Circadian blood pressure and intraocular pressure patterns in normal tension glaucoma patients with undisturbed sleep.
OBJECTIVE
To investigate and compare the circadian pattern of blood pressure (BP), intraocular pressure (IOP) and mean ocular perfusion pressure (MOPP) while experiencing undisturbed sleep in normal-tension glaucoma (NTG) and non-glaucoma control patient groups.


METHODS
Twenty-four eyes from 24 patients diagnosed with NTG and 22 eyes from 22 control group patients were enrolled. Systolic BP, diastolic BP and IOP were measured every two hours except for the period of time from 1 AM to 7 AM in the NTG group and from 11 PM to 7 AM in the control group over a one-day period. IOP and hemodynamic parameters were then compared between the two groups. NTG patients were subdivided according to the degree of morning BP dip and IOP, and hemodynamic parameters and visual field indices (mean deviation and pattern standard deviation) were also compared among these subgroups.


RESULTS
There were no significant differences in mean systolic BP, mean diastolic BP and mean arterial pressure (MAP) between the NTG and the control groups. The NTG group showed a significantly large morning BP dip compared to the control group (7.1+/-4.2% vs. 3.8+/-3.4%, p=0.022). However, there were no significant differences in mean or fluctuation of MOPP between the two groups. Morning over-dippers showed significantly large MAP and MOPP fluctuations compared to non-dippers and dippers, while there were no significant differences in visual field indices among the three subgroups.


CONCLUSIONS
NTG patients showed significant morning BP dips compared to the control group. The marked morning BP dip was associated with significantly large MAP or MOPP fluctuations but was not associated with visual field indices.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Yong-Kyu
YK
Kim
Won Hyuk
WH
Oh
Ki Ho
KH
Park
Joon Mo
JM
Kim
Dong Myung
DM
Kim
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002940:Circadian Rhythm; D003971:Diastole; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D057066:Low Tension Glaucoma / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012890:Sleep; D013599:Systole