations with late-life OCT structural measures. Translational Relevance OCT imaging results in our population-based sample suggest that neither hypertension, even when present in midlife, nor late-life hypotension are significant risk factors for late-life optic nerve damage.
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Affiliation(s)
- Nathan Pan-Doh
- Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Xinxing Guo
- Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, USA
| | | | - Keenan A. Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
| | - A. Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alison G. Abraham
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA,Department of Ophthalmology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
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Bai WL, Kang YT, Li SM, Gan JH, Wei SF, Kang MT, Sun YY, Sun MH, Li H, Zhang FJ, Wang NL. Ocular Perfusion Pressure in 7- and 12-Year-Old Chinese Children: The Anyang Childhood Eye Study. Transl Vis Sci Technol 2022; 11:26. [PMID: 36255359 PMCID: PMC9587466 DOI: 10.1167/tvst.11.10.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to report the distribution of mean ocular perfusion pressure (MOPP) and its associated factors in Chinese children. Methods We enrolled 3048 grade 1 students and 2258 grade 7 students of the Anyang Childhood Eye Study in central China. Systolic and diastolic blood pressure (SBP and DBP) were recorded with a digital automatic sphygmomanometer. Intraocular pressure (IOP) was assessed by a non-contact tonometer. MOPP was calculated as 2/3 × (DBP + 1/3[SBP – DBP]) - IOP. Risk factors for myopia were obtained through a questionnaire survey. Results The MOPP was 33.83 ± 6.37 mm Hg (mean ± SD) in grade 1, which was lower than 36.99 ± 6.80 mm Hg in grade 7 (P < 0.001). Compared with myopic eyes, non-myopic eyes had higher MOPP in grade 7 (37.72 ± 6.72 mm Hg versus 36.58 ± 6.57 mm Hg, P < 0.001) and in grade 1 (33.88 ± 6.29 mm Hg versus 33.12 ± 7.03 mm Hg, P = 0.12). Multivariable analysis showed that higher MOPP was associated with less myopia (P < 0.001), higher body mass index (BMI; P < 0.001), thinner central corneal thickness (P < 0.001), less time on near work (P < 0.001), and more time on sleeping (P = 0.04). Conclusions MOPP was higher in children of older age, with higher BMI, less time on near work, and more time on sleeping, and was higher in eyes with less myopia. Translational Relevance We found that MOPP might be an indicator for the detection of myopia development.
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Affiliation(s)
- Wei-Ling Bai
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Yu-Ting Kang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Shi-Ming Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Jia-He Gan
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Shi-Fei Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Meng-Tian Kang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Yun-Yun Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Ming-Hao Sun
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - He Li
- Anyang Eye Hospital, Henan Province, Anyang, China
| | - Feng-Ju Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Ning-Li Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
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Garg P, Malik M, Rai N, Singh A, Chellaiyan VG. Prevalence of pre-perimetric primary open angle glaucoma in hypertensives of North India. J Family Med Prim Care 2022; 11:5257-5262. [PMID: 36505564 PMCID: PMC9731015 DOI: 10.4103/jfmpc.jfmpc_2288_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/25/2022] [Accepted: 03/03/2022] [Indexed: 12/15/2022] Open
Abstract
Background Systemic hypertension is alleged to increase the risk of glaucoma. As clinically Primary Open angle Glaucoma (POAG) is diagnosed only after approximately 40% of ganglion cell loss has occurred, therefore this study was commenced with an aim to determine the prevalence of pre-perimetric glaucomatous damage and its association with systemic hypertension using optical coherence tomography (OCT). Materials and Methods A total of 680 study participants were enrolled in this cross-sectional study. Among them 340 patients were of systemic hypertension (Group 1) and 340 patients without hypertension (Group 2). All patients underwent detailed history, ocular and systemic examination including slit lamp examination, fundus examination by +90 D lens, Humphrey field analyser for field charting and OCT for nerve fiber analysis. For glaucomatous nerve damage. Results Group 1 and Group 2 had Male: Female ratio of 1:8 and 1:9, respectively (P = 0.809). Maximum participants 48.8% and 54.4% in Group 1 and Group 2, respectively, were in age group 50-59 years. Statistically significant difference was seen in the percentage of pre-perimetric glaucomatous patients between the two groups (P < 0.001). On OCT analysis between pre-perimetric glaucomatous eyes and healthy eyes significant difference in thickness was seen in temporal inner macula, inferior outer macula, temporal outer macula, superior outer macula and nasal outer macula. Significant difference in volume was seen for inferior temporal and nasal outer macula (P < 0.001). Conclusion In hypertensives, glaucomatous optic nerve damage starts much earlier before the obvious clinical signs of POAG appear, as compared to normotensive individuals.
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Affiliation(s)
- Pragati Garg
- Department of Ophthalmology, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India
| | - Mehvish Malik
- Department of Ophthalmology, Era’s Medical College, Lucknow, Uttar Pradesh, India,Address for correspondence: Dr. Mehvish Malik, Era’s Medical College, Lucknow, Uttar Pradesh, India. E-mail:
| | - Nishant Rai
- Department of Ophthalmology, Era’s Medical College, Lucknow, Uttar Pradesh, India
| | - Abhay Singh
- Department of Community Medicine, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India
| | - Vinoth G. Chellaiyan
- Department of Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, OMR- Kelambakkam, Tamil Nadu, India
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Tiambeng C, Batur A, Dikmetas Ö, Aksu NM. The acute effect of systemic blood pressure reduction on intraocular pressure in hypertensive patients. Turk J Emerg Med 2022; 22:131-136. [PMID: 35936951 PMCID: PMC9355068 DOI: 10.4103/2452-2473.348441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/03/2022] [Accepted: 04/11/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES: Previous studies have shown an association between systemic hypertension and intraocular pressure (IOP). We analyzed the relationship between the decreases of the blood pressure (BP) and IOP in hypertensive patients. METHODS: The study includes a total of 214 patients: 158 hypertensive and 56 normotensive patients as study and control groups, respectively. The IOP of each eye in both the groups was measured once with a noncontact tonometer at presentation and an hour after BP reduction to normal in the study group. We analyzed the reduction in IOP with decreasing BP. RESULTS: In the study group, the mean IOP was 15.29 ± 4.05 mmHg in the right and 15.11 ± 3.78 mmHg in the left eyes. The mean IOP measured an hour after the patients became normotensive was 13.78 ± 4.06 mmHg in the right and 13.51 ± 3.82 in the left eyes. There was a statistically significant decrease in the IOPs (P < 0.001). The mean IOP in the control group was 13.54 ± 3.51 mmHg in the right and 13.20 ± 3.33 mmHg in the left eyes. The mean IOP at presentation in the study and control groups was found to be significantly different (P < 0.001). CONCLUSIONS: Patients in the study group showed a significantly higher IOP compared to patients in the normotensive group. Furthermore, patients in the study group showed a significant reduction in IOP after BP reduction. This may indicate that uncontrolled hypertension poses a risk for prolonged higher IOP. Prolonged higher IOP can be considered a risk factor for the glaucoma.
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Affiliation(s)
- Canan Tiambeng
- Department of Emergency Medicine, Faculty of Medicine, Hacettepe University, Altindag, Ankara, Turkey
| | - Ali Batur
- Department of Emergency Medicine, Faculty of Medicine, Hacettepe University, Altindag, Ankara, Turkey
| | - Özlem Dikmetas
- Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Altindag, Ankara, Turkey
| | - Nalan Metin Aksu
- Department of Emergency Medicine, Faculty of Medicine, Hacettepe University, Altindag, Ankara, Turkey
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Nislawati R, Taufik Fadillah Zainal A, Ismail A, Waspodo N, Kasim F, Gunawan AMAK. Role of hypertension as a risk factor for open-angle glaucoma: a systematic review and meta-analysis. BMJ Open Ophthalmol 2021; 6:e000798. [PMID: 34632075 PMCID: PMC8479953 DOI: 10.1136/bmjophth-2021-000798] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/05/2021] [Indexed: 11/30/2022] Open
Abstract
Glaucoma is the leading cause of irreversible blindness. It is estimated that as many as 3.2 million people worldwide experience blindness due to glaucoma, including open-angle glaucoma (OAG). Until now, there is no definite mechanism related to the incidence of OAG. However, increased intraocular pressure (IOP) is considered to be the most important risk factor. Several current studies show that there is a significant relationship between hypertension (HTN) and IOP. In particular, several epidemiological studies have shown that an increase in systemic blood pressure (BP) is associated with an increase in IOP. However, several studies report that high BP provides a protective effect at a young age against the incidence of OAG. Therefore, this literature aims to explore the effect of HTN on the incidence of OAG. In this review, search for the literature using keywords that match the topic, then a gradual screening was carried out with the predetermined eligibility criteria. From 3711 studies, 16 studies matched the criteria having a total sample size of 72 212 and then a quantitative meta-analysis was conducted. The results showed a risk ratio of 1.69 (95% CI 1.50 to 1.90) in the HTN group. However, from our qualitative synthesis, we found that people who have an unstable diastolic blood pressure (DBP), either high or low, are both able to increase the risk of OAG events. In conclusion, we found that HTN was able to increase the risk of OAG and DBP instability, whether high or low, can also increase the risk of OAG incidence.
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Affiliation(s)
- Ririn Nislawati
- Department of Ophthalmology, Hasanuddin University, Makassar, Indonesia
| | | | - Abrar Ismail
- Department of Ophthalmology, Hasanuddin University, Makassar, Indonesia
| | - Noro Waspodo
- Department of Ophthalmology, Hasanuddin University, Makassar, Indonesia
| | - Firdaus Kasim
- Department of Community Medicine, Hasanuddin University, Makassar, Indonesia
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Torabi R, Harris A, Siesky B, Zukerman R, Oddone F, Mathew S, Januleviciene I, Vercellin ACV. Prevalence Rates and Risk Factors for Primary Open Angle Glaucoma in the Middle East. J Ophthalmic Vis Res 2021; 16:644-656. [PMID: 34840687 PMCID: PMC8593541 DOI: 10.18502/jovr.v16i4.9755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/09/2021] [Indexed: 12/16/2022] Open
Abstract
Glaucoma is a multifactorial disease and a leading cause of irreversible blindness worldwide. Current data has demonstrated the approximate distribution of primary open-angle glaucoma (POAG) in patients of European, African, Hispanic, and Eastern Asian descent. However, a significant gap in the literature exists regarding the prevalence of POAG in Middle Eastern (ME) populations. Current studies estimate ME POAG prevalence based on a European model. Herein we screened 65 total publications on ME prevalence of POAG and specific risk factors using keywords: "glaucoma", "prevalence", "incidence", "risk factor", "Middle East", "Mideast", "Persian", "Far East", as well as searching by individual ME countries through PubMed, Embase, Ovid, Scopus, and Trip searches with additional reference list searches from relevant articles published up to and including March 1, 2021. Fifty qualifying records were included after 15 studies identified with low statistical power, confounding co-morbid ophthalmic diseases, and funding bias were excluded. Studies of ME glaucoma risk factors that identify chromosomes, familial trend, age/gender, socioeconomic status, lifestyle, intraocular pressure, vascular influences, optic disc hemorrhage, cup-to-disc ratio, blood pressure, obstructive sleep apnea, and diabetes mellitus were included in this systematic review. We conclude that the prevalence of POAG in the ME is likely higher than the prevalence rate that European models suggest, with ME specific risk factors likely playing a role. However, these findings are severely limited by the paucity of population-level data in the ME. Well-designed, longitudinal population-based studies with rigorous inclusion and exclusion criteria are ultimately needed to accurately assess the epidemiology and specific mechanistic risk factors of glaucoma in ME populations.
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Affiliation(s)
- Rana Torabi
- Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana, University School of Medicine, Indianapolis, IN, USA
| | - Alon Harris
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brent Siesky
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ryan Zukerman
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Sunu Mathew
- Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana, University School of Medicine, Indianapolis, IN, USA
| | - Ingrida Januleviciene
- Eye Clinic of Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania
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7
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Abstract
Healthcare in the twenty-first century has witnessed an increased use of prescription drugs. As a member of a patient's health care team, optometrists should be aware of the pharmaceuticals taken by patients and their potential ocular complications. This paper will discuss the most prescribed medications in Australia today and their effects on the visual system. The paper will review the agents used to treat six common systemic conditions, their frequency of use, mechanism of action, clinical indications, and potential ocular manifestations. Literature has documented both positive and negative associations of systemic medications on the eye's health. Many associations documented here have shown conflicting evidence, thus warranting further investigation. Based on the frequency and severity of the ocular manifestations in the literature, recommendations for clinical care are given. Being familiar with the most common ocular side effects associated with common systemic medications aids in the correct and timely diagnosis of ocular complications to prevent permanent sequelae.
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Affiliation(s)
- Rachel Williams
- University of Houston College of Optometry, Houston, United States
| | - Alex Hui
- School of Optometry and Vision Science, UNSW, Sydney, Australia
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8
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Harris A, Guidoboni G, Siesky B, Mathew S, Verticchio Vercellin AC, Rowe L, Arciero J. Ocular blood flow as a clinical observation: Value, limitations and data analysis. Prog Retin Eye Res 2020; 78:100841. [PMID: 31987983 PMCID: PMC8908549 DOI: 10.1016/j.preteyeres.2020.100841] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 12/24/2022]
Abstract
Alterations in ocular blood flow have been identified as important risk factors for the onset and progression of numerous diseases of the eye. In particular, several population-based and longitudinal-based studies have provided compelling evidence of hemodynamic biomarkers as independent risk factors for ocular disease throughout several different geographic regions. Despite this evidence, the relative contribution of blood flow to ocular physiology and pathology in synergy with other risk factors and comorbidities (e.g., age, gender, race, diabetes and hypertension) remains uncertain. There is currently no gold standard for assessing all relevant vascular beds in the eye, and the heterogeneous vascular biomarkers derived from multiple ocular imaging technologies are non-interchangeable and difficult to interpret as a whole. As a result of these disease complexities and imaging limitations, standard statistical methods often yield inconsistent results across studies and are unable to quantify or explain a patient's overall risk for ocular disease. Combining mathematical modeling with artificial intelligence holds great promise for advancing data analysis in ophthalmology and enabling individualized risk assessment from diverse, multi-input clinical and demographic biomarkers. Mechanism-driven mathematical modeling makes virtual laboratories available to investigate pathogenic mechanisms, advance diagnostic ability and improve disease management. Artificial intelligence provides a novel method for utilizing a vast amount of data from a wide range of patient types to diagnose and monitor ocular disease. This article reviews the state of the art and major unanswered questions related to ocular vascular anatomy and physiology, ocular imaging techniques, clinical findings in glaucoma and other eye diseases, and mechanistic modeling predictions, while laying a path for integrating clinical observations with mathematical models and artificial intelligence. Viable alternatives for integrated data analysis are proposed that aim to overcome the limitations of standard statistical approaches and enable individually tailored precision medicine in ophthalmology.
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Affiliation(s)
- Alon Harris
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.
| | | | - Brent Siesky
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Sunu Mathew
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Alice C Verticchio Vercellin
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA; University of Pavia, Pavia, Italy; IRCCS - Fondazione Bietti, Rome, Italy
| | - Lucas Rowe
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Julia Arciero
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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9
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Gore V, Shah P, Kanhere M, Gore S. Relationship between optical perfusion pressure and systemic blood pressure on glaucoma: Case-control study. Oman J Ophthalmol 2019; 12:150-155. [PMID: 31902988 PMCID: PMC6826592 DOI: 10.4103/ojo.ojo_112_2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIM: To investigate the relationship between blood pressure (BP), ocular perfusion pressure (OPP), intraocular pressure (IOP) and open angle glaucoma (OAG) in Primary Open Angle Glaucoma (POAG) patients and normal population. DESIGN: Cross-sectional observation study. MATERIALS AND METHODS: Hospital-based, case control cross-sectional study conducted on 150 patients, of which 75 people were included in the control group and 75 people in the glaucoma group. The diagnosis of cases was based on disc evaluation, gonioscopy, perimetry and applanation tonometry. Systolic and diastolic blood pressure (SBP and DBP) was measured with a Mercury Sphygmomanometer. Mean ocular perfusion pressure (MOPP) = ⅔ (mean arterial pressure − IOP), where mean arterial pressure (MAP) = DBP + ⅓ (SBP − DBP), systolic perfusion pressure (SPP) = SBP – IOP and diastolic perfusion pressure (DPP) = DBP − IOP was calculated. RESULTS: DBP, OPP, SPP and DPP showed positive association with POAG. There is positive correlation between IOP and SBP, DBP and there is a negative correlation between IOP, OPP, SPP and DPP. Lower OPP was strongly associated with an increased risk for POAG, with a relative risk of 6.27 and the odds ratio of 0.075 for those with OPP less than 50 mmHg. Similarly, a low DPP less than 55 mmHg were also associated with increased risk for POAG with relative risk of 5.3 and the odds ratio of 0.020. CONCLUSION: Low MOPP and low DPP show strong association with increased prevalence of POAG and are independent risk factors for OAG.
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Affiliation(s)
- Varshav Gore
- Department of Ophthalmology, Navi Mumbai, Maharashtra, India
| | - Parthav Shah
- MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Minal Kanhere
- Department of Ophthalmology, Navi Mumbai, Maharashtra, India
| | - Shalini Gore
- Terna Medical College, Navi Mumbai, Maharashtra, India
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Chong Seong NT, Yaakub A, Jalil RA, Tirmandas Vn K, A/P Sandragasu T, Noor JBM, Husain NB, Mustari ZB, Hamid SAA, Mt Saad AB, At LS. Effect of physical activity on severity of primary angle closure glaucoma. Ther Adv Ophthalmol 2019; 11:2515841419864855. [PMID: 31384724 PMCID: PMC6664631 DOI: 10.1177/2515841419864855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 06/24/2019] [Indexed: 01/13/2023] Open
Abstract
Objective: To determine the association between physical activity and severity of
primary angle closure glaucoma in Malay patients. Methods: A cross-sectional study was conducted involving 150 primary angle closure
glaucoma patients between April 2014 and August 2016. Using the
International Physical Activity Questionnaire, the physical activity status
was assessed and divided into three categories: mild, moderate and heavy
physical activity. The duration of physical activity and corresponding
minimum energy requirements were calculated. Ocular examination was
performed including Humphrey visual field 24-2 analysis assessment. Based on
two consecutive reliable Humphrey visual fields, the severity of glaucoma
was scored according to modified Advanced Glaucoma Intervention Study and
classified as mild (0–5), moderate (6–11) and severe (12–20). Association
between physical activity and Advanced Glaucoma Intervention Study score was
determined with multiple linear regression analysis. Results: A total of 150 Malay patients with primary angle closure glaucoma were
included (50 patients with mild, 50 with moderate and 50 with severe
glaucoma). Physical activity showed inverse association with the severity of
primary angle closure glaucoma. After calculating adjustments for age, sex,
duration of glaucoma, body mass index, systemic co-morbidities, family
history of glaucoma, myopia and educational status [adjusted
b –3.41, 95% confidence interval (–5.23, –1.59),
p < 0.001], there was also an inverse relationship
with Advanced Glaucoma Intervention Study score. Every increase in physical
activity level reduces the Advanced Glaucoma Intervention Study score by 3.4
point. Conclusion: Physical activity is the potential modifiable risk factor in reducing the
severity of glaucoma among primary angle closure glaucoma patients. However,
there is possibility of the severity of glaucoma restricted the physical
activity of primary angle closure glaucoma patients.
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Affiliation(s)
- Niven Teh Chong Seong
- Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Azhany Yaakub
- Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Rohana Abdul Jalil
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Karunakar Tirmandas Vn
- Department of Ophthalmology, Hospital Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - Jelinar Binti Mohd Noor
- Department of Ophthalmology, Hospital Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Norhalwani Bt Husain
- Department of Ophthalmology, Hospital Raja Perempuan Zainab II, Kota Bharu, Malaysia
| | | | - Siti Azrin Ab Hamid
- Department of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Ahmad B Mt Saad
- Department of Ophthalmology, Hospital Sultanah Bahiyah, Alor Setar, Malaysia
| | - Liza-Sharmini At
- Professor of Ophthalmology and Senior Consultant Ophthalmologist (Glaucoma), Head of Department, Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kota Bharu, Kelantan, Malaysia
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11
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Barbosa‐Breda J, Abegão‐Pinto L, Van Keer K, Jesus DA, Lemmens S, Vandewalle E, Rocha‐Sousa A, Stalmans I. Heterogeneity in arterial hypertension and ocular perfusion pressure definitions: Towards a consensus on blood pressure-related parameters for glaucoma studies. Acta Ophthalmol 2019; 97:e487-e492. [PMID: 30315616 DOI: 10.1111/aos.13942] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 09/14/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE Glaucoma studies have long taken into account the blood pressure (BP) status of patients. This study summarizes and evaluates the impact of the different criteria that have been used for BP-related variables in glaucoma research. METHODS Studies included in two meta-analyses that reviewed the role of BP in glaucoma were analyzed. Additional studies published after the search periods of the meta-analyses were also included. Criteria for the definition of arterial hypertension and other BP-related variables, such as mean arterial pressure (MAP) and mean ocular perfusion pressure (MOPP), were retrieved. RESULTS Sixty-four studies were evaluated. One-third used 140 mmHg as a systolic BP cut-off to define hypertension, 20% used 160 mmHg and the remaining half used various other criteria. Less than 20% of studies reported MAP and/or MOPP. While eight of the ten studies reporting MAP used a correct formula that only happened for five of the eleven studies reporting MOPP. Using as an example average blood pressure values, incorrectly used formulas could have led to an overestimation of more than 100% of the expected values. CONCLUSION Considerable heterogeneity exists in BP-related variables in glaucoma research and different definitions can lead to large disparities. Glaucoma research would benefit from a consensus regarding blood pressure parameters.
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Affiliation(s)
- João Barbosa‐Breda
- Research Group Ophthalmology Department of Neurosciences KULeuven Leuven Belgium
- Faculty of Medicine of the University of Porto Ophthalmology Unit, Surgery and Physiology Porto Portugal
| | - Luis Abegão‐Pinto
- Faculty of Medicine of the University of Lisbon Visual Sciences Study Center Lisbon Portugal
| | - Karel Van Keer
- Research Group Ophthalmology Department of Neurosciences KULeuven Leuven Belgium
- Department of Ophthalmology University Hospitals Leuven Leuven Belgium
| | - Danilo A. Jesus
- Research Group Ophthalmology Department of Neurosciences KULeuven Leuven Belgium
| | - Sophie Lemmens
- Research Group Ophthalmology Department of Neurosciences KULeuven Leuven Belgium
- Department of Ophthalmology University Hospitals Leuven Leuven Belgium
| | - Evelien Vandewalle
- Research Group Ophthalmology Department of Neurosciences KULeuven Leuven Belgium
- Department of Ophthalmology University Hospitals Leuven Leuven Belgium
| | - Amândio Rocha‐Sousa
- Faculty of Medicine of the University of Porto Ophthalmology Unit, Surgery and Physiology Porto Portugal
| | - Ingeborg Stalmans
- Research Group Ophthalmology Department of Neurosciences KULeuven Leuven Belgium
- Department of Ophthalmology University Hospitals Leuven Leuven Belgium
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12
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García-Porta N, Gantes-Nuñez FJ, Tabernero J, Pardhan S. Characterization of the ocular surface temperature dynamics in glaucoma subjects using long-wave infrared thermal imaging. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2019; 36:1015-1021. [PMID: 31158132 DOI: 10.1364/josaa.36.001015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/23/2019] [Indexed: 06/09/2023]
Abstract
We evaluated the dynamics of ocular surface temperature using thermal imaging in 21 glaucoma subjects and 19 healthy subjects. On opening of the eye, subjects with glaucoma showed significantly cooler temperatures in the central cornea compared to the control group. The upper eyelid was also significantly cooler just before the eye opened. Immediately after opening the eye, the dynamic of temperature change was different in the two groups. In subjects with glaucoma, the eyes cooled significantly faster, with an average decrease of 0.49°C during the first second compared to 0.24°C in the control group. Our results support the hypothesis that both the stability of the tear film and changes in the ocular blood supply in subjects with glaucoma play an important role in thermal dynamics of the ocular surface.
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13
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Evaluation of the 24-hour intraocular pressure and systemic blood pressure at the same time. J Fr Ophtalmol 2019; 42:739-745. [PMID: 31104874 DOI: 10.1016/j.jfo.2019.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 02/20/2019] [Accepted: 03/11/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE To obtain simultaneous 24-hour contact lens voltage and systemic arterial blood pressure values with the Sensimed Triggerfish system and Holter monitoring device. METHODS Ten primary open-angle glaucoma (POAG) and 8 pseudoexfoliation glaucoma (PXG) patients were included in the study. The Sensimed Triggerfish contact lens device was used to calculate the 24-hour IOP, and a Holter sphygmomanometer device was used for simultaneous 24-hour blood pressure measurements. We define the 8:00 am-11:00 pm period measurements as diurnal values and the other measurements as nocturnal values. RESULTS The mean nocturnal systolic values (nocturnal SBP 120.5±3.4 for POAG and 122.8±5.3mmHg for PXG) and diastolic BP (nocturnal DBP 70.2±1.9 for POAG and 68.1±1.2mmHg for PXG) were lower than the diurnal (diurnal SBP 134.6±5.3 for POAG, 145.9±41.7mmHg for PXG, diurnal DBP 79.4±5.8 for POAG and 78.6±5.1mmHg for PXG) values, and these differences were statistically significant in both groups (P=0.001 in DBP in PXG and P<0.001 for other values). In addition, nocturnal CL voltage values (228.8±41.1 for POAG and 214.3±47.0mVEq for PXG) were higher than the diurnal values (55.8±77.2 for POAG and 145.9±41.7mVEq for PXG) in the POAG and PXG groups, and these were statistically significant as well (P<0.001 for all). In the POAG and PXG groups, CL voltage had a statistically significant negative correlation with systolic (respectively, r: -0.248, P=0.001 and r: -0.272, P˂0.001) and diastolic (respectively, r: -0.115, P=0.036 and r: -0.160, P=0.028) BP values. CONCLUSION We observed that CL voltage values rose during the nocturnal period, with a concomitant decrease in systolic and diastolic BP.
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Siddiqui M, Iltis J, Yanev P, Sladic J, Huynh C, Nolan D, Singer M. Effect of systemic antihypertensives on change in intraocular pressure after initiating topical prostaglandins for primary open-angle glaucoma. Clin Ophthalmol 2019; 13:207-213. [PMID: 30774300 PMCID: PMC6350645 DOI: 10.2147/opth.s192010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose There is a limited understanding of factors that influence the efficacy of topical glaucoma medication. Our study is a long-term, case–control analysis of how systemic antihypertensive (anti-HTN) medications influence the change in IOP after initiating prostaglandin (PG) drop therapy. Materials and methods A retrospective chart review of 3,781 patients was performed on patients with a diagnosis of glaucoma suspect that progressed to primary open-angle glaucoma (POAG) by ICD-9 codes over a 10-year period. Inclusion criteria consisted of the following: 1) progression from preglaucoma to glaucoma diagnosis in a time span of ≥6 months; 2) two visual fields recorded between these dates; 3) initial average IOP of both eyes of ≥21 mmHg; and 4) initiation of topical PG therapy alone. IOP (in mmHg) was measured at initiation of PG drops and at next visit. Results One hundred eleven patients were qualified for analysis. Patients not on anti-HTN agents had an average IOP decrease of 6.38±0.56 mmHg. Comparatively, patients on anti-HTN agents had an average IOP decrease of 6.66±0.48 mmHg (P=0.61). In addition, there was no statistical difference between IOP decrease between patients on single vs multiple systemic anti-HTN agents (P=0.85). There were eight nonresponders to PGs on no anti-HTN medications and 12 nonresponders on anti-HTN medication (P=0.55). Conclusion Systemic anti-HTN medication use did not significantly impact IOP reduction after topical PG initiation for POAG. Additionally, nonresponse to PG therapy was not correlated to systemic anti-HTN use.
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Affiliation(s)
- Mehdi Siddiqui
- Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Joshua Iltis
- Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Petar Yanev
- Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - John Sladic
- Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Charles Huynh
- Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Daniel Nolan
- Medical Center Ophthalmology Associates, San Antonio, TX, USA,
| | - Michael Singer
- Medical Center Ophthalmology Associates, San Antonio, TX, USA,
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15
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Horwitz A, Klemp M, Jeppesen J, Tsai JC, Torp-Pedersen C, Kolko M. Antihypertensive Medication Postpones the Onset of Glaucoma: Evidence From a Nationwide Study. Hypertension 2016; 69:202-210. [PMID: 27920127 DOI: 10.1161/hypertensionaha.116.08068] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 07/16/2016] [Accepted: 11/16/2016] [Indexed: 01/21/2023]
Abstract
The aim was to investigate the impact of antihypertensive medication on the onset of glaucoma. Data from the complete Danish population between 40 and 95 years of age were used in the period from 1996 to 2012, covering >2.6 million individuals. The National Danish Registry of Medicinal Products Statistics was used to identify all claimed prescriptions for glaucoma medication and antihypertensive drugs. We first investigated basic correlations in the data and found that patients treated with antihypertensive medication, at any time during the study period, had a significantly higher overall relative risk (RR) of glaucoma, even when controlling for age and sex (with a RR of 1.31 and P<0.0001). Furthermore, our data confirm the well-known positive association between age and glaucoma. To investigate the causal effect of antihypertensive treatment on the onset of treatment for glaucoma, we used a regression discontinuity study design. This analysis provides our main finding, namely that prescription of antihypertensive medication leads to a significant reduction in the risk of developing glaucoma. Therefore, although hypertension-as indicated by the use of antihypertensive medication-is positively correlated with glaucoma, our study indicates that antihypertensive medication itself may have a preventive effect on the development of glaucoma.
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Affiliation(s)
- Anna Horwitz
- From the Department of Neuroscience and Pharmacology (A.H.), Center for Healthy Aging (A.H., M.K.), Department of Economics (M.K.), and Department of Drug Design and Pharmacology (M.K.), University of Copenhagen, Denmark; Department of Economics and Population Studies and Training Center, Brown University, Providence, RI (M.K.); Department of Cardiology, Copenhagen University Hospital Glostrup, Denmark (J.J.); New York Eye and Ear Infirmary of Mount Sinai (J.C.T.); Department of Health, Science and Technology, Aalborg University Hospital, Denmark (C.T.-P.); and Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark (M.K).
| | - Marc Klemp
- From the Department of Neuroscience and Pharmacology (A.H.), Center for Healthy Aging (A.H., M.K.), Department of Economics (M.K.), and Department of Drug Design and Pharmacology (M.K.), University of Copenhagen, Denmark; Department of Economics and Population Studies and Training Center, Brown University, Providence, RI (M.K.); Department of Cardiology, Copenhagen University Hospital Glostrup, Denmark (J.J.); New York Eye and Ear Infirmary of Mount Sinai (J.C.T.); Department of Health, Science and Technology, Aalborg University Hospital, Denmark (C.T.-P.); and Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark (M.K)
| | - Jørgen Jeppesen
- From the Department of Neuroscience and Pharmacology (A.H.), Center for Healthy Aging (A.H., M.K.), Department of Economics (M.K.), and Department of Drug Design and Pharmacology (M.K.), University of Copenhagen, Denmark; Department of Economics and Population Studies and Training Center, Brown University, Providence, RI (M.K.); Department of Cardiology, Copenhagen University Hospital Glostrup, Denmark (J.J.); New York Eye and Ear Infirmary of Mount Sinai (J.C.T.); Department of Health, Science and Technology, Aalborg University Hospital, Denmark (C.T.-P.); and Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark (M.K)
| | - James C Tsai
- From the Department of Neuroscience and Pharmacology (A.H.), Center for Healthy Aging (A.H., M.K.), Department of Economics (M.K.), and Department of Drug Design and Pharmacology (M.K.), University of Copenhagen, Denmark; Department of Economics and Population Studies and Training Center, Brown University, Providence, RI (M.K.); Department of Cardiology, Copenhagen University Hospital Glostrup, Denmark (J.J.); New York Eye and Ear Infirmary of Mount Sinai (J.C.T.); Department of Health, Science and Technology, Aalborg University Hospital, Denmark (C.T.-P.); and Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark (M.K)
| | - Christian Torp-Pedersen
- From the Department of Neuroscience and Pharmacology (A.H.), Center for Healthy Aging (A.H., M.K.), Department of Economics (M.K.), and Department of Drug Design and Pharmacology (M.K.), University of Copenhagen, Denmark; Department of Economics and Population Studies and Training Center, Brown University, Providence, RI (M.K.); Department of Cardiology, Copenhagen University Hospital Glostrup, Denmark (J.J.); New York Eye and Ear Infirmary of Mount Sinai (J.C.T.); Department of Health, Science and Technology, Aalborg University Hospital, Denmark (C.T.-P.); and Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark (M.K)
| | - Miriam Kolko
- From the Department of Neuroscience and Pharmacology (A.H.), Center for Healthy Aging (A.H., M.K.), Department of Economics (M.K.), and Department of Drug Design and Pharmacology (M.K.), University of Copenhagen, Denmark; Department of Economics and Population Studies and Training Center, Brown University, Providence, RI (M.K.); Department of Cardiology, Copenhagen University Hospital Glostrup, Denmark (J.J.); New York Eye and Ear Infirmary of Mount Sinai (J.C.T.); Department of Health, Science and Technology, Aalborg University Hospital, Denmark (C.T.-P.); and Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark (M.K).
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