Vascular risk factors for primary open angle glaucoma: the Egna-Neumarkt Study

Ophthalmology. 2000 Jul;107(7):1287-93. doi: 10.1016/s0161-6420(00)00138-x.


Objective: To assess the impact of vascular risk factors on the prevalence of primary open angle glaucoma.

Design: Population-based cross-sectional study.

Participants: Four thousand two hundred ninety-seven patients more than 40 years of age underwent a complete ocular examination in the context of the Egna-Neumarkt Glaucoma Study.

Intervention: Ocular examinations were performed by trained, quality-controlled ophthalmologists according to a predefined standardized protocol including medical interview, blood pressure reading, applanation tonometry, computerized perimetry, and optic nerve head examination.

Main outcome measures: Prevalences of ocular hypertension, primary open-angle glaucoma, normal-tension glaucoma, and other types of glaucoma were determined. Correlation coefficients were calculated for the association between systemic blood pressure and age-adjusted intraocular pressure (IOP) and between age and both intraocular and systemic blood pressures. Odds ratios were computed to assess the risk of primary open-angle glaucoma and normal-tension glaucoma in relation to systemic hypertension or antihypertensive medication, blood pressure levels, diastolic perfusion pressure, and a number of other cardiovascular risk factors.

Results: A positive correlation was found between systemic blood pressure and IOP, and an association was found between diagnosis of primary open-angle glaucoma and systemic hypertension. Lower diastolic perfusion pressure is associated with a marked, progressive increase in the frequency of hypertensive glaucoma. No relationship was found between systemic diseases of vascular origin and glaucoma.

Conclusions: Our data are in line with those reported in other recent epidemiologic studies and show that reduced diastolic perfusion pressure is an important risk factor for primary open-angle glaucoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Pressure*
  • Cross-Sectional Studies
  • Female
  • Glaucoma, Open-Angle / epidemiology*
  • Glaucoma, Open-Angle / etiology
  • Humans
  • Intraocular Pressure*
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Ocular Hypertension / epidemiology
  • Ocular Hypertension / etiology
  • Odds Ratio
  • Optic Disk / blood supply
  • Prevalence
  • Risk Factors
  • Tonometry, Ocular
  • Vascular Diseases / complications
  • Vascular Diseases / epidemiology*
  • Visual Field Tests