Elsevier

Ophthalmology

Volume 115, Issue 7, July 2008, Pages 1173-1178.e1
Ophthalmology

Original article
Glaucoma Is Associated with Peripheral Vascular Endothelial Dysfunction

https://doi.org/10.1016/j.ophtha.2007.10.026Get rights and content

Purpose

To evaluate peripheral vascular endothelial function in patients with normal-tension glaucoma (NTG) and primary open-angle glaucoma (POAG) using noninvasive endothelium-dependent flow-mediated vasodilation (FMD).

Design

Case–control study.

Participants

Thirty patients with NTG, 30 with POAG, and 30 healthy age- and gender-matched controls.

Methods

Participants underwent measurement of FMD and endothelium-independent nitroglycerin-mediated vasodilation (NMD) via high-resolution 2-dimensional ultrasonographic imaging of the brachial artery. All patients also underwent blood sampling for biochemistry, lipid profile, and high sensitivity C-reactive protein analysis.

Main Outcome Measures

The association of FMD with NTG and POAG.

Results

The FMD values differed significantly between the patients with NTG, those with POAG, and controls: NTG, 2.70±2.25%; POAG, 5.33±2.81%; controls, 7.21±2.36%; P<0.001. In comparison with the POAG group and normal controls, the NTG group demonstrated markedly impaired FMD. The POAG group exhibited higher intermediate FMD than the NTG group (P<0.001) but significantly lower FMD than normal controls (P = 0.012). Multivariate analysis indicated that independent predictors for impaired FMD were presence of NTG, presence of POAG, and advanced age. Additionally, FMD values were significantly lower in glaucoma patients than in controls (4.02±2.85% vs. 7.21±2.36%; P<0.001).

Conclusions

Patients with glaucoma have impaired FMD. Additionally, patients with NTG have lower FMD than those with POAG.

Section snippets

Participants

Patients with NTG (n = 30), POAG (n = 30), and age- and gender-matched normal controls (n = 30) were recruited for this study. The NTG and POAG patients were recruited from the glaucoma clinic of Chang Gung Memorial Hospital. The normal controls were recruited from patients undergoing routine medical examinations in the same hospital. The diagnostic criteria for NTG were as follows: untreated IOP not exceeding 22 mmHg measured at varying intervals from 8 am to 5 pm, open anterior chamber angles

Results

Table 2 lists the demographics for the NTG, POAG, and control groups. Table 3 lists the vascular parameters in the 3 groups. The FMD values were 2.70±2.25% in the NTG group, 5.33±2.81% in the POAG group, and 7.21±2.36% in the control group (P<0.001). Multiple comparisons between groups also differed significantly. Meanwhile, the NMD values were 12.95±5.82% in the NTG group, 15.62±4.29% in the POAG group, and 16.01±5.00% in the control group (P = 0.044). However, no significant difference was

Discussion

Several studies have shown impaired vascular endothelial function in patients with NTG,12, 13, 14 but data for POAG patients have not been reported. The analytic results of this study indicated that FMD in patients with NTG, in those with PAOG, and controls significantly differed. The NTG group tended to exhibit severe vascular endothelial dysfunction, and the POAG group demonstrated moderate impairment. Although IOP currently is considered the most important risk factor for developing

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    Manuscript no. 2007-688.

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