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A Phenotype of Primary Open-angle Glaucoma With Systemic Vasospasm.

Reza Alizadeh1, Laura Vickers1, Pradtana Hirunpatravong1

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This study identifies a primary open-angle glaucoma (POAG) subtype characterized by acquired pits of the optic nerve (APON) and vascular instability, often occurring in women with low blood pressure and migraine, leading to optic nerve damage at low pressures.

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Vascular Biology

Background:

  • Primary open-angle glaucoma (POAG) is a heterogeneous condition.
  • Identifying distinct patient subtypes can enhance understanding of POAG pathogenesis and genotype-phenotype correlations.

Purpose of the Study:

  • To describe a specific phenotype of POAG associated with systemic disorders.
  • To investigate POAG patients with acquired pits of the optic nerve (APON) and vascular instability, who may be susceptible to optic nerve damage at low intraocular pressures.

Main Methods:

  • Retrospective analysis of glaucoma patient records from January 1996 to 2017.
  • Inclusion criteria: POAG, APON, and at least one of: persistently low systolic blood pressure (≤100 mmHg), history of migraine, or Raynaud syndrome.

Main Results:

  • 37 out of 87 patients with APON met the study criteria.
  • The identified POAG subtype predominantly affected females (92%) with a median age of 55.
  • Commonly observed conditions included low systolic blood pressure (73%), Raynaud syndrome (68%), and history of migraine (68%).

Conclusions:

  • A POAG subtype characterized by APON and systemic vascular instability is described.
  • This phenotype predominantly affects females in their sixth decade and exhibits glaucomatous damage at low intraocular pressures.
  • Further research into this phenotype may guide diagnosis and personalized treatment strategies for POAG.