The Effect of 24-Hour Blood Pressure on Rates of Central and Peripheral Glaucomatous Visual Field Progression

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma Pub Date : 2026-03-01 Epub Date: 2025-10-10 DOI:10.1016/j.ogla.2025.10.001

Alessandro A. Jammal MD, PhD, Richard Donkor MSc, PhD, David S. Greenfield MD

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Abstract

Purpose

To examine the effect of 24-hour ambulatory blood pressure (BP) measurements on the rates of change in central and peripheral visual field (VF) loss in eyes with glaucoma and suspected glaucoma.

Design

Prospective cohort study.

Participants

One hundred twenty-four eyes of 63 subjects with glaucoma or suspect of glaucoma at baseline.

Methods

Participants underwent 24-hour ambulatory BP measurement acquired at the baseline visit and 24-2C standard automated perimetry (SAP) every 4 months for up to 48 months. The rates of change in mean sensitivity (MS) were calculated with linear mixed models and used to investigate the effect of BP on the rates of VF loss in the central (≤10°, 26 points) and peripheral (>10°, 36 points) regions separately. Models were adjusted for age, gender, race, intraocular pressure during follow-up, baseline glaucoma severity, and central corneal thickness.

Main Outcome Measures

Effect of 24-hour BP values on the rates of future central and peripheral VF loss.

Results

Eyes had an average of 7.7 ± 2.2 SAP tests over 27.4 ± 6.4 months of follow-up. The median rate in global mean deviation change was 0.23 dB/year (range –1.00 to 0.94 dB/year). Each 10 mmHg lower in 24-hour average systolic BP (SBP) and diurnal mean arterial pressure (MAP) were associated with –0.119 dB/year (P = 0.021) and –0.162 dB/year (P = 0.018) faster rates of MS loss in the central region, respectively, after adjusting for confounding factors. Lower diurnal MAP was also significantly associated (P = 0.003) with faster progression in the peripheral VF. Eyes of subjects within the lowest tertile of average 24-hour SBP (range 100–116 mmHg) had significantly faster rates of central VF loss than the highest tertile (range 125–168 mmHg; difference between tertiles 0.06 dB/year faster; P = 0.045), but not faster peripheral loss (P = 0.101).

Conclusions

Lower baseline 24-hour ambulatory BP measurements were significantly associated with faster rates of SAP progression in the central and peripheral regions. Subjects with the lowest values of average 24-hour SBP demonstrated significantly faster rates of central VF loss and may be used as a predictor for severe glaucomatous progression.

Financial Disclosure(s)

The authors have no proprietary or commercial interest in any materials discussed in this article.

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24小时血压对中枢性和外周性青光眼视野进展的影响。

目的：探讨24小时动态血压（BP）测量对青光眼和疑似青光眼中央和周围视野丧失变化率的影响。设计：前瞻性队列研究参与者：基线时患有青光眼或疑似青光眼的63例受试者124只眼。方法：参与者在基线就诊时进行24小时动态血压测量，并每4个月进行24-2C标准自动视野测量（SAP），持续48个月。采用线性混合模型计算平均灵敏度（MS）的变化率，并分别用于研究BP对中心（≤10°，26分）和周围（≤10°，36分）区域VF损失率的影响。模型根据年龄、性别、种族、随访期间的眼压、基线青光眼严重程度和中央角膜厚度进行调整。主要观察指标：24小时血压值对未来中央和周围视野丧失率的影响。结果：随访27.4±6.4个月，眼部平均SAP检查7.7±2.2次。全球平均偏差变化的中位数为0.23 dB/年（范围为-1.00 ~ 0.94 dB/年）。校正混杂因素后，24小时平均收缩压和日平均动脉压（MAP）每降低10mmHg，中央区MS损失率分别增加-0.119 dB/年（P=0.021）和-0.162 dB/年（P=0.018）。较低的日MAP也与周围视野的快速进展显著相关（P=0.003）。24小时平均收缩压最低分位数（100-116 mmHg）受试者的眼睛中央VF丧失率明显快于最高分位数（125-168 mmHg，各分位数之间的差异快0.06 dB/年，P=0.045），但外周丧失速度不快（P=0.101）。结论：较低的基线24小时动态血压测量值与中央和外周区域SAP进展速度显著相关。24小时平均收缩压最低的受试者中枢性VF丧失的速度明显更快，可作为青光眼严重进展的预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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