Korean J Ophthalmol.  2010 Feb;24(1):23-28. 10.3341/kjo.2010.24.1.23.

Circadian Blood Pressure and Intraocular Pressure Patterns in Normal Tension Glaucoma Patients with Undisturbed Sleep

• Kim YK
• Oh WH
• Park KH
• Kim JM
• Kim DM

• KMID: 1098789
• DOI: http://doi.org/10.3341/kjo.2010.24.1.23

Abstract

PURPOSE: To investigate and compare the circadian pattern of blood pressure (BP), intraocular pressure (IOP) and mean ocular perfusion pressure (MOPP) while experiencing undisturbed sleep in normal-tension glaucoma (NTG) and non-glaucoma control patient groups.
METHODS
Twenty-four eyes from 24 patients diagnosed with NTG and 22 eyes from 22 control group patients were enrolled. Systolic BP, diastolic BP and IOP were measured every two hours except for the period of time from 1 AM to 7 AM in the NTG group and from 11 PM to 7 AM in the control group over a one-day period. IOP and hemodynamic parameters were then compared between the two groups. NTG patients were subdivided according to the degree of morning BP dip and IOP, and hemodynamic parameters and visual field indices (mean deviation and pattern standard deviation) were also compared among these subgroups.
RESULTS
There were no significant differences in mean systolic BP, mean diastolic BP and mean arterial pressure (MAP) between the NTG and the control groups. The NTG group showed a significantly large morning BP dip compared to the control group (7.1+/-4.2% vs. 3.8+/-3.4%, p=0.022). However, there were no significant differences in mean or fluctuation of MOPP between the two groups. Morning over-dippers showed significantly large MAP and MOPP fluctuations compared to non-dippers and dippers, while there were no significant differences in visual field indices among the three subgroups.
CONCLUSIONS
NTG patients showed significant morning BP dips compared to the control group. The marked morning BP dip was associated with significantly large MAP or MOPP fluctuations but was not associated with visual field indices.

Keyword

Blood pressure; Circadian rhythm; Intraocular pressure; Low tension glaucoma; Ocular perfusion pressure

MeSH Terms

Adult
Aged
*Blood Pressure
*Circadian Rhythm
Diastole
Female
Humans
*Intraocular Pressure
Low Tension Glaucoma/*physiopathology
Male
Middle Aged
*Sleep
Systole

Figure

• 

  Fig. 1 Circadian hemodynamic patterns in the normal tension glaucoma (NTG) and the non-glaucoma control group. SBP=systolic blood pressure; DBP=diastolic blood pressure; MAP=mean arterial pressure; MOPP=mean ocular perfusion pressure.

• 

  Fig. 2 Circadian intraocular pressure (IOP) patterns in the normal tension glaucoma (NTG) and the non-glaucoma control group.

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