Adding to the literature linking glaucoma and heart-related conditions, a new study in Ophthalmology reports cardiovascular disease is an important risk factor for macular ganglion cell–inner plexiform layer (mGCIPL) defects and glaucoma progression.
The investigation enrolled 2,628 eyes of 1,314 participants who were recruited to the Progression Risk of Glaucoma: Relevant SNPs with Significant Association (PROGRESSA) study. Researchers used SD-OCT and Humphrey visual fields to evaluate patients at baseline and to look for any longitudinal structural thinning during follow-up.
At the study enrollment, the researchers classified patients as showing structural changes as predominantly mGCIPL, mainly peripapillary retinal nerve fiber layer (pRNFL) or both. The study then compared the three groups’ cardiovascular disease and medication characteristics to a control group of healthy patients.
After accounting for age and cardiovascular characteristics, patients with predominantly mGCIPL thinning at baseline had 2.7 times higher prevalence of hypertension, 2.03 times higher risk of anti-hypertensive use and 1.98 times higher use of statins use compared with the controls.
However, patients with predominantly pRNFL thinning did not exhibit a higher prevalence of cardiovascular disease or medication use than the control patients.
At a follow-up of about five years, SD-OCT and visual field results showed systemic hypertension was associated with an increased risk of SD-OCT progression and visual field progression.
Other study findings included:
- Anti-hypertensive treatment use was associated with an increased risk of SD-OCT progression and visual field conversion.
- A one-standard deviation (∼21mm Hg) increase in systolic blood pressure at baseline was associated with a greater risk of SD-OCT progression and greater risk of visual field progression.
- The association between systolic blood pressure and structural progression was comparable to that observed between IOP and structural progression.
The study’s findings indicate hypertensive treatment may be important in preventing longitudinal progression in early glaucoma, the researchers noted.
Marshall H, Mullany S, Qassim A, et al. Cardiovascular disease predicts structural and functional progression in early glaucoma. Ophthalmology. July 27, 2020. [Epub ahead of print].