The following is a summary of “Systemic Arterial Stiffness and Choroidal Microvascular Insufficiency on the Structural Progression of Normal Tension Glaucoma,” published in the July 2024 issue of Ophthalmology by Lee et al.

Researchers conducted a retrospective study determining how systemic arterial stiffness and choroidal microvascular insufficiency contribute to the structural progression of normal-tension glaucoma (NTG).

They examined 107 eyes from 88 patients with early NTG. All patients underwent two tests which are pulse wave velocity (PWV) to measure arterial stiffness and optical coherence tomography angiography (OCT-A) to assess blood flow in the eye. Patients were categorized based on the tests and the presence of a specific blood vessel issue peripapillary choroidal microvasculature dropout (MvD). The analysis of factors influencing the worsening of glaucoma damage was performed over time using a specific analysis of retinal scans (cirrus OCT).

The results showed that 32 eyes exhibited choroidal MvD, with an average age of 62.7 years (95% CI 58.4-67.0) and 53.6% being male, while 70 eyes had no MvD, with an average age of 59.9 years (95% CI 57.1-62.6) and 53.3% being male following 48.4 (95% CI 40.0-56.8) months. Eyes with choroidal MvD and stiffer arteries with high PWV, when divided based on PWV (high PWV≥1400cm/sec), showed a significantly faster rate of thinning in a retinal layer called the macular ganglion cell-inner plexiform layer (GCIPL; P=0.023) compared to eyes with other combinations of the various factors. Compared to the group with low PWV and no MvD, eyes with high PWV and MvD in the peripapillary area were 6.019 times more likely (95% CI 1.619-38.531, P=0.025) to experience rapid structural progression in the macular GCIPL.

Investigators concluded that combined systemic arterial stiffness and choroidal microvascular insufficiency might significantly accelerate structural damage in NTG. 

Source: ajo.com/article/S0002-9394(24)00293-9/abstract