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Titolo:
Role of nocturnal arterial hypotension in optic nerve head ischemic disorders
Autore:
Hayreh, SS; Podhajsky, P; Zimmerman, MB;
Indirizzi:
Univ Iowa, Coll Med, Dept Ophthalmol & Visual Sci, Iowa City, IA USA Univ Iowa Iowa City IA USA pt Ophthalmol & Visual Sci, Iowa City, IA USA Univty,wa, Coll Med, Dept Prevent Med & Environm Hlth, Div Biostat, Iowa Ci Univ Iowa Iowa City IA USA ent Med & Environm Hlth, Div Biostat, Iowa Ci
Titolo Testata:
OPHTHALMOLOGICA
fascicolo: 2, volume: 213, anno: 1999,
pagine: 76 - 96
SICI:
0030-3755(199903/04)213:2<76:RONAHI>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOW-TENSION GLAUCOMA; AMBULATORY BLOOD-PRESSURE; EXPERIMENTAL RENOVASCULAR HYPERTENSION; INTRAOCULAR-PRESSURE; FLOW AUTOREGULATION; NEUROPATHY; REDUCTION; CIRCULATION; BABOON; MANAGEMENT;
Keywords:
ambulatory blood pressure monitoring; anterior ischemic optic neuropathy; blood pressure; glaucomatous optic neuropathy; intraocular pressure; nocturnal arterial hypotension; optic nerve head ischemia;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
95
Recensione:
Indirizzi per estratti:
Indirizzo: Hayreh, SS UnivAIowa Hosp & Clin, Dept Ophthalmol & Visual Sci, Iowa City,IA 52242 US Univ Iowa Hosp & Clin Iowa City IA USA 52242 City, IA 52242 US
Citazione:
S.S. Hayreh et al., "Role of nocturnal arterial hypotension in optic nerve head ischemic disorders", OPHTHALMOLA, 213(2), 1999, pp. 76-96

Abstract

Objective: To investigate the role of nocturnal arterial hypotension, intraocular pressure (IOP) and heart rate in optic nerve head (ONH) ischemic disorders, and the effects of systemic factors and topical beta-blocker eyedrops on nocturnal arterial hypotension and heart rate. Methods: We investigated prospectively, by 24-hour ambulatory blood pressure (BP) monitoring anddiurnal curve of the IOP, 275 white patients with anterior ischemic optic neuropathy (AION - 114), normal tension glaucoma (NTG - 131) and primary open angle glaucoma (POAG - 30). Results: Hourly average BP data analyses showed a significantly greater drop in mean diastolic BP (p < 0.009) at night in NTG than AION. Cases with visual field deterioration had significantly (p = 0.05) lower minimum nighttime diastolic BP. Arterial hypertensives on oral hypotensive therapy showed a significantly lower mean nighttime systolic BP (p = 0.006) and larger mean percentage drop in systolic (p < 0.0001), diastolic (p = 0.0009) and mean (p < 0.0001) BPs. Normotensives and hypertensives without therapy had no such difference. IOP showed no significant correlation with visual field deterioration in any of these conditions. Patients using P-blocker eyedrops, compared with those not using them, had greater percentage drop in diastolic BP (p = 0.028), lower minimum nighttime diastolic BP (p = 0.072) and lower minimum nighttime heart rate (p = 0.002). Conclusions: Findings of our study suggest that nocturnal hypotension, by reducing the ONH blood flow below a crucial level during sleep in a vulnerable ONH, may play a role in the pathogenesis of AION and glaucomatous optic neuropathy (GON) and progression of visual loss in them. Thus, nocturnal hypotension may be the final insult in a multifactorial situation.

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Documento generato il 02/07/20 alle ore 19:08:27