Retrobulbar blood flow in glaucoma patients with nocturnal over-dipping in systemic blood pressure.
OBJECTIVE
To evaluate the relationship between the circadian blood pressure rhythm and the retrobulbar blood flow in glaucoma patients.


METHODS
Cross-sectional study.


METHODS
Circadian blood pressure measurements and color Doppler imaging (CDI) in the ophthalmic artery as well as the central retinal artery of one randomly selected eye were obtained in 193 primary open-angle glaucoma patients. CDI parameters were compared by means of analysis of covariance between patients with a nocturnal decrease in mean systemic blood pressure (MBP) below 20% of the average daytime MBP (over-dippers), patients with a decrease between 10% to 20% (dippers), and patients with a decrease of less than 10% (nondippers), using age, intraocular pressure (IOP), and MBP during color Doppler measurement as covariates.


RESULTS
An analysis of covariance disclosed, after correcting for age, IOP, and MBP during color Doppler imaging, a significantly lower EDV (P =.0096) and a significantly higher RI (P =.033) in the central artery of over-dipping glaucoma patients compared with nondippers or dippers. This effect seemed independent of the use of vasoactive drugs .


CONCLUSIONS
Glaucoma patients with a marked drop in nocturnal systemic blood pressure seem to have altered retrobulbar blood flow parameters, suggesting that an abnormal systemic blood pressure profile may be the manifestation of some kind of systemic vascular dysregulation relevant for the ocular circulation.
Gherghel
D
D
University Eye Clinic, Basel, Switzerland.
Orgül
S
S
Gugleta
K
K
Flammer
J
J
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D002940:Circadian Rhythm / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012161:Retinal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013449:Sulfonamides / Q000627:therapeutic use; D013876:Thiophenes / Q000627:therapeutic use; D018615:Ultrasonography, Doppler, Color
D000319:Adrenergic beta-Antagonists; D002257:Carbonic Anhydrase Inhibitors; D013449:Sulfonamides; D013876:Thiophenes; C062765:dorzolamide