Donkor Richard, Jammal Alessandro A, Greenfield David S
Department of Ophthalmology, University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Palm Beach Gardens, Florida.
Department of Ophthalmology, University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Palm Beach Gardens, Florida.
Ophthalmology. 2025 Jan;132(1):30-38. doi: 10.1016/j.ophtha.2024.07.026. Epub 2024 Aug 6.
To examine the relationship between systemic arterial blood pressure (BP) and the rate of change in standard automated perimetry (SAP) in eyes with glaucoma and suspected glaucoma.
Prospective cohort study.
One hundred twenty-four eyes (91 eyes with glaucoma, 33 eyes with suspected glaucoma) of 64 patients (mean age, 68.4 ± 7.6 years) followed up at the Bascom Palmer Eye Institute, Palm Beach Gardens, Florida.
Participants underwent ophthalmic examination, BP measurement, and SAP at 4-month intervals. At the baseline visit, 24-hour ambulatory blood pressure monitoring (ABPM) was acquired. Linear mixed models (adjusted for inclusion of both eyes, age, sex, race, intraocular pressure, baseline severity, and central corneal thickness) were used to investigate the effect of BP on the rates of SAP mean deviation (MD) change over time.
Effect of baseline 24-hour and follow-up mean arterial pressure (MAP), systolic BP (SBP), and diastolic BP on change in SAP MD.
Eyes underwent an average of 8.9 ± 1.5 SAP examinations over 28.3 ± 6.0 months of follow-up. The median rate of MD change was 0.14 dB/year (range, -1.21 to 0.96 dB/year) with 9 eyes (7%) showing moderate to fast progression (MD change, ≤ -0.50 dB/year). Each 10 mmHg lower in 24-hour average MAP and SBP were associated with -0.171 dB/year (P = 0.045) and -0.137 dB/year (P = 0.023) faster rates of MD loss. Lower mean SBP during follow-up was associated significantly (P = 0.003) with MD progression.
Lower baseline 24-hour ABPM measurements, as well as low SBP during follow-up, were associated significantly with faster rates of glaucomatous SAP progression and may be used as a predictor of risk of glaucomatous progression.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
研究青光眼及疑似青光眼患者的全身动脉血压（BP）与标准自动视野计（SAP）变化率之间的关系。
前瞻性队列研究。
佛罗里达州棕榈滩花园市巴斯科姆帕尔默眼科研究所对64例患者（平均年龄68.4±7.6岁）的124只眼进行了随访（91只青光眼眼，33只疑似青光眼眼）。
参与者每隔4个月接受一次眼科检查、血压测量和SAP检查。在基线访视时，进行24小时动态血压监测（ABPM）。采用线性混合模型（对双眼、年龄、性别、种族、眼压、基线严重程度和中央角膜厚度进行校正）来研究BP对SAP平均偏差（MD）随时间变化率的影响。
基线24小时及随访平均动脉压（MAP）、收缩压（SBP）和舒张压（DBP）对SAP MD变化的影响。
在28.3±6.0个月的随访期间，眼睛平均接受了8.9±1.5次SAP检查。MD变化的中位数为0.14 dB/年（范围为-1.21至0.96 dB/年），9只眼（7%）显示中度至快速进展（MD变化≤-0.50 dB/年）。24小时平均MAP和SBP每降低10 mmHg，MD损失率分别加快-0.171 dB/年（P = 0.045）和-0.137 dB/年（P = 0.023）。随访期间较低的平均SBP与MD进展显著相关（P = 0.003）。
较低的基线24小时ABPM测量值以及随访期间较低的SBP与青光眼性SAP进展速度加快显著相关，可作为青光眼进展风险的预测指标。
专有或商业披露信息可在本文末尾的脚注和披露中找到。
