Behera Geeta, Kunnilethu Ritu, Thirunavukarasu Suresh Chidambaram, Jayaraman Ramesh, Subramanyam Thanikachalam, Subramanian Anandaraja
Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India.
Department of Ophthalmology, Indira Gandhi Government General Hospital and Post Graduate Institute (IGGGH&PGI), Puducherry, India.
Curr Eye Res. 2024 Jun;49(6):631-638. doi: 10.1080/02713683.2024.2319774. Epub 2024 Feb 22.
To compare blood pressure (BP), intraocular pressure (IOP), ophthalmic artery flow (OAF) velocity, retinal nerve fiber layer (RNFL) thickness, and visual fields in newly diagnosed hypertension (HT) patients (before treatment), chronic HT (on antihypertensive medications >5 years) and normotensives.
A prospective, cross-sectional study at a tertiary care centre in India. Three groups of 45 patients each: group 1 - early HT, group 2 - chronic HT, and Group 3 - normotensives, underwent evaluation of BP, IOP by Goldmann applanation tonometry (GAT), OAF velocity by transcranial doppler (TCD), RNFL analysis by spectral-domain optical coherence tomography (SD-OCT), and visual fields.
The BP was highest in early HT > chronic HT > normotensives ( < 0.001). The IOP of early HT, chronic HT, and normotensives were 15.87 ± 2.19 mmHg, 13.47 ± 1.92 mmHg, and 15.67 ± SD 1.75 mmHg ( < 0.001). The OAF velocity [peak systolic velocity (PSV), end-diastolic velocity (EDV) in cm/sec] was lowest in chronic HT (30.80 ± 7.05, 8.58 ± 1.58) < early HT (35.47 ± 5.34, 10.02 ± 1.74) < normotensives (36.29 ± 4.43, 10.44 ± 2.29), ( < 0.001). The average RNFL thickness was significantly lower in chronic HT ( = 0.022). The PSV, EDV, and MFV showed significant correlation with IOP ( = 0.247, = 0.004; = 0.206, = 0.016; = 0.266, = 0.002) and average RNFL thickness ( = 0.309, = <0.001; = 0.277, = 0.001; = 0.341, < 0.001).
Patients with chronic HT demonstrated the lowest retrobulbar flows, IOP and lower RNFL measurements. Lower ocular perfusion may be associated with lower IOP and may be a risk factor for end-organ damage (RNFL) independent of IOP.
比较新诊断高血压（HT）患者（治疗前）、慢性高血压（服用抗高血压药物>5年）患者和血压正常者的血压（BP）、眼压（IOP）、眼动脉血流（OAF）速度、视网膜神经纤维层（RNFL）厚度和视野。
在印度一家三级医疗中心进行的一项前瞻性横断面研究。每组45例患者：第1组-早期HT，第2组-慢性HT，第3组-血压正常者，接受了血压、通过Goldmann压平眼压计（GAT）测量眼压、通过经颅多普勒（TCD）测量OAF速度、通过光谱域光学相干断层扫描（SD-OCT）进行RNFL分析以及视野评估。
早期HT患者的血压最高>慢性HT患者>血压正常者（<0.001）。早期HT、慢性HT和血压正常者的眼压分别为15.87±2.19 mmHg、13.47±1.92 mmHg和15.67±标准差1.75 mmHg（<0.001）。慢性HT患者的OAF速度[收缩期峰值速度（PSV）、舒张末期速度（EDV），单位为cm/秒]最低（30.80±7.05，8.58±1.58）<早期HT患者（35.47±5.34，10.02±1.74）<血压正常者（36.29±4.43，10.44±2.29），（<0.001）。慢性HT患者的平均RNFL厚度显著更低（=0.022）。PSV、EDV和平均血流速度（MFV）与眼压显著相关（=0.247，=0.004；=0.206，=0.016；=0.266，=0.002）以及与平均RNFL厚度显著相关（=0.309，=<0.001；=0.277，=0.001；=0.341，<0.001）。
慢性HT患者表现出最低的球后血流、眼压以及更低的RNFL测量值。较低的眼部灌注可能与较低的眼压相关，并且可能是独立于眼压的终末器官损伤（RNFL）的一个危险因素。
