PMID- 30853468
OWN - NLM
STAT- Publisher
LR  - 20190408
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
DP  - 2019 Mar 8
TI  - Baseline Systolic versus Diastolic Blood Pressure Dip and Subsequent Visual Field
      Progression in Normal-Tension Glaucoma.
LID - S0161-6420(18)33181-6 [pii]
LID - 10.1016/j.ophtha.2019.03.001 [doi]
AB  - PURPOSE: To investigate the impact of systolic and diastolic blood pressure (DBP)
      dip at baseline on subsequent visual field (VF) progression in eyes with
      normal-tension glaucoma (NTG). DESIGN: Prospective cohort study. PARTICIPANTS:
      This study included 119 eyes of 119 newly diagnosed NTG patients followed up for 
      at least 2 years (average, 40.4+/-16.9 months). METHODS: All participants
      underwent baseline 24-hour ambulatory blood pressure (BP) monitoring and
      measurements of intraocular pressure (IOP) and at least 5 serial VF examinations.
      Participants were followed up as outpatients at 4- to 6-month intervals. Visual
      field progression was defined according to Early Manifest Glaucoma Trial
      criteria. The associations of VF progression with systolic BP (SBP) and DBP
      measured during the day and at night and other clinical variables were analyzed. 
      MAIN OUTCOME MEASURES: Factors associated with VF progression over time. RESULTS:
      During follow-up, 41 eyes (34%) showed VF progression. In the multivariate Cox
      regression model, lower nighttime trough DBP (hazard ratio, 0.953; P = 0.023) and
      greater nighttime DBP dip area (time multiplied by nighttime DBP > 10 mmHg less
      than mean daytime DBP; hazard ratio, 1.017; P = 0.003) at baseline were
      significant predictors of subsequent VF progression. None of the SBP parameters
      was associated with VF progression. Nocturnal DBP dip showed a greater
      association with VF progression than SBP dip. CONCLUSIONS: Nocturnal trough DBP
      and DBP dip area at baseline are significant predictors of subsequent VF
      progression in NTG. Nocturnal DBP dip may be more relevant to future VF
      progression than SBP dip in NTG eyes.
CI  - Copyright (c) 2019 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Kwon, Junki
AU  - Kwon J
AD  - Department of Ophthalmology, College of Medicine, University of Ulsan, Asan
      Medical Center, Seoul, South Korea.
FAU - Jo, Youn Hye
AU  - Jo YH
AD  - Department of Ophthalmology, College of Medicine, University of Ulsan, Asan
      Medical Center, Seoul, South Korea.
FAU - Jeong, Daun
AU  - Jeong D
AD  - Department of Ophthalmology, College of Medicine, University of Ulsan, Asan
      Medical Center, Seoul, South Korea.
FAU - Shon, Kilhwan
AU  - Shon K
AD  - Department of Ophthalmology, College of Medicine, University of Ulsan, Asan
      Medical Center, Seoul, South Korea.
FAU - Kook, Michael S
AU  - Kook MS
AD  - Department of Ophthalmology, College of Medicine, University of Ulsan, Asan
      Medical Center, Seoul, South Korea. Electronic address: mskook@amc.seoul.kr.
LA  - eng
PT  - Journal Article
DEP - 20190308
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
EDAT- 2019/03/12 06:00
MHDA- 2019/03/12 06:00
CRDT- 2019/03/12 06:00
PHST- 2018/12/04 00:00 [received]
PHST- 2019/02/28 00:00 [revised]
PHST- 2019/03/01 00:00 [accepted]
PHST- 2019/03/12 06:00 [pubmed]
PHST- 2019/03/12 06:00 [medline]
PHST- 2019/03/12 06:00 [entrez]
AID - S0161-6420(18)33181-6 [pii]
AID - 10.1016/j.ophtha.2019.03.001 [doi]
PST - aheadofprint
SO  - Ophthalmology. 2019 Mar 8. pii: S0161-6420(18)33181-6. doi:
      10.1016/j.ophtha.2019.03.001.