Ocular perfusion pressure and glaucoma: clinical trial and epidemiologic findings.
OBJECTIVE
A possible connection between ocular perfusion pressure and open-angle glaucoma (OAG) has been hypothesized. This review summarizes the scientific rationale for the proposed relationship, presents recent data, and outlines potential implications.


RESULTS
Population-based epidemiologic studies found strong relationships between low ocular perfusion pressure and OAG prevalence, as well as OAG incidence. Clinical studies report similar associations between low perfusion pressure and OAG progression. These consistent findings suggest that altered blood flow in the optic disc increases both the risk of OAG development and the progression of established OAG. An underlying factor would be impaired vascular autoregulation, which may lead to poor perfusion in OAG. In contrast, there is conflicting evidence on the possible link of glaucoma to blood pressure/hypertension.


CONCLUSIONS
Current evidence supports the role of vascular factors as part of the multifactorial cause of OAG. As ocular perfusion pressure reflects the vascular status at the optic disc, it may be more relevant than systemic blood pressure alone. Although the associations of OAG to perfusion pressure are strong, consistent, and biologically plausible, they require careful interpretation. The evidence implicating a vascular cause in OAG is mounting, but the clinical implications for patient management are still uncertain.
Leske
M Cristina
MC
Department of Preventive Medicine, Stony Brook University, Stony Brook, New York 11794-8036, USA. cleske@notes.cc.sunysb.edu
D001794:Blood Pressure; D001808:Blood Vessels / Q000503:physiopathology; D002986:Clinical Trials as Topic; D018450:Disease Progression; D005123:Eye / Q000098:blood supply*; D005902:Glaucoma, Open-Angle / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006706:Homeostasis; D006801:Humans; D009898:Optic Disk / Q000098:blood supply; D015995:Prevalence; D012039:Regional Blood Flow; D012307:Risk Factors; D014652:Vascular Diseases / Q000150:complications / Q000503:physiopathology