Department of Ophthalmology, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea.
Medical Research Collaborating Center, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Sci Rep. 2020 Jun 22;10(1):10056. doi: 10.1038/s41598-020-66914-w.
Low ocular perfusion pressure (OPP) has been proposed as an important risk factor for glaucoma development and progression, but controversy still exists between studies. Therefore, we conducted a systematic review and meta-analysis to analyze the association between OPP and open-angle glaucoma (OAG). Studies were identified by searching PubMed and EMBASE databases. The pooled absolute and standardised mean difference in OPP between OAG patients and controls were evaluated using the random-effects model. Meta-regression analysis was conducted to investigate the factors associated with OPP difference between OAG patients and controls. A total of 43 studies were identified including 3,009 OAG patients, 369 patients with ocular hypertension, and 29,502 controls. The pooled absolute mean difference in OPP between OAG patients and controls was -2.52 mmHg (95% CI -4.06 to -0.98), meaning significantly lower OPP in OAG patients (P = 0.001). Subgroup analyses showed that OAG patients with baseline IOP > 21 mmHg (P = 0.019) and ocular hypertension patients also had significantly lower OPP than controls (P < 0.001), but such difference in OPP was not significant between OAG patients with baseline IOP of ≤21 mmHg and controls (P = 0.996). In conclusion, although no causal relationship was proven in the present study, our findings suggest that in patients with high baseline IOP, who already have a higher risk of glaucoma, low OPP might be another risk factor.
低眼灌注压（OPP）已被提出作为青光眼发展和进展的重要危险因素，但研究之间仍存在争议。因此，我们进行了系统评价和荟萃分析，以分析 OPP 与开角型青光眼（OAG）之间的关系。通过搜索 PubMed 和 EMBASE 数据库来确定研究。使用随机效应模型评估 OAG 患者和对照组之间 OPP 的汇总绝对和标准化均数差值。进行荟萃回归分析以探讨与 OAG 患者和对照组之间 OPP 差异相关的因素。共确定了 43 项研究，包括 3009 例 OAG 患者、369 例高眼压患者和 29502 例对照者。OAG 患者和对照组之间 OPP 的汇总绝对均数差值为-2.52mmHg（95%CI-4.06 至-0.98），这意味着 OAG 患者的 OPP 明显较低（P=0.001）。亚组分析表明，基线眼压（IOP）>21mmHg 的 OAG 患者（P=0.019）和高眼压患者的 OPP 也明显低于对照组（P<0.001），但基线 IOP 为≤21mmHg 的 OAG 患者和对照组之间的 OPP 差异无统计学意义（P=0.996）。总之，尽管本研究未证明因果关系，但我们的研究结果表明，在基线眼压较高的患者中，低 OPP 可能是另一个危险因素，这些患者已经具有更高的青光眼风险。
