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Coexistence of macro‐ and micro‐vascular abnormalities in newly diagnosed normal tension glaucoma patients
Author(s) -
Mroczkowska Stephanie,
Ekart Aniko,
Sung Velota,
Negi Anil,
Qin Lu,
Patel Sunni R.,
Jacob Sarita,
Atkins Carole,
BenaventePerez Alexandra,
Gherghel Doina
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.02494.x
Subject(s) - normal tension glaucoma , medicine , retinal , subclinical infection , constriction , glaucoma , cardiology , ophthalmology , blood pressure , intima media thickness , carotid arteries , open angle glaucoma
. Purpose: To investigate the coexistence of ocular microvascular and systemic macrovascular abnormalities in early stage, newly diagnosed and previously untreated normal tension glaucoma patients (NTG). Methods: Retinal vascular reactivity to flickering light was assessed in 19 NTG and 28 age‐matched controls by means of dynamic retinal vessel analysis (IMEDOS GmbH, Jena, Germany). Using a newly developed computational model, the entire dynamic vascular response profile to flicker light was imaged and used for analysis. In addition, assessments of carotid intima‐media thickness (IMT) and pulse wave analysis (PWA) were conducted on all participants, along with blood pressure (BP) measurements and blood analyses for lipid metabolism markers. Results: Patients with NTG demonstrated an increased right and left carotid IMT (p = 0.015, p = 0.045) and an elevated PWA augmentation index (p = 0.017) in comparison with healthy controls, along with an enhanced retinal arterial constriction response (p = 0.028), a steeper retinal arterial constriction slope (p = 0.031) and a reduced retinal venous dilation response (p = 0.026) following flicker light stimulation. Conclusions: Early stage, newly diagnosed, NTG patients showed signs of subclinical vascular abnormalities at both macro‐ and micro‐vascular levels, highlighting the need to consider multi‐level circulation‐related pathologies in the development and progression of this type of glaucoma.