Autonomic dysfunction in unselected and untreated primary open angle glaucoma patients: a pilot study

To investigate the presence of silent cardiac ischaemic episodes and the status of autonomic function in consecutive, newly diagnosed and untreated primary open-angle glaucoma patients.

Twenty-four consecutively diagnosed glaucoma patients and 22 age-matched controls were subjected to ambulatory 24-h blood pressure (BP) and electrocardiogram (ECG) monitoring by using Cardiotens-01 (Meditech Ltd). Based on the ECG recordings, heart rate variability (HRV) frequency domain parameters [low-frequency (LF), high-frequency (HF) and LF/HF ratio] were calculated and analysed in the two study groups.

Glaucoma patients demonstrated higher LF and LF/HF values than normal subjects for both the active period (p=0.020 and 0.029) and the passive period (p=0.044 and 0.049 respectively). HRV parameters were similar in patients and controls suffering from silent cardiac ischaemia (p>0.05); however, glaucoma patients with normal ECG demonstrated higher LF and LF/HF values during the active period of the 24-h measurement period than control subjects characterized by the same cardiac activity (p=0.010 and 0.021 respectively).

Independent of a history and/or clinical signs of cardiovascular disease, glaucoma patients exhibit abnormal autonomic function.