Department of Ophthalmology, Mayo Clinic, Rochester, MN.
Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL.
J Glaucoma. 2022 Jan 1;31(1):15-22. doi: 10.1097/IJG.0000000000001964.
Multiple systemic vascular-associated conditions including systemic hypertension and hypotension, diabetes mellitus, migraine headache, peripheral vascular disease, Raynaud syndrome, and anemia were associated with low-tension glaucoma.
The purpose of this study was to identify systemic risk factors associated with low-tension glaucoma.
A retrospective case-control study design was employed to identify patients seen at the Mayo Clinic Department of Ophthalmology between 2005 and 2015 with low-tension glaucoma and an age-matched and sex-matched control group, each containing 277 patients.
The low-tension glaucoma group had more myopic refractive errors (-1.6 vs. -1.0 D, P<0.001), lower intraocular pressure (14.2 vs. 15.2 mm Hg, P<0.001), and a higher cup-to-disc ratio (0.7 vs. 0.3, P<0.001). The low-tension glaucoma group was significantly less likely to be obese (body mass index >30, P=0.03). This group had a significantly higher prevalence of systemic hypertension [odds ratio (OR): 1.64, P=0.004], diabetes mellitus (OR: 3.01, P<0.001), peripheral vascular disease (OR: 2.61, P=0.009), migraine headache (OR: 2.12, P=0.02), anemia (OR: 2.18, P=0.003), systemic hypotension (OR: 4.43, P<0.001), Raynaud syndrome (OR: 3.09, P=0.05), and angiotensin-converting enzyme inhibitor (OR: 1.64, P=0.01) or calcium channel blocker use (OR: 1.98, P=0.004). After adjusting for systemic hypertension, calcium channel blocker use remained significant (OR: 1.70, P=0.03). No significant difference was found between groups with respect to hyperlipidemia, obstructive sleep apnea, coronary artery disease, carotid stenosis, stroke, or statin, angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, beta-blocker, or metformin use.
Multiple vascular-associated conditions were associated with low-tension glaucoma including systemic hypertension, diabetes mellitus, peripheral vascular disease, migraine headache, Raynaud syndrome, anemia, systemic hypotension, and calcium channel blocker use. This study strengthens the evidence for the vascular hypothesis of low-tension glaucoma.
多种系统性血管相关疾病，包括高血压和低血压、糖尿病、偏头痛、外周血管疾病、雷诺综合征和贫血，与低眼压性青光眼有关。
本研究旨在确定与低眼压性青光眼相关的系统性危险因素。
采用回顾性病例对照研究设计，在 2005 年至 2015 年间，在梅奥诊所眼科部门就诊的低眼压性青光眼患者和年龄匹配、性别匹配的对照组患者中，每组各纳入 277 例。
低眼压性青光眼组的近视程度更严重（-1.6 与-1.0 D，P<0.001），眼压更低（14.2 与 15.2 mmHg，P<0.001），杯盘比更高（0.7 与 0.3，P<0.001）。低眼压性青光眼组肥胖的可能性明显较低（体重指数>30，P=0.03）。该组高血压（比值比 [OR]：1.64，P=0.004）、糖尿病（OR：3.01，P<0.001）、外周血管疾病（OR：2.61，P=0.009）、偏头痛（OR：2.12，P=0.02）、贫血（OR：2.18，P=0.003）、系统性低血压（OR：4.43，P<0.001）、雷诺综合征（OR：3.09，P=0.05）和血管紧张素转换酶抑制剂（OR：1.64，P=0.01）或钙通道阻滞剂（OR：1.98，P=0.004）的使用频率明显更高。在校正高血压后，钙通道阻滞剂的使用仍具有显著意义（OR：1.70，P=0.03）。两组在高脂血症、阻塞性睡眠呼吸暂停、冠心病、颈动脉狭窄、中风或他汀类药物、血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂、β受体阻滞剂或二甲双胍的使用方面无显著差异。
多种血管相关疾病与低眼压性青光眼有关，包括高血压、糖尿病、外周血管疾病、偏头痛、雷诺综合征、贫血、系统性低血压和钙通道阻滞剂的使用。本研究进一步支持了低眼压性青光眼的血管假说。
