Glaucoma may continue to progress after the reduction of IOP to targeted levels. Research is providing increasing support for the idea that vascular risk factors may be the cause.
Several population-based studies have suggested that low diastolic perfusion pressure is associated with an increased
incidence of open-angle glaucoma (OAG). Perfusion pressure is defined as the difference between arterial and venous pressure, which, in the eye, by convention equals IOP. Blood pressure and IOP are therefore the principal components of ocular perfusion pressure (perfusion pressure = blood pressure – IOP).
• Choi J, Kim KH, Jeong J, et al. Circadian fluctuation of mean ocular perfusion pressure is a consistent risk factor
for normal-tension glaucoma. Invest Ophthalmol Vis Sci. 2007;48:104-111.
• Tielsch JM, Katz J, Sommer A, et al. Hypertension, perfusion pressure, and primary open-angle glaucoma. A population-based
assessment. Arch Ophthalmol. 1995;113:216-221.
• Leske MC, Connell AM, Wu SY, et al. Risk factors for open-angle glaucoma. The Barbados Eye Study. Arch Ophthalmol.
1995;113:918-924.
• Hulsman CA, Vingerling JR, Hofman A, et al. Blood pressure, arterial stiffness, and open-angle glaucoma: the Rotterdam study.
Arch Ophthalmol. 2007;125:805-812.
Perfusion pressure can be affected by IOP and blood pressure, but which is really the most important? In a given patient, it
could be IOP alone, blood pressure alone, or a combination of the two.
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