Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May 2:15:4565-4573.
doi: 10.2147/IJGM.S362275. eCollection 2022.

The Effect of Autonomic Nervous System Dysfunction on the Progression of Primary Open-Angle Glaucoma

Binbin Liu  1 , Yin Zhao  1 , Hong Zhang  1
Affiliations

The Effect of Autonomic Nervous System Dysfunction on the Progression of Primary Open-Angle Glaucoma

Binbin Liu et al. Int J Gen Med. .

Abstract

Purpose: To study the effect of autonomic nervous system (ANS) dysfunction on glaucoma progression in patients with primary open angle glaucoma (POAG).

Patients and methods: A retrospective study of 40 cases of POAG patients who underwent regular reexamination for more than 3 years was performed. All participants were subjected to heart-rate variability (HRV) assessment. Patients were divided equally into the lowest and highest HRV groups according to the standard deviation value of the qualified normal to normal intervals (SDNN), a representative indicator of HRV. The lower the HRV, the more severe the ANS dysfunction with sympathetic predominance. Visual field (VF) parameters and retinal nerve fiber layer (RNFL) thickness were used to evaluate and compare the progression of glaucoma damage between the two groups.

Results: There were 20 cases in the lowest HRV group and 20 cases in the highest HRV group. The thinning rate of RNFL in the lowest HRV group was significantly faster than that in the highest HRV group (1.44±1.58 vs 0.29±0.56 μm/year, P=0.00), accompanied by greater fluctuation of intraocular pressure (IOP) (P=0.04), lower diastolic blood pressure (P=0.01), mean blood pressure (P=0.04), and lower mean ocular perfusion pressure (P=0.04). Meanwhile, the incidence of central VF defects in the lowest HRV group was significantly higher than that in the highest HRV group (65.0% vs 30%, P=0.03). Linear regression analysis showed that there was a significant correlation between SDNN and the thickness loss rate of RNFL (P=0.01).

Conclusion: POAG patients with lower HRV, which reflects ANS dysfunction with sympathetic predominance, presented faster glaucoma progression than patients with higher HRV. The more rapid progression of POAG with lower HRV may be explained by IOP and vascular risk factors.

Keywords: autonomic nervous system; heart rate variability; primary open angle glaucoma; retinal nerve fiber layer; visual field.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Scatter plot showing the relationship between RNFL thickness loss rate and SDNN values.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Jonas J, Aung T, Bourne R, Bron A, Ritch R, Panda-Jonas S. Glaucoma. Lancet. 2017;390:2183–2193. doi:10.1016/S0140-6736(17)31469-1 - DOI - PubMed
    1. Venkataraman ST, Flanagan JG, Hudson CJM. Vascular reactivity of optic nerve head and retinal blood vessels in glaucoma—a review. Microcirculation. 2010;17(7):568–581. doi:10.1111/j.1549-8719.2010.00045.x - DOI - PubMed
    1. Weinreb RN, Khaw P. Primary open-angle glaucoma. Lancet. 2004;363(9422):1711–1720. doi:10.1016/S0140-6736(04)16257-0 - DOI - PubMed
    1. Khatib T, Martin KJE. Protecting retinal ganglion cells. Eye. 2017;31(2):218–224. doi:10.1038/eye.2016.299 - DOI - PMC - PubMed
    1. Ophthalmol AGISJAJ. The relationship between control of intraocular pressure and visual field deterioration. AGIS Investigators. 2000;130(4):429–440. - PubMed