Does treated systemic hypertension affect progression of optic nerve damage in glaucoma suspects?
OBJECTIVE
To evaluate whether treatment of systemic hypertension has an effect on progression of optic nerve parameters in glaucoma suspects using confocal scanning laser ophthalmoscopy.


METHODS
Two hundred eyes of 103 glaucoma suspect patients were included in this retrospective cohort study. Thirty-one patients (of whom 59 eyes were included in the study) had systemic hypertension under treatment (based on medical history). The remaining 72 age-matched normotensive controls (of whom 141 eyes were included in the study) were not on blood-pressure-lowering medications. Each patient had a follow-up period of at least 4 years with a minimum of four Heidelberg retinal tomograph tests (one baseline and three follow-up scans). The slopes of progression of optic nerve head parameters with time were studied and compared between these two groups using mixed effects regression models.


RESULTS
Patients with systemic hypertension showed a statistically significant increase in cup area (slope 0.2, p = 0.03), cup-to-disk area ratio (slope 0.01, p = 0.007), and decrease in rim area (slope -0.4, p = 0.03), rim-to-disk area ratio (slope -0.01, p = 0.005), and global Retinal Nerve Fiber Layer (RNFL) thickness (p = 0.008) with time. The differences in slopes of progression of many parameters between hypertensives and normotensives were statistically significant.


CONCLUSIONS
Systemic hypertension treated with hypotensive medications may be a risk factor for increased progression of optic nerve parameters in glaucoma suspects compared with age-matched normotensive subjects.
Punjabi
Omar S
OS
Department of Ophthalmology, University of California, San Francisco (UCSF) School of Medicine, San Francisco, California, USA.
Stamper
Robert L
RL
Bostrom
Alan G
AG
Lin
Shan C
SC
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006068:Gonioscopy; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007429:Intraocular Pressure; D007834:Lasers; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000503:physiopathology*; D009887:Ophthalmoscopy / Q000379:methods; D009898:Optic Disk / Q000473:pathology; D009901:Optic Nerve Diseases / Q000503:physiopathology*; D012189:Retrospective Studies
D000959:Antihypertensive Agents