정상안압 및 원발개방각녹내장 사이의 Primary Vascular Dysregulation 비교
Comparison of Primary Vascular Dysregulation in Normal Tension Glaucoma and Primary Open Angle Glaucoma
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
목적: 정상안압녹내장 및 원발개방각녹내장간 primary vascular dysregulation과 관련된 증상 또는 질환의 빈도를 분석하였다. 대상과 방법: 2008년 6월부터 2009년 2월까지 11개의 문항으로 구성된 설문을 실시하여 정상안압녹내장 및 원발개방각녹내장을 비교하였고, 정상안압녹내장을 연령(기준: 55세) 및 시야 mean deviation (기준: -6dB)에 따라 분류하여 조사하였다. 결과: 원발개방각녹내장(68명)보다 정상안압녹내장(133명)에서 저혈압이 많았다(p=0.036). 편두통 및 감정적 스트레스는 젊은 연령의정상안압녹내장에서 나이든 연령보다 더 많았으며(p=0.027, 0.001), 약에 대한 민감도, 심혈관질환은 나이든 연령에서 더 많았으나(p=0.028, 0.030), 유병율을 고려시 오히려 젊은 연령에서 심혈관질환의 빈도가 높았다. 저혈압은 중등도 이상의 시야결손군에서 초기시야결손군보다 많았다(p=0.018). 결론: 저혈압의 병력이 원발개방각녹내장에 비해 정상안압녹내장의 위험인자로 더 작용하고, 젊고, 중등도 이상의 시야 결손을 보이는정상안압녹내장의 병인에 혈관질환이 관여할 가능성이 더욱 높음을 관찰할 수 있었다.
Abstract
Purpose: To evaluate the clinical symptoms or signs of primary vascular dysregulation (PVD) in patients with normal tension glaucoma (NTG) and primary open-angle glaucoma (POAG). Methods: From June 2008 to June 2009, we administered questionnaires to patients with glaucoma. The questionnaire was composed of 11 items, and the questionnaire results were compared between patients with NTG and POAG. NTG patients were subdivided by age(criterion: 55 years) and perimetric mean deviation (criterion: -6dB). Results: We detected a significant increase in hypotension (p=0.036) in NTG patients (n=133), compared to POAG patients (n=68). Migraines and emotional stress were more frequent in younger patients (＜55 years) with NTG (46%, 71%, p=0.027) than in older patients (＞55 years) with NTG (27.5%, 42.9%, p=0001). The frequency of drug sensitivity and systemic vasospasm is higher in older patients with NTG (28.6%, 17.4%) than younger patients with NTG (12.9%, 4.9%) but the rate of systemic vasospasm is much higher in younger patients, compared to the prevalence in the general Korean population. In patients with moderate and advanced NTG, hypotension is highly prevalent (p=0.018). Conclusions: Hypotension is a greater risk factor for NTG than for POAG. Indeed, vascular factors may be correlated with NTG,especially in younger patients with moderate, advanced visual field defects.
참고문헌 (31)
- Flammer J, "The impact of ocular blood flow in glaucoma", Pro Retin Eye Res, 21, pp.359~163 (2002)
- Flammer J, "Vasospasm, its role in the pathogenesis of disease with paticular reference to eye", Pro Retin Eye Res, 20, pp.319~349 (2001)
- Nicolela MT, "Clinical clues of vascular dysregulation and its association with glaucoma", Can J Ophthalmol, 43, pp.337~341 (2008)
- Levene RZ, "Low tension glaucoma: a critical review and new material", Surv Ophthalmol, 24, pp.621~624 (1980)
- Leske MC, "Risk factors for incident open angle glaucoma : the Barbados Eye Studies", Ophthalmology, 115, pp.85~93 (2008)
- Graham SL, "Ambulatory blood pressure monitoring in glaucoma. The nocturnal dip", Ophthalmology, 102, pp.61~69 (1995)
- Mayer JH, "Twenty four hour blood pressure monitoring in normal tension glaucoma", Br J Ophthalmol, 80, pp.864~867 (1996)
- Bechetoille A, "Diurnal and nocturnal blood pressure drops in patients with focal ischemic glaucoma", Graefes Arch Clin Exp Ophthalmol, 232, pp.675~679 (1994)
- Drance SM, "Some factors in the production of low tension glaucoma", Br J Ophthalmol, 56, pp.229~242 (1972)
- Drance SM, "Studies of factors involved in the production of low tension glaucoma", Arch Ophthalmol, 89, pp.457~465 (1973)
- Hayreh SS, "The blood supply of the optic nerve head and the evaluation of it: myth and reality", Prog Retin Eye Res, 20, pp.563~593 (2001)
- Gherghel D, "Relationship between ocular perfusion pressure and retrobulbar blood flow in patients with glaucoma with progressive damage", Am J Ophthalmol, 130, pp.597~605 (2000)
- Sehi M, "Relative change in diurnal mean ocular perfusion pressure; a risk factor for the diagnosis of primary open-angle glaucoma", Invest Ophthalmol Vis Sci, 46, pp.561~567 (2005)
- Tielsch JM, "Hypertension, perfusion pressure and primary open-angle glaucoma. A population-based assessment", Arch Ophthalmol, 113, pp.216~221 (1995)
- Bonomi L, "Vascular risk factors for primary open angle glaucoma: the Egna-Neumarkt Study", Ophthalmology, 107, pp.1287~1293 (2000)
- Mitchell P, "Open-angle glaucoma and systemic hypertension: The Blue Mountain Eye Study", J Glaucoma, 13, pp.319~326 (2004)
- Orzalesi N, "OPTIME Study Group (Osservatorio sulla Patologia glaucomatosa, Indagine Medico Epidemiologica); CONPROSO (Collegio Nazionale dei Professori Ordinari di Scienze Oftalmologiche). Vascular risk factors in glaucoma: the results of a national survey", Graefes Arch Clin Exp Ophthalmol, 245, pp.795~802 (2007)
- Usui T, "Finger blood flow in patients with low tension glaucoma and primary open-angle glaucoma", Br J Ophthalmol, 76, pp.2~4 (1992)
- Drance SM, "Response of blood flow to warm and cold in normal and low-tension glaucoma patients", Am J Ophthalmol, 105, pp.35~39 (1988)
- Hafez AS, "Correlation between finger blood flow and changes in optic nerve head blood flow following therapeutic intraocular pressure reduction", J Glaucoma, 14, pp.448~454 (2005)
- Fraenkel L, "Raynaud's phenomenon: epidemiology and risk factors", Curr Rheumatol Rep, 4, pp.123~128 (2002)
- Orgül S, "Headache in normal tension glaucoma patients", J Glaucoma, 3, pp.292~295 (1994)
- Lee TG, "Prevalence of migraine in Korean adults: A nationwide survey", Korean Journal of Headache, 1, pp.57~66 (2000)
- Usui T, "Prevalence of migraine in low-tension glaucoma and primary open angle glaucoma in Japanese", Br J Ophthalmol, 75, pp.224~226 (1991)
- Kaiser HJ, "Systemic blood pressure in glaucoma patients", Grafes Arch Clin Exp Ophthalnol, 231, pp.677~680 (1993)
- O’Brien E, "Twenty four hour ambulatory blood pressure in men and women aged 17 to 80 years; the Allied Irish Bank Study", J Hypertens, 9, pp.355~360 (1991)
- Hayreh SS, "Nocturnal arterial hypotension and its role in optic nerve head ischemic disorders", Am J Ophthalmol, 117, pp.603~624 (1994)
- Kaiser HJ, "Systemic hypotension; a risk factor for glaucomatous damage?", Ophthalmologica, 203, pp.105~108 (1991)
- Zachariah PK, "Orthostatic hypotension and ambulatory blood pressure monitoring", J Hypertens, 9, pp.S78~80 (1991)
- Anderson DR, "Normal Tension Glaucoma Study. Collaborative normal tension glaucoma study", Curr Opin Ophthalmol, 14, pp.86~90 (2003)
- Rojanapongpun P, "The response of blood flow velocity in the ophthalmic artery and blood flow of the finger to warm and cold stimuli in glaucomatous patients", Graefes Arch Clin Exp Ophthalmol, 231, pp.375~377 (1993)