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Abstract #71290 Published in IGR 18-3
Association between Nocturnal Blood Pressure Dips and Optic Disc Hemorrhage in Patients with Normal-Tension Glaucoma
Kwon J; Lee J; Choi J; Jeong D; Kook MSAmerican Journal of Ophthalmology 2017; 176: 87-101
See also comment(s) by Ki Ho Park •
PURPOSE: To investigate the effect of nocturnal blood pressure (BP) dips on the occurrence of optic disc hemorrhage (ODH) in normal-tension glaucoma (NTG) patients and determine whether ODH is associated with greater likelihood of visual field progression (VFP). DESIGN: Prospective case-control study. METHODS: This study enrolled 698 eyes of 349 consecutive NTG patients who were ≥40 years old, underwent 24 hour intraocular pressure and ambulatory BP monitoring in the habitual position, were examined for ODH every 4-6 months with optic disc photography, and had ≥ five reliable VF tests with minimum follow-up of 3 years. NTG patients were classified into two groups: "non-physiologic" dippers, including non-dippers and over-dippers, and "physiologic" dippers. Odds ratios for the association between the "non-physiologic" group and ODH were calculated using logistic regression models. Kaplan-Meier analyses were performed to compare outcomes with reference to the presence of ODH for VFP. RESULTS: Overall, ODH and VFP were detected in 15.3% and 8.6% of 698 eyes, respectively. Over-dippers showed a significantly greater frequency of ODH than non-dippers or dippers. Being over-dipper was a significant and an independent risk factor for ODH occurrence during follow-up. The rates of VFP were 6%, 7%, and 24% for dippers, non-dippers, and over-dippers, respectively. Eyes with ODH were associated with greater likelihoods of subsequent VFP than those without. VFP occurred only in eyes with ODH. CONCLUSIONS: Being over-dipper is a significant risk factor for ODH in NTG eyes. The detection of ODH during follow-up is a potent predictor of future VFP.
Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, South Korea.
Full articleClassification:
9.2.4 Normal pressure glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
6.11 Bloodflow measurements (Part of: 6 Clinical examination methods)
9.4.10 Glaucomas associated with hemorrhage (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
