Singapore Eye Research Institute, Singapore National Eye Center, Singapore.
Invest Ophthalmol Vis Sci. 2010 Jul;51(7):3399-404. doi: 10.1167/iovs.09-4867. Epub 2010 Feb 17.
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.
目的。描述马来人群体中的眼灌注压分布及其与开角型青光眼（OAG）的关系。
方法。这是一项基于人群的横断面研究，包括 3280 名（78.7%的应答率）马来族裔人群。使用 Goldmann 压平眼压计测量眼内压（IOP）。使用数字自动血压监测仪测量收缩压和舒张压（SBP 和 DBP）。平均眼灌注压（MOPP）=（2/3）（平均动脉压 - IOP），其中平均动脉压（MAP）=DBP +（1/3）（SBP - DBP），收缩期灌注压（SPP）=SBP - IOP，舒张期灌注压（DPP）=DBP - IOP，计算得出。OAG 的诊断基于国际地理和流行病学眼科协会标准。
结果。共有 3261 人（平均年龄 58.7 +/- 11 岁，包括 131 例[4.0%]OAG 病例）可用于分析。在没有青光眼的人群中，平均 +/- SD IOP、MOPP、SPP 和 DPP 分别为 15.3 +/- 3.5、52.8 +/- 9.3、131.5 +/- 23.3 和 64.5 +/- 11.3 mmHg。在 OAG 患者中，相应值分别为 16.8 +/- 5.9、51.6 +/- 10.2、134.5 +/- 24.6 和 61.4 +/- 11.5 mmHg。在调整 IOP、年龄、性别和 IOP 和 BP 降低治疗的多变量逻辑回归模型中，与 Q4 相比，DBP、MOPP 或 DPP 最低四分位数（Q1）的参与者的 OAG 风险显着更高（Q1 比 Q4：比值比[OR]，1.71 [95%置信区间（CI），1.04-2.96] 用于 DBP；OR，1.73 [95%CI，1.05-3.15] 用于 MOPP；OR，1.75 [95%CI，1.02-3.01] 用于 DPP）。
结论。DBP、MOPP 和 DPP 低是马来人群体 OAG 的独立危险因素，为不同人群中青光眼发病机制中的血管机制提供了进一步证据。
