A review of ocular perfusion pressure and retinal thickness: A case for the role of systemic hypotension in glaucoma

Background: Ocular perfusion pressure (OPP) is defined as blood pressure (BP) minus intraocular pressure (IOP). Low OPP may result in decreased ocular blood flow (OBF) and oxygen to the optic nerve head (ONH) and retina. Aim: To review the role of systemic hypotension and similar conditions in OPP...

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Autores principales:	Naazia Vawda, Alvin J. Munsamy
Formato:	article
Lenguaje:	EN
Publicado:	AOSIS 2021
Materias:	ocular perfusion pressure blood pressure intraocular pressure retinal nerve fibre layer ganglion cell complex Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/4236c1bc8c3b4f9ba0d5dbf5f975f166
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spelling	oai:doaj.org-article:4236c1bc8c3b4f9ba0d5dbf5f975f1662021-11-24T07:40:34ZA review of ocular perfusion pressure and retinal thickness: A case for the role of systemic hypotension in glaucoma2413-31832410-151610.4102/aveh.v80i1.630https://doaj.org/article/4236c1bc8c3b4f9ba0d5dbf5f975f1662021-11-01T00:00:00Zhttps://avehjournal.org/index.php/aveh/article/view/630https://doaj.org/toc/2413-3183https://doaj.org/toc/2410-1516Background: Ocular perfusion pressure (OPP) is defined as blood pressure (BP) minus intraocular pressure (IOP). Low OPP may result in decreased ocular blood flow (OBF) and oxygen to the optic nerve head (ONH) and retina. Aim: To review the role of systemic hypotension and similar conditions in OPP and its influence on retinal nerve fibre layer (RNFL) thickness and the ganglion cell complex (GCC). Method: A literature search was conducted using the following search terms: ‘systemic hypotension’; ‘glaucoma’; ‘retinal nerve fibre layer’; ‘optic nerve’; ‘ocular blood flow’ and ‘ocular perfusion pressure’. Results: The Los Angeles Eye Study and Barbados Eye Study found that decreased OPP and BP increased the risk of glaucoma development by up to six times. Reduced retinal perfusion with resultant thinning of the RNFL in conditions with a similar mechanism, such as obstructive sleep apnoea syndrome, has indicated the importance of reduced OPP in retinal thickness. In the absence of any study directly showing the effect of systemic hypotension on OPP and retinal thickness, a working hypothesis proposes that reduced BP with or without normal-to-raised IOP will reduce OPP. The reduced OPP and OBF in those with systemic hypotension may result in oxidative stress and hypoxia which may then cause retinal ganglion cell death and the resultant retinal thinning. Conclusion: The increased risk of glaucoma development and progression relating to decreased BP and OPP has been proven to be of importance. Monitoring patients with systemic hypotension and evaluating the macula, ONH RNFL and GCC thickness may alert clinicians to possible glaucomatous changes.Naazia VawdaAlvin J. MunsamyAOSISarticleocular perfusion pressureblood pressureintraocular pressureretinal nerve fibre layerganglion cell complexOphthalmologyRE1-994ENAfrican Vision and Eye Health, Vol 80, Iss 1, Pp e1-e9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ocular perfusion pressure blood pressure intraocular pressure retinal nerve fibre layer ganglion cell complex Ophthalmology RE1-994
spellingShingle	ocular perfusion pressure blood pressure intraocular pressure retinal nerve fibre layer ganglion cell complex Ophthalmology RE1-994 Naazia Vawda Alvin J. Munsamy A review of ocular perfusion pressure and retinal thickness: A case for the role of systemic hypotension in glaucoma
description	Background: Ocular perfusion pressure (OPP) is defined as blood pressure (BP) minus intraocular pressure (IOP). Low OPP may result in decreased ocular blood flow (OBF) and oxygen to the optic nerve head (ONH) and retina. Aim: To review the role of systemic hypotension and similar conditions in OPP and its influence on retinal nerve fibre layer (RNFL) thickness and the ganglion cell complex (GCC). Method: A literature search was conducted using the following search terms: ‘systemic hypotension’; ‘glaucoma’; ‘retinal nerve fibre layer’; ‘optic nerve’; ‘ocular blood flow’ and ‘ocular perfusion pressure’. Results: The Los Angeles Eye Study and Barbados Eye Study found that decreased OPP and BP increased the risk of glaucoma development by up to six times. Reduced retinal perfusion with resultant thinning of the RNFL in conditions with a similar mechanism, such as obstructive sleep apnoea syndrome, has indicated the importance of reduced OPP in retinal thickness. In the absence of any study directly showing the effect of systemic hypotension on OPP and retinal thickness, a working hypothesis proposes that reduced BP with or without normal-to-raised IOP will reduce OPP. The reduced OPP and OBF in those with systemic hypotension may result in oxidative stress and hypoxia which may then cause retinal ganglion cell death and the resultant retinal thinning. Conclusion: The increased risk of glaucoma development and progression relating to decreased BP and OPP has been proven to be of importance. Monitoring patients with systemic hypotension and evaluating the macula, ONH RNFL and GCC thickness may alert clinicians to possible glaucomatous changes.
format	article
author	Naazia Vawda Alvin J. Munsamy
author_facet	Naazia Vawda Alvin J. Munsamy
author_sort	Naazia Vawda
title	A review of ocular perfusion pressure and retinal thickness: A case for the role of systemic hypotension in glaucoma
title_short	A review of ocular perfusion pressure and retinal thickness: A case for the role of systemic hypotension in glaucoma
title_full	A review of ocular perfusion pressure and retinal thickness: A case for the role of systemic hypotension in glaucoma
title_fullStr	A review of ocular perfusion pressure and retinal thickness: A case for the role of systemic hypotension in glaucoma
title_full_unstemmed	A review of ocular perfusion pressure and retinal thickness: A case for the role of systemic hypotension in glaucoma
title_sort	review of ocular perfusion pressure and retinal thickness: a case for the role of systemic hypotension in glaucoma
publisher	AOSIS
publishDate	2021
url	https://doaj.org/article/4236c1bc8c3b4f9ba0d5dbf5f975f166
work_keys_str_mv	AT naaziavawda areviewofocularperfusionpressureandretinalthicknessacasefortheroleofsystemichypotensioninglaucoma AT alvinjmunsamy areviewofocularperfusionpressureandretinalthicknessacasefortheroleofsystemichypotensioninglaucoma AT naaziavawda reviewofocularperfusionpressureandretinalthicknessacasefortheroleofsystemichypotensioninglaucoma AT alvinjmunsamy reviewofocularperfusionpressureandretinalthicknessacasefortheroleofsystemichypotensioninglaucoma
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A review of ocular perfusion pressure and retinal thickness: A case for the role of systemic hypotension in glaucoma

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