Ocular Perfusion Pressure as a Mediator between Systemic Hypertension and Glaucoma

Abstract

Objective: To evaluate the relationship between systemic hypertension, ocular perfusion pressure and glaucoma.

Methodology: A cross-sectional comparative study was conducted, and the sample was divided into two groups (22 hypertensive patients and 22 normotensive controls) who had ages between 40 and 60 years. The participants were thoroughly examined with the measurement of systemic blood pressure, intraocular pressure and ocular perfusion pressure calculation. Fundus photography, optical coherence tomography (OCT), and automated perimetry were used to measure structural and functional damage. The SPSS was used to analyze data, with the help of the Mann-Whitney U test and correlation analysis.

Results: The hypertensive group's mean IOP was significantly higher (25.68 +- 8.98 mmHg) than the normotensive group's (18.22 +- 2.72 mmHg, p=0.001). However, there was no significant difference in the mean OPP between the groups (47.9 +- 9.8 mmHg vs. 46.2 +- 6.5 mmHg, p=0.49), which is indicative of compensatory hemodynamics, whereby elevated IOP compensated for elevated systemic blood pressure. More significantly, 40.9% and 45.5% of the hypertensive group, respectively, presented abnormal fundus photographs and OCT results, indicating a significantly higher prevalence of structural optic nerve damage (vs. 18.2 and 13.6, p=0.03 and p=0.01). According to the correlation analysis, there was a significant relationship between the OPP values and structural glaucomatous defects on fundus examination (r=-0.29, p=0.04) and OCT (r=-0.35, p=0.02).

Conclusion: Ocular Perfusion Pressure is the primary mediating factor, according to the data. It effectively connects glaucoma damage to systemic hypertension.