Cardiovascular Disease Predicts Structural and Functional Progression in Early Glaucoma

Area of Science:

• Ophthalmology
• Cardiology
• Public Health

Background:

• Glaucoma is a leading cause of irreversible blindness worldwide.
• Cardiovascular disease (CVD) is increasingly recognized as a potential risk factor for glaucoma.
• Understanding the link between CVD and glaucoma progression is crucial for early intervention.

Purpose of the Study:

• To investigate the association between cardiovascular disease and baseline structural defects in glaucoma.
• To determine if cardiovascular disease influences the progression of glaucoma.

Main Methods:

• A prospective, longitudinal study involving 2,628 eyes from 1,314 glaucoma patients.
• Structural thinning was assessed using spectral-domain OCT (macula ganglion cell-inner plexiform layer [mGCIPL] and peripapillary retinal nerve fiber layer [pRNFL]).
• Visual field progression was evaluated using Humphrey visual field (HVF) assessment, with CVD and medication data compared to a stable reference group.

Main Results:

• Patients with predominantly mGCIPL thinning showed higher prevalence of hypertension, antihypertensive use, and statin use.
• Hypertension was associated with increased risk of both OCT and HVF progression (mean follow-up: 5.34 years).
• Increased systolic blood pressure correlated with greater risk of OCT and HVF progression, comparable to intraocular pressure's effect.

Conclusions:

• Cardiovascular disease, especially hypertension, is an important risk factor for glaucoma progression.
• These findings highlight the need to consider systemic vascular health in glaucoma management.
• Targeting blood pressure may help slow glaucoma progression.