Prospective Assessment of the Clinical Correlation of Glaucoma with Systemic Hypertension and its Effect on Visual Morbidity
Creators
- 1. Senior Resident, Department of Ophthalmology, Nalanda Medical College and Hospital, Patna, Bihar, India
- 2. Senior Resident, Department of Ophthalmology, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India
- 3. Associate Professor, Department of Ophthalmology, Nalanda Medical College and Hospital, Patna, Bihar, India
Description
Aim: To evaluate the association between hypertension and occurrence of glaucoma. Methodology: A prospective study was conducted in the Department of Ophthalmology, NMCH, Patna, Bihar, India from November 2017 to October 2018. including 72 patients between the age groups of 30 to 70 years diagnosed with hypertension. Patients with other systemic diseases or vascular pathologies were excluded from the study. All the patients were followed up for atleast 6 months and the need for regular review visits was explained to them. During the first visit and each follow up opinions regarding the progress of hypertension was obtained from departments of cardiology and internal medicine. The oral hypertensive medication taken by patients were categorized into 5 groups as calcium channel blockers (CCB), diuretics, angiotensin converting enzyme inhibitors (ACE), angiotensin receptor blockers and beta blockers. A detailed history of age, sex, duration of hypertension, history of other co-morbidities and treatment were collected. The participants then underwent a detailed ophthalmological evaluation. IOP measurement was done by applanation tonometry with Goldman Applanation Tonometer. The same procedure was repeated in the other eye. Phasing technique of repeating recordings was done and the average IOP was used in the study. Results: Among the 72 hypertension patients involved in the study, 40 patients (55.5%) were found to have glaucoma. 39 patients (54.2%) were female, and 33 patients (45.8%) were male. Age group affected was 9.7% between 30-40 years, 15.3% between 41 to 50 years, 23.6% between 51 to 60 years and 51.4% between 61 to 70 years. 51.7% patients taking CCB, 58.8% taking ACE inhibitors, 54.6% taking ARB, 55.6% taking beta blockers, and 66.7% taking diuretics had reduced IOP. The range of IOP in the treated population was between 10-16mmHg and this difference in those on hypertension medications was statistically significant. Conclusion: It can be concluded from this study that there is a correlation between higher systemic blood pressure and higher intraocular pressure, and this also produces effects to be regarded as risk factors for glaucoma. Patients taking oral hypertensive drugs also had reduced intraocular pressure and prevent further progression of glaucoma.
Abstract (English)
Aim: To evaluate the association between hypertension and occurrence of glaucoma. Methodology: A prospective study was conducted in the Department of Ophthalmology, NMCH, Patna, Bihar, India from November 2017 to October 2018. including 72 patients between the age groups of 30 to 70 years diagnosed with hypertension. Patients with other systemic diseases or vascular pathologies were excluded from the study. All the patients were followed up for atleast 6 months and the need for regular review visits was explained to them. During the first visit and each follow up opinions regarding the progress of hypertension was obtained from departments of cardiology and internal medicine. The oral hypertensive medication taken by patients were categorized into 5 groups as calcium channel blockers (CCB), diuretics, angiotensin converting enzyme inhibitors (ACE), angiotensin receptor blockers and beta blockers. A detailed history of age, sex, duration of hypertension, history of other co-morbidities and treatment were collected. The participants then underwent a detailed ophthalmological evaluation. IOP measurement was done by applanation tonometry with Goldman Applanation Tonometer. The same procedure was repeated in the other eye. Phasing technique of repeating recordings was done and the average IOP was used in the study. Results: Among the 72 hypertension patients involved in the study, 40 patients (55.5%) were found to have glaucoma. 39 patients (54.2%) were female, and 33 patients (45.8%) were male. Age group affected was 9.7% between 30-40 years, 15.3% between 41 to 50 years, 23.6% between 51 to 60 years and 51.4% between 61 to 70 years. 51.7% patients taking CCB, 58.8% taking ACE inhibitors, 54.6% taking ARB, 55.6% taking beta blockers, and 66.7% taking diuretics had reduced IOP. The range of IOP in the treated population was between 10-16mmHg and this difference in those on hypertension medications was statistically significant. Conclusion: It can be concluded from this study that there is a correlation between higher systemic blood pressure and higher intraocular pressure, and this also produces effects to be regarded as risk factors for glaucoma. Patients taking oral hypertensive drugs also had reduced intraocular pressure and prevent further progression of glaucoma.
Files
IJTPR,Vol12,Issue2,Article2.pdf
Files
(170.7 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:3bdddd2e5c01f67d63fce7c89aa296e0
|
170.7 kB | Preview Download |
Additional details
Dates
- Accepted
-
2022-01-09
Software
References
- 1. "Facts About Glaucoma". National Eye Institute. Archivedfrom the original on 28 March 2016. Retrieved 2 January 2022 2. Priority Eye Disease, http://www.who.int/blindness/c auses/priority/en/index7.html, 2011.Retrieved 2 January 2022 3. A. Iwase, Y. Suzuki, M. Araie et al., "The prevalence of primary open-angle glaucoma in Japanese: The Tajimi Study," Ophthalmology, vol. 111, no. 9, pp. 1641–1648, 2004. 4. C. S. Kim, G. J. Seong, N. H. Lee, and K. C. Song, "Prevalence of primary openangle Glaucoma in central South Korea: The Namil study," Ophthalmology, vol. 118, no. 6, pp. 1024–1030, 2011. 5. M. A. Kass, "Normal-pressure glaucoma," American Journal of Ophthalmology, vol. 125, no. 2, pp. 242– 244, 1998. 6. Mantravadi AV, Vadhar N (September 2015). "Glaucoma". Primary Care. 42 (3): 437–49. 7. Rhee DJ (2012). Glaucoma (2 ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 180. 8. Mi XS, Yuan TF, So KF (16 September 2014). "The current research status of normal tension glaucoma". Clinical Interventions in Aging. 9: 1563–71. 9. Alguire P (1990). "The Eye Chapter 118 Tonometry>Basic Science". In Walker HK, Hall WD, Hurst JW (eds.). Clinical methods: the history, physical, and laboratory examinations (3rd ed.). London: Butterworths. 10. Langman MJS. Systemic hypertension and glaucoma: mechanisms in common and co-occurrence. Br J Ophthalmol. 2005;89(8):960–3. 11. Omoti AE, Enock ME, Okeigbemen VW, Akpe BA, Fuh UC. Vascular risk factors for open angle glaucoma in African eyes Middle East Afr J Ophthalmol. 2009;16(3):146. 12. Maurya R. Biomarkers of primary openangle glaucoma. Ind J ClinExpOphth. 2017;3(4):387–388. 13. Deokule S, Weinreb RN. Relationships among systemic blood pressure, intraocular pressure, and open-angle glaucoma. Can J Ophthalmol. 2008;43(3):302–7. 14. Costa VP, Arcieri ES, Harris A. Blood pressure and glaucoma. Br J Ophthalmol. 2009;93(10):1276–82. 15. Leske MC. The epidemiology of openangle glaucoma: a review. Am J Epidemiol 1983; 118:166–91. 16. McLeod SD, West SK, Quigley HA, Fozard JL. A longitudinal study of the relationship between intraocular and blood pressures. Invest Ophthalmol Vis Sci 1990; 31:2361–6. 17. Tielsch JM, Katz J, Sommer A et al. Hypertension, perfusion pressure, and primary open-angle glaucoma. A population-based assessment. Arch Ophthalmol 1995; 113:216–21. 18. Dielemans I, Vingerling JR, Algra D, et al. Primary openangle glaucoma, intraocular pressure, and systemic blood pressure in the general elderly population. The Rotterdam Study. Ophthalmology 1995;102:54–60. 19. Leske MC, Connell AM, Wu SY et al. Risk factors for open-angle glaucoma. The Barbados Eye Study. Arch Ophthalmol 1995;113:918–24. 20. Bonomi L, Babighian S, Bonadimani M, et al. Correlation between glaucoma and vascular factors, and circumstances leading to the diagnosis of glaucoma. ActaOphthalmolScandSuppl 2000, (232):34—35. 21. Leske MC, Wu SY, Nemesure B, et al. Incident open-angle glaucoma and blood pressure. Arch Ophthalmol 2002; 120:954—959. 22. Hayreh SS, Zimmerman MB, Podhajsky P, et al. Nocturnal arterial hypotension and its role in optic nerve head and ocular ischemic disorders. Am J Ophthalmol 1994; 117:603—624. 23. Hayreh SS. Role of nocturnal arterial hypotension in the development of ocular manifestations of systemic arterial hypertension. CurrOpinOphthalmol 1999; 10:474—482 24. Tokunaga T, Kashiwagi K, Tsumura T, et al. Association between nocturnal blood pressure reduction and progression of visual field defect in patients with primary open-angle glaucoma or normaltension glaucoma. Jpn J Ophthalmol 2004; 48:380—385 25. Kashiwagi K, Hosaka O, Kashiwagi F, et al. Systemic circulatory parameters. comparison between patients with normal tension glaucoma and normal subjects using ambulatory monitoring. Jpn J Ophthalmol 2001; 45:388—396. 26. Wilson MR, Hertzmark E, Walker AM, et al. A case-control study of risk factors in open-angle glaucoma. Arch Ophthalmol 1987; 105:1066–71. 27. V. P. Costa, E. S. Arcieri, and A. Harris, "Blood pressure and glaucoma," British Journal of Ophthalmology, vol. 93, no. 10, pp. 1276–1282, 2009. 28. J. M. Tielsch, J. Katz, A. Sommer, H. A. Quigley, and J. C. Javitt, "Hypertension, perfusion pressure, and primary openangle glaucoma: a population-based assessment," Archives of Ophthalmology, vol. 113, no. 2, pp. 216– 221, 1995.