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Arteriolar pressure may predict progression to early glaucoma
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MONTREAL — A measurement of arteriolar pressure can predict the progression from ocular hypertension to open-angle glaucoma, researchers here said. Measuring the low-end arteriolar pressure can provide an early, reproducible and physiological method to study vascular phenomena in glaucoma, the researchers said.
“Our study is the first to quantify a difference between ocular hypertension that progresses compared with ocular hypertension that does not, independent of a difference in cup-disc ratio,” reported Shawn Cohen, MD, and colleagues here.
The researchers calculated the pressure attenuation index (PAI) for 27 eyes of 14 patients with ocular hypertension using digitized optic disc photographs taken over the course of 5- to 18-year follow-up.
The PAI links retinal arteriolar changes to measurements of arteriolar pressure. Healthy people share a common pressure attenuation index value; significant alterations in index values have been shown to reflect a pathophysiological change in the retinal arterioles themselves, according to the study authors. In this study, serial stereo color disc photographs and visual fields were analyzed to determine progression.
At baseline, the arteriolar tree of eight subjects with ocular hypertension that progressed to open-angle glaucoma (OAG) demonstrated a 45.8% greater mean PAI than that of seven subjects who did not progress. The progression was independent of baseline cup:disc ratio.
The values of subjects with stable ocular hypertension remained stable after a median follow-up of 12 years. The values of subjects with ocular hypertension that progressed to OAG demonstrated a mean increase of 20% during a median follow-up of 6 years.
The study is published in the January issue of Archives of Ophthalmology.