Acil Servis Hastalarında Sitemik Kan Basıncı–İntraoküler Basınç İlişkisi

Abstract

Aim: Previous studies have shown an association between systemic hypertension and intraocular pressure and hence, the risk of development of primary open-angle glaucoma. The aim of this study was to analyze the relationship between systemic blood pressure and intraocular pressure and whether high intraocular pressure can lead to the early diagnosis of glaucoma. Methods: This study took place at Hacettepe University Hospital Department of Emergency Medicine between January 30, 2019 and January 30, 2020. 214 patients were included in this study; 158 hypertensive patients (SBP ≥180 and/or DBP ≥120 mmHg) and 56 normotensive patients (SBP ≤130 and/or DBP ≤80 mmHg) were included in the study and control group, respectively. The intraocular pressures of each eye in both groups were measured once with a non-contact tonometer at presentation and after blood pressure reduction to normal in the study group. Patients with intraocular pressure measurements ≥ 21mmHg were referred to the ophthalmology department for an assessment of glaucoma. Results: In the study group, the mean intraocular pressure was 15.29±4.05 mmHg in the right and 15.11±3.78 mmHg in the left eye. In the study group, the mean intraocular pressures measured when patients were normotensive were 13.78±4.06 mmHg in the right and 13.51±3.82 in the left eye. There was a statistically significant decrease in the intraocular pressures; -1.50 mmHg and -1.59 mmHg in the right and left eye, respectively (p<0.01). The mean intraocular pressure in the control group was 13.54±3.51 mmHg in the right eye and 13.20±3.33 mmHg in the left eye. The mean intraocular pressures at presentation between the study group and the control group were found to be significantly different (p<0.01). In the study group, 14 patients had an intraocular pressure ≥21mmHg in at least one eye and were referred to the ophthalmology department; 9 were lost to follow-up and 5 patients were evaluated for glaucoma. None of the latter 5 patients were diagnosed with glaucoma. Conclusion: Patients in the study group showed a significantly higher IOP compared to patients in the normotensive group. The patients in the study group showed a significant reduction in IOP after blood pressure reduction. This may indicate that uncontrolled hypertension poses a risk for the development of glaucoma. Further studies with larger numbers of subjects, including ophthalmologic evaluation of patients with uncontrolled hypertension, will help to predict possible glaucoma in this group.