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Systemic Arterial Stiffness Is Associated With Structural Progression in Early Open-Angle Glaucoma.
Jihei Sara Lee1, Hyoung Won Bae1, Sungeun Park1
1Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Investigative Ophthalmology & Visual Science
|March 30, 2022
Summary
Systemic arterial stiffness, measured by brachial-ankle pulse wave velocity (PWV), predicts where structural damage begins in early open-angle glaucoma. Higher PWV is linked to earlier macular ganglion cell-inner plexiform layer loss, suggesting vascular factors in glaucoma progression.
Area of Science:
- Ophthalmology
- Cardiology
- Vascular Biology
Background:
- Open-angle glaucoma is a leading cause of irreversible blindness.
- Systemic arterial stiffness is an emerging risk factor for various vascular diseases.
- The relationship between arterial stiffness and the initial site of structural damage in glaucoma requires further investigation.
Purpose of the Study:
- To determine the association between systemic arterial stiffness, assessed by brachial-ankle pulse wave velocity (PWV), and the initial location of structural progression in early open-angle glaucoma.
- To explore if arterial stiffness influences whether damage first appears in the macula or optic nerve head.
Main Methods:
- Retrospective review of 160 eyes from 160 patients with early open-angle glaucoma.
- Measurement of brachial-ankle pulse wave velocity (PWV) to categorize patients into low, intermediate, and high arterial stiffness groups.
- Assessment of structural progression using event-based analysis of optical coherence tomography (OCT) Guided Progression Analysis (GPA) to identify the initial site of damage (macular ganglion cell-inner plexiform layer [mGCIPL] vs. peripapillary retinal nerve fiber layer [ppRNFL]).
Main Results:
- Patients with high PWV showed a significantly higher incidence of initial mGCIPL loss compared to those with low PWV (86.7% vs. 26.7%).
- The average PWV was significantly higher in patients whose initial structural progression was detected in the mGCIPL compared to the ppRNFL (1744.1 cm/s vs. 1452.0 cm/s).
- High PWV was independently associated with an increased likelihood of initial structural progression occurring at the mGCIPL (OR, 7.484).
Conclusions:
- Brachial-ankle pulse wave velocity (PWV) is a significant predictor of the initial location of structural progression in open-angle glaucoma.
- Vascular insufficiency, as indicated by arterial stiffness, may play a crucial role in the pathogenesis and progression patterns of glaucoma.
- These findings highlight the importance of considering systemic vascular health in managing glaucoma patients.
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