The association of lower ocular perfusion pressure with glaucoma severity independent of intraocular pressure
Narasimha Mukkamala, Pradeep Pakalapati, Thamatam HarithaPurpose:
To investigate the relationship between systemic hypertension, ocular perfusion pressure (OPP), and intraocular pressure (IOP) with glaucoma severity, with a secondary analysis on the impact of antihypertensive medication.
Design:
Cross-sectional observational study.
Methods:
A total of 75 patients (75 eyes) with primary open-angle glaucoma (POAG) were included. One eye per patient was randomly selected for analysis. All participants underwent comprehensive ophthalmic examination and a single time-point systemic blood pressure (BP) measurement. Data on antihypertensive medication usage were also collected. Glaucoma was staged as early, moderate, or advanced. Key variables included systolic/diastolic blood pressure (SBP/DBP), mean arterial pressure (MAP), IOP, and estimated OPP. Analysis of variance and Pearson’s correlation were used. A sub-group analysis compared hemodynamic parameters between patients on antihypertensive medication and those who were not.
Results:
The mean age was 53.99 ± 6.53 years. While mean IOP did not differ significantly across glaucoma stages (
Conclusions:
Lower OPP, DPP, DBP, and MAP were significantly associated with advanced glaucoma severity. Patients on antihypertensive medication had lower mean OPP, suggesting they may be at higher risk for perfusion-related damage not captured by in hospital BP readings. This highlights the importance of considering the hemodynamic effects of medication in glaucoma management.