DOI: 10.4103/joco.joco_336_25 ISSN: 2452-2325

Systemic Hemodynamics and Ocular Perfusion in Normal-Tension Glaucoma: Evaluation of Beta-Blocker Effect

Kübra Özata Gündoğdu, Nilgün Özkan Aksoy, Seren Kaplan Güngördü
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Abstract

Purpose:

To compare the effects of topical treatments with and without beta-blockers on diurnal and nocturnal intraocular pressure (IOP), systemic blood pressure (BP), and ocular perfusion pressure (OPP) in patients with normal-tension glaucoma (NTG).

Methods:

NTG patients followed at the Glaucoma Unit of the Department of Ophthalmology, Sakarya University Training and Research Hospital between 2020 and 2025 were retrospectively analyzed. Patients receiving beta-blocker-containing therapy (Group 2, n = 21) and nonbeta-blocker therapy (Group 1, n = 18) were included. Twenty-four-hour IOP and systolic/diastolic BP (DBP) measurements were recorded, and OPP was calculated. Optical coherence tomography parameters and visual field tests were also evaluated.

Results:

Patients using beta-blockers had significantly lower diurnal and nocturnal systolic BP (SBP) compared to the nonbeta-blocker group (P 1 = 0.012, P 2 = 0.048). No significant differences were observed in DBP between groups during diurnal and nocturnal periods ( P 1 = 0.126, P 2 = 0.255). There were no significant differences between groups in 24-h mean IOP values or IOP fluctuation ( P 1 = 0.590, P 2 = 0.753). Diurnal OPP was significantly lower in the beta-blocker group, while nocturnal OPP did not differ between groups ( P 1 = 0.012, P 2 = 0.258). Ganglion cell–inner plexiform layer thickness was higher in the nonbeta-blocker group ( P = 0.012). No significant differences were observed in other structural or functional measurements (retinal nerve fiber layer, P = 0.599; mean deviation, P = 0.457; pattern standard deviation, P = 0.805).

Conclusions:

In NTG patients, beta-blocker use reduces diurnal SBP and diurnal OPP but has no significant effect on 24-h IOP or nocturnal OPP. These findings support the critical role of systemic hemodynamics and ocular perfusion in NTG progression and suggest that beta-blockers should be monitored carefully for OPP effects, especially in normotensive patients.

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