Association of Blood Pressure and Glaucomatous Progression,
A Study was conducted to investigate the effect of systemic arterial blood pressure (BP) on rates of progressive structural damage over time in glaucoma.

7,501 eyes of 3,976 subjects with glaucoma or suspected of glaucoma followed over time from the Duke Glaucoma Registry. Linear mixed models were used to investigate the effects of BP on the rates of retinal nerve fiber layer (RNFL) loss from spectral-domain optical coherence tomography (SD OCT) over time.

--157,291 BP visits, 45,408 IOP visits, and 30,238 SDOCT visits were included.

--Mean rate of RNFL change was -0.70 microm/y. In univariable models, neither MAP, SAP, nor DAP during follow-up were significantly associated with rates of RNFL loss.

--However, when adjusted for mean IOP during follow-up, each 10mmHg lower in mean MAP and mean DAP, but not SAP, were associated with significantly faster rates of RNFL thickness change over time.

--The effect of the arterial pressure metrics remained significant after additional adjustment for baseline age, diagnosis, sex, race, follow-up time, disease severity, and corneal thickness.

Lower MAP and DAP during follow-up were substantially related with faster rates of RNFL loss when adjusted for IOP, showing that systemic blood pressure levels may be a significant component in glaucoma progression.