RT Journal
A1 Mroczkowska S, Benavente-Perez A, Negi A, Sung V, Patel SR, Gherghel D
T1 Primary open-angle glaucoma vs normal-tension glaucoma: The vascular perspective
JF JAMA Ophthalmology
JO JAMA Ophthalmology
YR 2013
FD January 1
VO 131
IS 1
SP 36
OP 43
DO 10.1001/2013.jamaophthalmol.1
UL http://dx.doi.org/10.1001/2013.jamaophthalmol.1
AB Objective 
                  To compare and contrast the presence of ocular and systemic vascular function in patients with newly diagnosed and previously untreated primary open-angle glaucoma (POAG) vs those with normal-tension glaucoma (NTG) and comparable early-stage, functional loss.Methods 
                  The systemic vascular function of 19 patients with POAG, 19 patients with NTG, and 20 healthy individuals serving as controls was assessed using 24-hour ambulatory blood pressure monitoring, peripheral pulse-wave analysis, and carotid intima-media thickness. Retinal vascular reactivity to flicker light was assessed using dynamic retinal vessel analysis (Imedos, GmbH).Results 
                  Compared with controls, patients with POAG and those with NTG exhibited similarly increased nocturnal systemic blood pressure variability (P = .01), peripheral arterial stiffness (P = .02), carotid intima-media thickness (P = .04), and reduced ocular perfusion pressure (P < .001). Furthermore, on dynamic retinal vessel analysis, both glaucoma groups exhibited steeper retinal arterial constriction slopes after cessation of flicker (P = .007) and a similarly increased fluctuation in arterial and venous baseline diameter (P = .008 and P = .009, respectively) compared with controls.Conclusions 
                  Patients with POAG or NTG exhibit similar alterations in ocular and systemic circulation in the early stages of their disease process. This finding highlights the importance of considering vascular risk factors in both conditions and raises questions about the current separation of the two conditions into distinct clinical entities.