Hypertension, perfusion pressure, and primary open-angle glaucoma. A population-based assessment

Abstract

Objective: To evaluate the association of vascular factors with primary open-angle glaucoma (POAG).

Design: A population-based prevalence survey of ocular disease among black and white residents.

Setting: Communities of east Baltimore, Md.

Participants: A stratified cluster sample of 5308 residents 40 years of age or older.

Main outcome measures: Primary open-angle glaucoma as defined by demonstrable glaucomatous optic nerve damage based on visual fields and/or optic disc findings. Intraocular pressure level was not a criterion for diagnosis.

Results: Systolic and diastolic blood pressure showed modest, positive association with POAG. The effect of blood pressure on POAG was modified by age, with a stronger association among older subjects. Lower perfusion pressure (blood pressure-intraocular pressure) was strongly associated with an increased prevalence of POAG, with a sixfold excess for those in the lowest category of perfusion pressure.

Conclusion: These results suggest that POAG is associated with an alteration in factors related to ocular blood flow and a breakdown of autoregulation.