Nikhil Prasad Fact checked by:Thailand Medical News Team Nov 19, 2024 2 weeks, 16 hours, 17 minutes ago
Medical News: A groundbreaking study led by researchers from the University of California, San Diego, has revealed a strong connection between long-term blood pressure variability and the accelerated loss of peripheral vision in glaucoma patients. This finding sheds light on a critical vascular factor that may influence the progression of this vision-threatening condition.
Blood Pressure Fluctuations May Worsen Glaucoma Progression
Understanding Glaucoma and Its Risk Factors
Glaucoma, a leading cause of irreversible blindness worldwide, is characterized by the progressive degeneration of retinal ganglion cells and the optic nerve. While elevated intraocular pressure (IOP) is a well-known and modifiable risk factor, other contributors to disease progression remain under investigation. This
Medical News report delves into the role of vascular factors, particularly blood pressure variability, in exacerbating glaucoma-related vision loss.
The research team, which included collaborators from the University of Alabama-Birmingham and Columbia University Medical Center in New York, hypothesized that impaired blood flow regulation in the eye could be a key factor in disease progression. By analyzing the relationship between blood pressure fluctuations and visual field loss, the researchers aimed to clarify the vascular contributions to glaucoma.
The Study Design: A Deep Dive into Decades of Data
In their retrospective cohort study, titled "Long-Term Blood Pressure Variability and Visual Field Progression in Glaucoma," the team analyzed data collected over two decades from 1,674 eyes of 985 patients with either suspected or confirmed glaucoma. The study participants were drawn from two large cohorts: the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study.
Participants underwent regular blood pressure measurements and visual field testing between November 2000 and December 2022. Blood pressure metrics, including mean values and standard deviations for systolic and diastolic pressures, were calculated for each participant. These parameters were incorporated into advanced statistical models to determine their association with the rate of visual field mean deviation loss, a key indicator of glaucoma progression.
Key Findings: Blood Pressure Variability and Vision Loss
The analysis uncovered compelling evidence that greater long-term variability in blood pressure is linked to faster rates of peripheral vision decline in glaucoma patients. Specifically:
-Higher Blood Pressure Variability
Greater fluctuations in both systolic and diastolic blood pressure were significantly associated with faster annual rates of visual field loss. This suggests that inconsistent blood flow to the optic nerve may accelerate damage over time.
-Interaction with Mean Blood Pressure and IOP
When combined with higher average blood pressure or elevated IOP,
blood pressure variability was even more strongly linked to visual field deterioration. Patients with these combined factors experienced the fastest rates of vision loss.
-Mean Blood Pressure Trends
While higher mean blood pressure alone showed a marginal trend toward faster visual field decline, it was not statistically significant. However, its interaction with variability and IOP highlighted its potential role as a modifier.
Implications for Glaucoma Management
These findings emphasize the need for a broader approach to managing glaucoma, one that considers systemic vascular health alongside traditional treatments targeting IOP. Clinicians may need to monitor and control blood pressure fluctuations more closely in glaucoma patients to slow disease progression.
The study also raises an important question: Are vascular changes a cause of glaucoma progression, or are they a consequence of the disease? Further research is needed to unravel this complex relationship and determine whether interventions targeting vascular stability can effectively preserve vision.
Conclusion: A Call for Comprehensive Care
This study highlights the significance of blood pressure variability as a potential modifier of glaucoma progression. By addressing both IOP and systemic vascular factors, healthcare providers can better support patients in preserving their vision. The findings also underscore the importance of personalized care, as patients with higher blood pressure variability may require tailored treatment strategies.
As glaucoma remains a major public health challenge, understanding and mitigating these risk factors is crucial. By combining insights from ophthalmology and cardiovascular medicine, researchers and clinicians can work toward more effective prevention and management strategies.
The study findings were published in the peer-reviewed journal: JAMA Ophthalmology.
https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2826006
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