Elsevier

Ophthalmology

Volume 107, Issue 7, July 2000, Pages 1287-1293
Ophthalmology

Vascular risk factors for primary open angle glaucoma: The Egna-Neumarkt Study

https://doi.org/10.1016/S0161-6420(00)00138-XGet rights and content

Abstract

Objective

To assess the impact of vascular risk factors on the prevalence of primary open angle glaucoma.

Design

Population-based cross-sectional study.

Participants

Four thousand two hundred ninety-seven patients more than 40 years of age underwent a complete ocular examination in the context of the Egna-Neumarkt Glaucoma Study.

Intervention

Ocular examinations were performed by trained, quality-controlled ophthalmologists according to a predefined standardized protocol including medical interview, blood pressure reading, applanation tonometry, computerized perimetry, and optic nerve head examination.

Main outcome measures

Prevalences of ocular hypertension, primary open-angle glaucoma, normal-tension glaucoma, and other types of glaucoma were determined. Correlation coefficients were calculated for the association between systemic blood pressure and age-adjusted intraocular pressure (IOP) and between age and both intraocular and systemic blood pressures. Odds ratios were computed to assess the risk of primary open-angle glaucoma and normal-tension glaucoma in relation to systemic hypertension or antihypertensive medication, blood pressure levels, diastolic perfusion pressure, and a number of other cardiovascular risk factors.

Results

A positive correlation was found between systemic blood pressure and IOP, and an association was found between diagnosis of primary open-angle glaucoma and systemic hypertension. Lower diastolic perfusion pressure is associated with a marked, progressive increase in the frequency of hypertensive glaucoma. No relationship was found between systemic diseases of vascular origin and glaucoma.

Conclusions

Our data are in line with those reported in other recent epidemiologic studies and show that reduced diastolic perfusion pressure is an important risk factor for primary open-angle glaucoma.

Section snippets

Patients and methods

The entire population more than 40 years of age from the Egna-Neumarkt area of the South Tyrol, Italy, comprising 11 rural districts in the vicinity of Bolzano, was eligible.

The investigation was carried out in a specially equipped screening center by specifically trained medical staff, periodically subjected to quality control, according to procedures described in a prepared operating manual.

The study was conducted in three phases. At the first screening visit, a medical history questionnaire

Results

One thousand eight hundred eighty-two men and 2415 women were examined from a total population of 5816 for an overall participation rate of 73.9%. The composition of the sample together with the participation rates according to sex and age have been analyzed in detail in a previous article.20 Table 1 shows the overall prevalence of OH and of the different forms of glaucoma in the population studied. Table 2 gives details of the association between systemic blood pressure and age-adjusted IOP.

Discussion

Although OH is generally regarded as being the main risk factor for glaucoma, there can be no doubt, especially in the primary open-angle form, that other factors make a decisive contribution toward increasing the vulnerability of the optic nerve and generating the typical anatomic–functional damage that characterizes this disease.

According to the vascular or ischemic hypothesis, glaucomatous damage is caused by, or at least facilitated by, inadequate perfusion of the proximal portion of the

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  • Cited by (0)

    Supported in part by Regione Trentino Alto Adige, Bolzano, and Merck, Sharp, and Dohme, Roma, Italy.

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