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Year : 2014  |  Volume : 62  |  Issue : 9  |  Page : 917-922

Relationship between systemic hypertension, perfusion pressure and glaucoma: A comparative study in an adult Indian population

1 Department of Ophthalmology, Jawaharlal Institute of Post Graduate Medical Education and Research, Gorimedu, India
2 Vitreoretina Services, Aravind Eye Hospital, Thavalakuppam, Pondicherry, India

Correspondence Address:
Amit K Deb
Plot No. 44, Raja Annamalai Nagar, Gorimedu Post, Puducherry - 605 006
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0301-4738.143927

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Aims: To study the relationship between blood pressure (BP), intraocular pressure (IOP), mean ocular perfusion pressure (MOPP) and primary open angle glaucoma (POAG) in patients with hypertension and compare it to a control group of normotensives. Design: Cross-sectional observational study. Materials and Methods: A total of 108 subjects with primary hypertension and 100 age-matched controls without hypertension were enrolled for the study. IOP measurement using Noncontact Tonometer and dilated fundus evaluation using + 90 D lens were done for all cases. Single recording of BP was taken. Gonioscopy, Humphrey's central visual fields, optical coherence tomography and pachymetry were done for all subjects with IOP > 21 mm Hg or C: D ratio ≥ 0.5 or asymmetry of > 0.2. Statistical Analysis: Univariate and multivariate multinomial regression models were used to determine the association between covariates and risk of glaucoma or glaucoma suspect. Results: There was no difference in the glaucoma status between subjects with and without hypertension. Subjects on antihypertensive medications were 1΍ times more likely to have suspicious glaucoma (odds ratio [OR] =1.56] and nearly twice as likely to have POAG (OR = 1.85). In addition, we found a 31% and 12% reduction in risk of having POAG (95% confidence interval [CI] =13-45%, P = 0.001) and glaucoma suspect (95% CI = 2-21%, P = 0.03) respectively with every 1 mm Hg increment in MOPP. Conclusion: Subjects on antihypertensive medications are more likely to have either glaucoma or glaucoma suspect, and higher ocular perfusion pressure offers relative protection from glaucomatous damage.

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