A population-based assessment of 24-hour ocular perfusion pressure among patients with primary open angle glaucoma: The handan eye study

Purpose: To compare the 24-hour ocular perfusion pressure (OPP) among patients with primary open angle glaucoma (POAG) and those with suspected POAG identified in a population-based study in China. Methods: Forty-seven patients with POAG and 35 with suspected POAG attended the 24-hour OPP study. Intraocular pressure (IOP) and blood pressure (BP) were measured at 2, 6, and 10 AM and 2, 6, and 10 PM. Subjects were not taking any medications to lower IOP, which was measured with Goldmann applanation in an upright sitting position. Blood pressure was measured in a supine position using a digital automatic BP monitor (OMRON, model HEM-907). Mean arterial pressure was calculated as diastolic BP + 1/3 × (systolic BP-diastolic BP). Mean OPP (MOPP) was defined as 2/3 × mean arterial pressure-IOP, systolic OPP (SOPP) was defined as 2/3 × systolic BP-IOP, and diastolic OPP (DOPP) was defined as 2/3 × diastolic BP-IOP. Results: After adjustment for age, sex, and IOP, the maximum, mean, and minimum SOPP, DOPP, and MOPP were statistically significantly lower in subjects with POAG than in those with suspected POAG (P < 0.05). The minimum MOPP, SOPP, and DOPP occurred from 10 AM to 2 PM in approximately 60% of eyes with POAG and between 20% and 30% of minimum MOPP, SOPP, and DOPP occurred around 10 PM. Conclusions: Systolic OPP, DOPP, and MOPP were consistently lower in eyes with POAG than in those with suspected POAG, providing further evidence that OPP plays a role in the development of glaucoma.