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The correlations between posterior scleral profile and autonomic dysfunction in normal tension glaucoma
Author(s) -
Young Shin Da,
Kee Park Chan
Publication year - 2019
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.1755-3768.2019.5310
Subject(s) - medicine , normal tension glaucoma , heart rate variability , standard deviation , glaucoma , ophthalmology , abnormality , cardiology , heart rate , mathematics , open angle glaucoma , statistics , blood pressure , psychiatry
Purpose To investigate the association between autonomic dysfunction and posterior scleral profile in normal tension glaucoma. Design Observational, cross‐sectional study. Participants Two hundred eight NTG patients. Method Complete ophthalmic examination was performed in all patients including heart rate variability to evaluate autonomic dysfunction. Posterior scleral profile, which was identified by the disc tilt ratio, disc torsion, disc foveo angle and peripapapillary area(PPA) to disc ratio was measured from disc photographs. Patients were classified into the two groups according to the standard deviation value of the qualified normal to normal intervals(SDNN) of the heart‐rate‐variability assessment. Group 1 consisted of patients within the one standard deviation from the average of the SDNN measurements. And Group 2 consisted of patients outside one standard deviation from the average of the SDNN measurements, indicating that they had too higher or too lower SDNN of HRV. So Group 2 having deviated value was thought to have abnormality in HRV. Two groups were compared. Logistic regression analysis was used to determine the relationship between posterior scleral profile and abnormality of heart rate variability. Main outcome and measure Association between posterior scleral profile(axial length, tilt ratio, torsion ratio, disc foveo angle, PPA to disc ratio) and autonomic dysfunction. Results The mean value of SDNN in 208 NTG patients was 33.71 and the standard deviation was 18.16. Group1 had a SDNN values between 15.55 and 51.87 and Group 2 had a SDNN value less than 15.55 or greater than 51.87. Among 208 NTG eyes, 164 (78.8%) were group 1 and 44 (21.2%) were group 2. Axial length was significantly longer in Group 2 than Group 1 (p = 0.008). Degree of disc torsion were significantily higher in Group 2 than group 1 (p < 0.001). Although just short of statistical significance (p = 0.058), disc tilt ratio was higher in group 2. Torsion degree was the only factor related to heart rate variability in both univariate (p < 0.001) and multivariate (p = 0.008) logistic regression analyses. Conclusion Our study results showed that the dysfunction of an autonomic control is associated with posterior scleral profile such like disc tilt ratio, torsion degree, axial length.