The Clinical Characteristics Of Ocular Perfusion Pressure Fluctuations After Position Adjustment With Primary Open-angle

BackgroundPrimary open-angle glaucoma is a disease with progressive optic neuropathy cause by multiple factors. In the study of the pathogenesis, we found that ocular perfusion pressure play an important role in the development of glaucoma. Stable and adequate blood perfusion in ocular are necessary to perform its normal function, and it relies on blood pressure, intraocular pressure and auto-regulation of ocular blood flow. Currently, studies on ocular perfusion pressure mostly are confined to a single time point of detection, so lack of study on circadian ocular perfusion pressure fluctuations. Therefore, it is necessary to monitor 24 h ocular perfusion pressure in POAG patients and normal subjects. Then, to analyze the characteristic of ocular perfusion pressure fluctuations in two groups.ObjectiveWe will monitor the 24 h intraocular pressure and blood pressure in POAG patients and normal subjects, calculate the perfusion pressure, compare of ocular perfusion pressure and its fluctuation in two groups. We hope that can provide the basis for clinical diagnosis and treatment.Methods24 h intraocular pressure and blood pressure were measured in 29 POAG patients (POAG group) and 30 healthy individuals (normal group) with matched age and sex. The POAG patients are confirmed by intraocular pressure, vision, fundus examination from May 2013 to March 2015 in the General Hospital of Chinese People’s Armed Police.24 h intraocular pressure were measured every 2 h from 8 am to 8 am the next day, all measurement were operated by a trained physician. Measurement with sitting position during the day (8:00-21:59) and supine position during the night (22:00-7:59).24 h blood pressure measured by the ambulatory blood pressure monitoring. Ocular perfusion pressure calculated by the formula after adjust position. Using SPSS 20.0 statistical software for analyze the daytime and nocturnal intraocular pressure, blood pressure, ocular perfusion pressure and its fluctuation between the two groups.Results1. Intraocular pressure at night was increased in two groups, intraocular pressure during the day and night were significantly higher in POAG group (P< 0.05); Nocturnal intraocular pressure fluctuations and 24 h average intraocular pressure were higher in POAG group (P< 0.05), while intraocular pressure fluctuations during the daytime has no difference between the two groups (P> 0.05).2. Mean blood pressure in the daytime and 24 h mean blood pressure have no difference in two groups (P> 0.05), but nocturnal mean blood pressure was lower in POAG group (P< 0.05), blood pressure fluctuations during the day and night was higher (P< 0.05); Systolic blood pressure and diastolic blood pressure during the day and night have no difference in two groups (P> 0.05), the fluctuations of systolic blood pressure and diastolic blood pressure during day and night were higher in POAG group (P< 0.05).3. Nocturnal mean ocular perfusion pressure was higher than daytime in two groups, mean ocular perfusion pressure during the day and night were lower in POAG group (P< 0.05), and it has higher fluctuation (P< 0.05); Systolic ocular perfusion pressure during the day and night have no difference in two groups (P> 0.05), Systolic ocular perfusion pressure fluctuation during the day and night were higher in POAG group (P< 0.05); Diastolic ocular perfusion pressure during the day and night were lower in POAG (P< 0.05), and it has higher fluctuation (P< 0.05).ConclusionPOAG patients has low nocturnal blood pressure, higher fluctuation of intraocular pressure, blood pressure, ocular perfusion pressure. These suggest that ocular blood perfusion has important effect on glaucoma and ocular perfusion pressure can be used as monitoring index for diagnosis and treatment of glaucoma in clinical.