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Jo, Lee, and Cho: 24-hour Ambulatory Blood Pressure in Normal Tension Glaucoma: Associations with Retinal Vessel Diameter and Visual Field Defect Progression
Original Article

Journal of the Korean Ophthalmological Society 2017; 58(11): 1242-1247.

Published online: 15 November 2017

DOI: https://doi.org/10.3341/jkos.2017.58.11.1242

24-hour Ambulatory Blood Pressure in Normal Tension Glaucoma: Associations with Retinal Vessel Diameter and Visual Field Defect Progression

Aerin Jo, MD, Hyungwoo Lee, MD, Byung Joo Cho, MD, PhD

Department of Ophthalmology, Konkuk University School of Medicine, Seoul, Korea.

Address reprint requests to Byung Joo Cho, MD, PhD. Department of Ophthalmology, Konkuk University Medical Center, #120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea. Tel: 82-2-2030-7651, Fax: 82-2-2030-5273, bjcho@kuh.ac.kr

Received 25 May 2017       Revised 21 August 2017       Accepted 30 October 2017

©2017 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the correlation between 24-hour ambulatory blood pressure (BP) monitoring and peripapillary retinal vessel width and visual field (VF) defect progression in normal tension glaucoma (NTG) patients.

Methods

All patients were classified by 24-hour ambulatory BP monitoring as non-dipper (nocturnal dip < 10%) and dipper (nocturnal dip ≥ 10%) group. Vessel diameter, mean deviation (MD) value by VF test and VF progression from Glaucoma Progression Analysis (GPA) were compared among non-dipper and dipper groups.

Results

Retinal arterial diameter was wider in the non-dipper group compared to the dipper group (p = 0.015), while retinal venous diameter had no significant relationship between the two groups (p = 0.131). The MD value at baseline and 2 years after was worse in the non-dipper group than the dipper group, respectively (p = 0.006, p = 0.030). But, there was no significant relationship between nocturnal dip and GPA progression (p = 0.658).

Conclusions

There was a statistically significant correlation between nocturnal dips and retinal arterial diameter and MD values. These results suggest that non-invasive fundus photography can predict hemodynamic features like nocturnal dip.

Keywords: Nocturnal dip, Normal tension glaucoma, Retinal vessel, Vessel narrowing, 24-hour ambulatory blood pressure monitoring

Figures and Tables

Figure 1

The geometric measurement of the retinal vessels. The 1 disc-diameter is marked as the white line based on the optic disc margin. All retinal vessel's diameter that cross the white line are measured two times by manual method then we selected the biggest 5 from arteries (A, red arrows) and veins (B, blue arrows).

jkos-58-1242-g001
Table 1

Demographics of patients in non-dipper and dipper

jkos-58-1242-i001

‘Non-dipper’ means ‘less than 10% of nocturnal dip’ and ‘Dipper’ means ‘more than 10% of nocturnal dip’. Statistical significance: p < 0.05. IOP = intraocular pressure.

*Student t-test; †Fisher's exact test.

Table 2

The number of patients classified by GPA in non-dipper and dipper

jkos-58-1242-i002

‘Non-dipper’ means ‘less than 10% of nocturnal dip’ and ‘Dipper’ means ‘more than 10% of nocturnal dip’. Statistical significance: p < 0.05. GPA = Glaucoma Progression Analysis.

*Fisher's exact test.

Notes

This study was presented as a poster at the 117th Annual Meeting of the Korean Ophthalmological Society 2017.

Conflicts of Interest The authors have no conflicts to disclose.

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