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    Ocular perfusion pressure, cerebrospinal fluid pressure: New players in glaucoma


    Nocturnal perfusion pressure

    Dr. Liebmann and colleagues performed a pilot study in which they looked at nocturnal hypotension by monitoring the BP in patients 3 times over a 12-month period for 48 hours at a time. The investigators evaluated the patients’ series of visual fields to identify signs of progression of damage and found that patients with nocturnal hypotension with an arterial BP that was 20 mm Hg below their mean arterial daytime BP were at greater risk of disease progression. When the arterial BP was 10 mm Hg below the mean arterial daytime BP, there was a substantial risk of progression, he reported.

    After this pilot study was completed, doctors who specialized in hypertension performed a meta-analysis and reached the same conclusion–glaucoma specialists need to evaluate nocturnal hypotension when patients are receiving BP-lowering drugs and perform a prospective randomized study.


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