eCite Digital Repository

Cardiovascular disease predicts structural and functional progression in early glaucoma


Marshall, H and Mullany, S and Qassim, A and Siggs, O and Hassall, M and Ridge, B and Nguyen, T and Awadalla, M and Andrew, NH and Healey, PR and Agar, A and Galanopoulos, A and Hewitt, AW and MacGregor, S and Graham, SL and Mills, R and Shulz, A and Landers, J and Casson, RJ and Craig, JE, Cardiovascular disease predicts structural and functional progression in early glaucoma, Ophthalmology, 128, (1) pp. 58-69. ISSN 0161-6420 (2021) [Refereed Article]

Copyright Statement

Copyright 2020 Crown Copyright. Published by Elsevier Inc. on behalf of the American Academy of Ophthalmology

DOI: doi:10.1016/j.ophtha.2020.06.067


Purpose:To investigate the association between cardiovascular disease and baseline structural defects and disease progression in glaucoma.

Design: Prospective, longitudinal study of preperimetric and perimetric glaucoma.

Participants: Two thousand six hundred twenty-eight eyes from 1314 participants recruited to the Progression Risk of Glaucoma: Relevant SNPs with Significant Association (PROGRESSA) study were evaluated for baseline and longitudinal structural thinning using spectral-domain OCT and for visual field progression on Humphrey visual field (HVF) assessment.

Methods: Patients were classified as either predominantly macula ganglion cell-inner plexiform layer (mGCIPL), predominantly peripapillary retinal nerve fiber layer (pRNFL), or both mGCIPL and pRNFL structural change at enrollment, and then evaluated for longitudinal OCT or HVF progression. Cardiovascular disease and medication characteristics of the participants were compared with a reference group of stable patients.

Main outcome measures: OCT and HVF baseline status and longitudinal progression.

Results: After accounting for age and cardiovascular characteristics, patients with predominantly mGCIPL thinning at baseline showed a higher prevalence of hypertension (odds ratio [OR], 2.70; 95% confidence interval [CI], 1.66-4.41; P < 0.001), antihypertensive use (OR, 2.03; 95% CI, 1.20-3.46; P = 0.008), and statin use (OR, 1.98; 95% CI, 1.07-3.66; P = 0.029) than reference patients. Patients with predominantly pRNFL thinning exhibited a comparable prevalence of cardiovascular disease or medication with reference patients. Review of longitudinal OCT and HVF data (mean follow-up, 5.34 1.29 years) showed that hypertension was associated with an increased risk of both OCT (OR, 1.79; 95% CI, 1.17-2.75; P = 0.006) and HVF progression (OR, 1.92; 95% CI, 1.18-3.15; P = 0.013). A 1-standard deviation (approximately 21 mmHg) increase in systolic blood pressure at baseline was associated with a greater risk of OCT progression (OR, 1.27; 95% CI, 1.01-1.63; P = 0.041) and HVF progression (OR, 1.32; 95% CI, 1.01-1.73; P = 0.043). The association between systolic blood pressure and structural progression was comparable to that observed between intraocular pressure and structural progression (OR, 1.30; 95% CI, 1.01-1.67; P = 0.039).

Item Details

Item Type:Refereed Article
Keywords:OCT, cardiovascular disease, glaucoma
Research Division:Biomedical and Clinical Sciences
Research Group:Ophthalmology and optometry
Research Field:Ophthalmology
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Determinants of health
UTAS Author:Hewitt, AW (Professor Alex Hewitt)
ID Code:147344
Year Published:2021
Web of Science® Times Cited:5
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-10-27
Last Modified:2021-11-24

Repository Staff Only: item control page