Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Ophthalmologica. 2012;228(1):36-41. doi: 10.1159/000335978. Epub 2012 Feb 25.
The objective of this study was to investigate the association between blood pressure (BP) and visual field defect progression in normal-tension glaucoma (NTG).
The subjects were 35 consecutive patients with NTG who were admitted to Keio University Hospital for 24-hour intraocular pressure evaluation; all subjects underwent 6 or more visual field tests in either eye and were followed up for more than 5 years. Systolic and diastolic BPs were measured at 9.00 h. Subjects with negative regression lines and p values of less than 0.05 were classified as progressive; all others were defined as stable. Systolic BP, diastolic BP, and ocular perfusion pressure were compared between the 2 groups.
Twelve subjects showed progression in glaucomatous visual field defects (age 55.1 ± 15.1 years). Twenty-three subjects showed no progression (age 57.2 ± 10.9 years). Diastolic BP (stable group: 77.0 ± 12.1 mm Hg; progressive group: 67.7 ± 9.7 mm Hg; p = 0.03) was significantly lower in the progressive group than in the stable group. Multivariable analysis revealed that low diastolic BP is a significant risk factor for progression (OR 0.90; 95% CI 0.82-0.99).
Low diastolic BP was associated with glaucomatous visual field progression in subjects with NTG.
本研究旨在探讨正常眼压性青光眼（NTG）患者血压（BP）与视野缺损进展之间的关系。
该研究纳入了 35 例连续就诊于庆应义塾大学医院的 NTG 患者，所有患者均接受了 24 小时眼压评估，且至少有 6 次以上的双眼视野检查，并随访超过 5 年。于 9 时测量收缩压和舒张压。将回归线为负且 p 值小于 0.05 的患者定义为进展组，其余患者定义为稳定组。比较两组间的收缩压、舒张压和眼灌注压。
12 例患者（年龄 55.1 ± 15.1 岁）的青光眼视野缺损呈进展性，23 例患者（年龄 57.2 ± 10.9 岁）无进展。进展组的舒张压（稳定组：77.0 ± 12.1mmHg；进展组：67.7 ± 9.7mmHg；p=0.03）显著低于稳定组。多变量分析显示，舒张压较低是进展的显著危险因素（OR 0.90；95%CI 0.82-0.99）。
在 NTG 患者中，舒张压较低与青光眼视野进展相关。
