Purpose: To study the relationship between intraocular pressure (IOP) and mean ocular perfusion pressure (MOPP) in patients with POAG and NTG. The secondary objective was to identify other contributory ischemic factors.
Methods: This was an observational cross-sectional study from a tertiary eye hospital in patients who underwent full-day diurnal variation of tension (DVT). Blood pressure (BP) and IOP measurements were done every 3 h over 24 h. Mean arterial pressure (MAP) and MOPP were calculated. The nocturnal dip in BP was assessed; patients were classified as non-dippers, dippers, and over-dippers. The circadian MOPP fluctuation (CMF) was calculated using the Kruskal-Wallis test, and its relationship with type and severity of visual field was assessed.
Results: In total, 149 patients were evaluated; 109 were classified as NTG, and 40 were classified as POAG. A nocturnal dip in BP was noted in 20% of NTG and 17.5% of POAG. The MAP was found to be lower in patients with NTG than POAG. In the NTG subgroup, we found that 20% of patients were over-dippers, 32% were dippers, and 48% were non-dippers. The CMF showed a greater fluctuation for over-dippers (P = 0.004 for the RE and 0.003 for the LE) than dippers and non-dippers. A weak positive correlation of CMF with the severity of fields was found.
Conclusion: A 24-h monitoring of IOP, BP, MOPP, and assessment of systemic risk factors for primary glaucoma acts as an invaluable tool for the comprehensive management of NTG despite the limitations posed by DVT and BP recording.
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http://dx.doi.org/10.4103/ijo.IJO_861_21 | DOI Listing |
Ophthalmol Ther
January 2025
Rocky Vista University, Englewood, CO, USA.
Introduction: This retrospective, consecutive, real-world case series assessed the efficacy and safety of third-generation trabecular micro-bypass stent implantation (iStent infinite) with phacoemulsification in patients with mild-to-moderate primary open-angle glaucoma (POAG).
Methods: Patients underwent phacoemulsification combined with implantation of iStent infinite (containing three stents) by a single U.S.
Croat Med J
December 2024
Marijan Klarica, Department of Pharmacology and Croatian Institute for Brain Research, University of Zagreb School of Medicine, Šalata 3b, 10000 Zagreb, Croatia,
It is generally accepted that intraocular pressure (IOP) depends on the rate of aqueous humor production, system outflow resistance, and episcleral venous pressure. Therefore, control IOP values are expected to be within the strict and predictable limits in specific animal species, and there should be no vast differences between species. However, in the literature the control IOP values significantly vary (from potentially "hypotensive" to "hypertensive") within the same species, and especially between species depending on the measurement technique, head position in relation to the rest of the body, circadian rhythm, age, and topical and systemic drugs (anesthetics) applied.
View Article and Find Full Text PDFGMS Ophthalmol Cases
December 2024
Universidade Federal do Paraná (UFPR), Curitiba, Brazil.
Purpose: Idiopathic elevated episcleral venous pressure (IEEVP) or Radius-Maumenee syndrome (RMS) is a rare disease without any identified underlying cause. An increasing episcleral venous pressure (EVP) leads to raised intraocular pressure (IOP) and consequently glaucomatous damage of the optic nerve. The objective of this paper is to report this rare condition as well as its clinical management.
View Article and Find Full Text PDFKlin Monbl Augenheilkd
January 2025
Minimally invasive glaucoma surgeries (MIGS) offer an alternative approach, aiming to be both safe and effective. Defined by their ab interno technique, which avoids creating a bleb, MIGS procedures seek to reduce intraocular pressure (IOP) by enhancing the outflow pathways of aqueous humor. Techniques include stenting, incisions, and excisions of the trabecular meshwork, canaloplasty of Schlemm's canal, and drainage implants that enhance uveoscleral outflow to the subchoroidal space.
View Article and Find Full Text PDFInvest Ophthalmol Vis Sci
January 2025
NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
Purpose: To investigate the effect of average intraocular pressure (IOP) on the true rate of glaucoma progression (RoP) in the United Kingdom Glaucoma Treatment Study (UKGTS).
Methods: UKGTS participants were randomized to placebo or Latanoprost drops and monitored for up to two years with visual field tests (VF, 24-2 SITA standard), IOP measurements, and optic nerve imaging. We included eyes with at least three structural or functional assessments (VF with <15% false-positive errors).
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