Primary open-angle glaucoma vs normal-tension glaucoma

the vascular perspective

Stephanie Mroczkowska, Alexandra Benavente-Pérez, Anil Negi, Velota Sung, Sunni R. Patel, Doina Gherghel

Research output: Contribution to journalArticle

Abstract

Objective: To compare and contrast the presence of ocular and systemic vascular function in newly diagnosed and previously untreated primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients with comparable, early stage, functional loss.
Methods: The systemic vascular function of 19 POAG patients, 19 NTG patients and 20 healthy controls was assessed by means of 24 hour ambulatory blood pressure (ABPM), peripheral pulse wave analysis (PWA) and carotid intima-media thickness (IMT). Retinal vascular reactivity to flicker light was assessed using dynamic retinal vessel analysis (DVA,IMEDOS, GmbH, Jena, Germany).
Results: When compared to normal controls, both POAG and NTG patients exhibited similarly increased nocturnal systemic blood pressure variability (p=0.011); peripheral arterial stiffness (p=0.015), carotid IMT (p=0.040) and reduced ocular perfusion pressure (OPP) (p<0.001). Furthermore, on DVA analysis, both groups of glaucoma patients also exhibited steeper retinal arterial constriction slopes (slope AC) following cessation of flicker (p=0.007) and a similarly increased fluctuation in arterial and venous baseline diameter (p=0.008 and p=0.009 respectively) in comparison to controls.
Conclusion: POAG and NTG patients exhibit similar alterations in both ocular and systemic circulation at the early stages of their disease process. This highlights not only the importance of considering vascular risk factors in both conditions, but also raises questions about the current separation of the two conditions into completely distinct clinical entities.
Original languageEnglish
Pages (from-to)36-43
Number of pages8
JournalJAMA Ophthalmology
Volume131
Issue number1
DOIs
Publication statusPublished - Jan 2013

Fingerprint

Low Tension Glaucoma
Blood Vessels
Retinal Vessels
Carotid Intima-Media Thickness
Blood Pressure
Pulse Wave Analysis
Vascular Stiffness
Constriction
Glaucoma
Germany
Primary Open Angle Glaucoma
Perfusion
Light
Pressure

Cite this

Mroczkowska, Stephanie ; Benavente-Pérez, Alexandra ; Negi, Anil ; Sung, Velota ; Patel, Sunni R. ; Gherghel, Doina. / Primary open-angle glaucoma vs normal-tension glaucoma : the vascular perspective. In: JAMA Ophthalmology. 2013 ; Vol. 131, No. 1. pp. 36-43.
@article{24ffc9d015c54f949121c108db6356e6,
title = "Primary open-angle glaucoma vs normal-tension glaucoma: the vascular perspective",
abstract = "Objective: To compare and contrast the presence of ocular and systemic vascular function in newly diagnosed and previously untreated primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients with comparable, early stage, functional loss.Methods: The systemic vascular function of 19 POAG patients, 19 NTG patients and 20 healthy controls was assessed by means of 24 hour ambulatory blood pressure (ABPM), peripheral pulse wave analysis (PWA) and carotid intima-media thickness (IMT). Retinal vascular reactivity to flicker light was assessed using dynamic retinal vessel analysis (DVA,IMEDOS, GmbH, Jena, Germany).Results: When compared to normal controls, both POAG and NTG patients exhibited similarly increased nocturnal systemic blood pressure variability (p=0.011); peripheral arterial stiffness (p=0.015), carotid IMT (p=0.040) and reduced ocular perfusion pressure (OPP) (p<0.001). Furthermore, on DVA analysis, both groups of glaucoma patients also exhibited steeper retinal arterial constriction slopes (slope AC) following cessation of flicker (p=0.007) and a similarly increased fluctuation in arterial and venous baseline diameter (p=0.008 and p=0.009 respectively) in comparison to controls.Conclusion: POAG and NTG patients exhibit similar alterations in both ocular and systemic circulation at the early stages of their disease process. This highlights not only the importance of considering vascular risk factors in both conditions, but also raises questions about the current separation of the two conditions into completely distinct clinical entities.",
author = "Stephanie Mroczkowska and Alexandra Benavente-P{\'e}rez and Anil Negi and Velota Sung and Patel, {Sunni R.} and Doina Gherghel",
year = "2013",
month = "1",
doi = "10.1001/2013.jamaophthalmol.1",
language = "English",
volume = "131",
pages = "36--43",
journal = "JAMA Ophthalmology",
issn = "2168-6165",
publisher = "American Medical Association",
number = "1",

}

Mroczkowska, S, Benavente-Pérez, A, Negi, A, Sung, V, Patel, SR & Gherghel, D 2013, 'Primary open-angle glaucoma vs normal-tension glaucoma: the vascular perspective', JAMA Ophthalmology, vol. 131, no. 1, pp. 36-43. https://doi.org/10.1001/2013.jamaophthalmol.1

Primary open-angle glaucoma vs normal-tension glaucoma : the vascular perspective. / Mroczkowska, Stephanie; Benavente-Pérez, Alexandra; Negi, Anil; Sung, Velota; Patel, Sunni R.; Gherghel, Doina.

In: JAMA Ophthalmology, Vol. 131, No. 1, 01.2013, p. 36-43.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Primary open-angle glaucoma vs normal-tension glaucoma

T2 - the vascular perspective

AU - Mroczkowska, Stephanie

AU - Benavente-Pérez, Alexandra

AU - Negi, Anil

AU - Sung, Velota

AU - Patel, Sunni R.

AU - Gherghel, Doina

PY - 2013/1

Y1 - 2013/1

N2 - Objective: To compare and contrast the presence of ocular and systemic vascular function in newly diagnosed and previously untreated primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients with comparable, early stage, functional loss.Methods: The systemic vascular function of 19 POAG patients, 19 NTG patients and 20 healthy controls was assessed by means of 24 hour ambulatory blood pressure (ABPM), peripheral pulse wave analysis (PWA) and carotid intima-media thickness (IMT). Retinal vascular reactivity to flicker light was assessed using dynamic retinal vessel analysis (DVA,IMEDOS, GmbH, Jena, Germany).Results: When compared to normal controls, both POAG and NTG patients exhibited similarly increased nocturnal systemic blood pressure variability (p=0.011); peripheral arterial stiffness (p=0.015), carotid IMT (p=0.040) and reduced ocular perfusion pressure (OPP) (p<0.001). Furthermore, on DVA analysis, both groups of glaucoma patients also exhibited steeper retinal arterial constriction slopes (slope AC) following cessation of flicker (p=0.007) and a similarly increased fluctuation in arterial and venous baseline diameter (p=0.008 and p=0.009 respectively) in comparison to controls.Conclusion: POAG and NTG patients exhibit similar alterations in both ocular and systemic circulation at the early stages of their disease process. This highlights not only the importance of considering vascular risk factors in both conditions, but also raises questions about the current separation of the two conditions into completely distinct clinical entities.

AB - Objective: To compare and contrast the presence of ocular and systemic vascular function in newly diagnosed and previously untreated primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients with comparable, early stage, functional loss.Methods: The systemic vascular function of 19 POAG patients, 19 NTG patients and 20 healthy controls was assessed by means of 24 hour ambulatory blood pressure (ABPM), peripheral pulse wave analysis (PWA) and carotid intima-media thickness (IMT). Retinal vascular reactivity to flicker light was assessed using dynamic retinal vessel analysis (DVA,IMEDOS, GmbH, Jena, Germany).Results: When compared to normal controls, both POAG and NTG patients exhibited similarly increased nocturnal systemic blood pressure variability (p=0.011); peripheral arterial stiffness (p=0.015), carotid IMT (p=0.040) and reduced ocular perfusion pressure (OPP) (p<0.001). Furthermore, on DVA analysis, both groups of glaucoma patients also exhibited steeper retinal arterial constriction slopes (slope AC) following cessation of flicker (p=0.007) and a similarly increased fluctuation in arterial and venous baseline diameter (p=0.008 and p=0.009 respectively) in comparison to controls.Conclusion: POAG and NTG patients exhibit similar alterations in both ocular and systemic circulation at the early stages of their disease process. This highlights not only the importance of considering vascular risk factors in both conditions, but also raises questions about the current separation of the two conditions into completely distinct clinical entities.

UR - http://www.scopus.com/inward/record.url?scp=84872362313&partnerID=8YFLogxK

UR - http://archopht.jamanetwork.com/article.aspx?articleid=1357778

U2 - 10.1001/2013.jamaophthalmol.1

DO - 10.1001/2013.jamaophthalmol.1

M3 - Article

VL - 131

SP - 36

EP - 43

JO - JAMA Ophthalmology

JF - JAMA Ophthalmology

SN - 2168-6165

IS - 1

ER -