title: Distribution of ocular perfusion pressure and its relationship with open-angle glaucoma: the singapore malay eye study.
abstract: PURPOSE. To describe the distribution of ocular perfusion pressure and its relationship with open-angle glaucoma (OAG) in a Malay population. METHODS. This was a population-based, cross-sectional study comprising 3280 (78.7% response) ethnic Malays. Intraocular pressure (IOP) was measured with Goldmann applanation tonometry. Systolic and diastolic blood pressure (SBP and DBP) was measured with a digital automatic blood pressure monitor. Mean ocular perfusion pressure (MOPP) = (2/3)(mean arterial pressure - IOP), where mean arterial pressure (MAP) = DBP + (1/3)(SBP - DBP), systolic perfusion pressure (SPP) = SBP - IOP, and diastolic perfusion pressure (DPP) = DBP - IOP, was calculated. The diagnosis of OAG was based on International Society for Geographical and Epidemiologic Ophthalmology criteria. RESULTS. A total of 3261 persons (mean age, 58.7 +/- 11 years, including 131 [4.0%] cases of OAG) were available for analyses. Among persons without glaucoma, the mean +/- SD IOP, MOPP, SPP, and DPP were 15.3 +/- 3.5, 52.8 +/- 9.3, 131.5 +/- 23.3, and 64.5 +/- 11.3 mm Hg, respectively. Among persons with OAG, the corresponding values were 16.8 +/- 5.9, 51.6 +/- 10.2, 134.5 +/- 24.6, and 61.4 +/- 11.5 mm Hg, respectively. In multiple logistic regression models adjusting for IOP, age, sex, and IOP- and BP-lowering treatments, OAG risk was significantly higher in participants with DBP, MOPP, or DPP in the lowest quartile (Q1) than in participants in the highest quartile (Q4) (Q1 vs. Q4: odds ratio [OR], 1.71 [95% confidence interval (CI), 1.04-2.96] for DBP; OR, 1.73 [95% CI, 1.05-3.15] for MOPP; OR, 1.75 [95% CI, 1.02-3.01] for DPP). CONCLUSIONS. Low DBP, low MOPP, and low DPP are independent risk factors for OAG in ethnic Malays, providing further evidence of a vascular mechanism in glaucoma pathogenesis across different populations.
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore.
authors.forename: Yingfeng
authors.initials: Y
authors.lastname: Zheng
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.forename: Mingguang
authors.initials: M
authors.lastname: He
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000208:ethnology*; D001794:Blood Pressure / Q000502:physiology*; D015924:Blood Pressure Monitors; D003430:Cross-Sectional Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000208:ethnology* / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D014065:Tonometry, Ocular; D058609:Visual Field Tests; D014794:Visual Fields