%0 Journal Article
%T Detection of Glaucoma in a Cohort of Chinese Subjects with Systemic Hypertension
%A Rita A. Gangwani
%A Jonathan Chan
%A Jacky Lee
%A Alfred Kwong
%A Jimmy S. M. Lai
%J Journal of Ophthalmology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/463710
%X Purpose. To determine the presence and type of glaucoma in a cohort of adult Chinese subjects with systemic hypertension. Methods. This prospective cohort study included 200 hypertensive Chinese adults aged >40 years old who underwent screening via frequency doubling technology (FDT) perimetry and intraocular pressure (IOP) measurement by noncontact tonometry (NCT) in a general outpatient clinic. Those with £¿mmHg and/or visual field (VF) defects on FDT were referred for complete ophthalmological examination. The diagnosis of glaucoma was based on an abnormal VF on Humphrey Field Analyzer (HFA) by Hodapp-Parrish-Anderson's criteria and an increased vertical cup-disc ratio (VCDR). Results. The mean age of the subjects was years, and the male:female ratio was 92£¿:£¿108. All patients were hypertensive with a mean blood pressure (BP) of £¿mmHg whilst on systemic antihypertensive medication. Of the 111 patients that had an abnormal initial screening, 14 (7.9%) were confirmed to have glaucoma with the highest prevalence of normal tension glaucoma (NTG) (6.2%), followed by primary angle closure glaucoma (PACG) (1.1%) and primary open angle glaucoma (POAG) (0.5%). The positive predictive value of FDT perimetry was 71%. Conclusion. Nearly 8% of the adults with systemic hypertension had glaucoma, and NTG was the most prevalent type. 1. Introduction Glaucoma is a progressive optic neuropathy with characteristic changes in the optic nerve head and corresponding visual field loss. Currently, glaucoma accounts for 12% of all global blindness with 4.5 million people affected worldwide [1]. Primary open angle glaucoma (POAG) is more frequent in Caucasian and African populations whilst primary angle closure glaucoma (PACG) is more common in Asian ethnicity. Normal tension glaucoma (NTG) is especially prevalent in Japan and Korea [2¨C4]. Raised intraocular pressure (IOP) remains the most common and clinically modifiable risk factor. However, glaucomatous optic neuropathy can occur despite normal IOP as in NTG [5]. The role of vascular risk factors such as systemic blood pressure (BP) and ocular perfusion pressure, hypercoagulability, carotid artery disease, and vasospasm have been extensively studied, and it has been shown that abnormalities in systemic BP and ocular hypoperfusion are vital in the pathogenesis of NTG [6¨C10]. Speculations about the association of glaucoma and systemic hypertension still exist. Systemic hypertension has been found to be associated with glaucoma but hypoperfusion has been associated with the development and progression of NTG [8, 11]. The
%U http://www.hindawi.com/journals/joph/2013/463710/