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Editors Selection IGR 21-3
Intraocular pressure: 24-Hour fluctuation
Comment by John Liu on:
17018 Circadian fluctuation of mean ocular perfusion pressure is a consistent risk factor for normal-tension glaucoma, Choi J; Kim KH; Jeong J et al., Investigative Ophthalmology and Visual Science, 2007; 48: 104-111
Hypotheses for glaucoma pathogenesis always include factors related to intraocular pressure (IOP) as well as factors related to local hemodynamics. In recent years, there are increasing reports on risk factors associated with the onset and progression of glaucoma. Among them, studies involving a systematic approach, a comprehensive review of various factors, and a large sample size are obviously superior. One good example is the present study by Choi et al. (174) which is based on careful evaluations of clinical and laboratory data collected from 113 patients with normal-tension glaucoma. The authors concluded that, judging an array of functional and structural outcome variables, the 24-hour fluctuation/variation in the ocular perfusion pressure was the most consistent factor associated with the severity of glaucoma. Somewhat surprisingly, central corneal thickness was not associated with any outcome variable. In other studies, central corneal thickness was frequently associated with outcome variables in glaucoma patients having a high IOP.
24-hour fluctuation/variation in the ocular perfusion pressure was most consistently associated with the severity of glaucomaOcular perfusion pressure is the pressure difference between blood pressure in the ophthalmic arteries and IOP. Ocular perfusion pressure may be regarded as a combined factor of systemic blood pressure and IOP. A fluctuation in ocular perfusion pressure represents a fluctuation in local blood supply to the globe. There is still a gap whether or not a change in ocular blood supply can lead to a change in actual blood flow and tissue perfusion in intraocular structures critical to glaucoma, such as the optic nerve head. Further well-designed studies on ocular blood flow in patients with normal-tension glaucoma should be encouraged based upon the interesting discovery in this article.
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