Low blood pressure and perfusion pressure
| The relationship between blood pressure and glaucoma is well studied, but unfortunately the results seem to be contradictory. Often no clear distinction is made between the relationship between blood pressure and eye pressure and the relationship between blood pressure and glaucoma damage. Sometimes only hypertension is searched for and arterial hypotension is overlooked. Simplified, we can resume: High blood pressure increases the risk of higher eye pressure, and low blood pressure increases the risk of damage occurring or progressing at a given eye pressure. Low blood pressure decreases ocular perfusion especially when autoregulation is disturbed. | |
 HJ Kaiser, J Flammer, Th Graf, D Stümpfig: Systemic blood pressure in glaucoma patients |
The Basel research group had recognized very early on that normal-tension glaucoma patients often have low blood pressure. The same is true for high tension glaucoma patients, in whom the damage progresses despite well-controlled eye pressure. This study also shows that the vascular risk factors are not fundamentally different in the different forms of glaucoma, but the weighting is different. While vascular factors are practically always found in normal-pressure glaucoma, they are less prominent in the other forms of glaucoma. |
 D Gherghel, S Orgül, K Gugleta, J Flammer: Retrobulbar Blood Flow in Glaucoma Patients with Nocturnal Over-Dipping in Systemic Blood Pressure |
Statistically, a deep nocturnal drop in blood pressure is significantly associated with deterioration of glaucoma damage. Causality is less clear. Namely, this study from the Flammer group shows that patients with nocturnal "over-dipping," have slowed blood flow and increased flow resistance in the ophthalmic artery during the day. Thus, the deterioration in such patients with arterial hypotension could also be partly due to general vascular dysregulation. |