Glaucoma Service, Narayana Nethralaya-2, Bengaluru, Karnataka, India.
Indian J Ophthalmol. 2022 Feb;70(2):569-573. doi: 10.4103/ijo.IJO_861_21.
To study the relationship between intraocular pressure (IOP) and mean ocular perfusion pressure (MOPP) in patients with POAG and NTG. The secondary objective was to identify other contributory ischemic factors.
This was an observational cross-sectional study from a tertiary eye hospital in patients who underwent full-day diurnal variation of tension (DVT). Blood pressure (BP) and IOP measurements were done every 3 h over 24 h. Mean arterial pressure (MAP) and MOPP were calculated. The nocturnal dip in BP was assessed; patients were classified as non-dippers, dippers, and over-dippers. The circadian MOPP fluctuation (CMF) was calculated using the Kruskal-Wallis test, and its relationship with type and severity of visual field was assessed.
In total, 149 patients were evaluated; 109 were classified as NTG, and 40 were classified as POAG. A nocturnal dip in BP was noted in 20% of NTG and 17.5% of POAG. The MAP was found to be lower in patients with NTG than POAG. In the NTG subgroup, we found that 20% of patients were over-dippers, 32% were dippers, and 48% were non-dippers. The CMF showed a greater fluctuation for over-dippers (P = 0.004 for the RE and 0.003 for the LE) than dippers and non-dippers. A weak positive correlation of CMF with the severity of fields was found.
A 24-h monitoring of IOP, BP, MOPP, and assessment of systemic risk factors for primary glaucoma acts as an invaluable tool for the comprehensive management of NTG despite the limitations posed by DVT and BP recording.
研究 POAG 和 NTG 患者眼内压（IOP）与平均眼灌注压（MOPP）之间的关系。次要目的是确定其他促成缺血的因素。
这是一项来自一家三级眼科医院的观察性横断面研究，纳入了接受全天眼压变化（DVT）的患者。在 24 小时内，每 3 小时测量一次血压（BP）和 IOP。计算平均动脉压（MAP）和 MOPP。评估夜间 BP 下降情况；将患者分为非杓型、杓型和超杓型。使用 Kruskal-Wallis 检验计算昼夜 MOPP 波动（CMF），并评估其与视野类型和严重程度的关系。
共评估了 149 名患者；109 名患者被归类为 NTG，40 名患者被归类为 POAG。20%的 NTG 和 17.5%的 POAG 患者存在夜间 BP 下降。NTG 患者的 MAP 低于 POAG 患者。在 NTG 亚组中，我们发现 20%的患者为超杓型，32%为杓型，48%为非杓型。CMF 显示超杓型波动较大（右眼 P = 0.004，左眼 P = 0.003）。CMF 与视野严重程度呈弱正相关。
尽管 DVT 和 BP 记录存在限制，但 24 小时监测 IOP、BP、MOPP 和评估原发性青光眼的系统危险因素，是 NTG 综合管理的宝贵工具。
