Mivision article, March 2025
Long-term variability in blood pressure may be associated with visual field (VF) progression in glaucoma patients, suggesting new considerations for managing this sight-threatening condition.
Published in JAMA Ophthalmology,1 the retrospective cohort study analysed data from 1,674 eyes of 985 patients with suspected or confirmed glaucoma. Participants underwent blood pressure and VF testing over a 22-year period from November 2000 to December 2022.
Researchers calculated mean and standard deviation values for systolic and diastolic arterial pressures, incorporating these parameters into multivariable mixed-effect models to investigate their association with rates of VF mean deviation loss.
The study population had a mean age of 61.2 years, with 57.2% being female. Over a mean follow-up period of 8.0 years, the average rate of VF mean deviation change was -0.13 dB per year.
Significantly, the interaction terms of higher mean blood pressure and higher standard deviation of blood pressure were associated with faster annual mean deviation changes for both mean arterial pressure and diastolic arterial pressure. The interaction term of higher standard deviation of blood pressure and higher mean intraocular pressure was likewise associated with faster annual mean deviation changes.
These findings suggest that long-term variability of blood pressure may modify the relationship between intraocular pressure and VF progression in glaucoma. This highlights the potential importance of blood pressure monitoring and management as part of comprehensive glaucoma care.
Reference
- Pham VQ, Nishida T, Weinreb RN, et al. Long-term blood pressure variability and visual field progression in glaucoma. JAMA Ophthalmol. 2025;143(1):25-32. doi: 10.1001/jamaophthalmol.2024.4868.