Background: To evaluate the central retinal venous pulsation pressure (CRVPP) in patients with intraocular pressure (IOP)-controlled early, moderate and advanced open-angle glaucoma and a healthy control group.Methods: CRVPP was measured with a contact lens dynamometer calibrated in mm Hg (Meditron GmbH, Voelklingen, Germany) in 34 patients with IOP-controlled open-angle glaucoma who were selected consecutively and according to the stage of their visual fields and 27 age-matched healthy controls. If a spontaneous venous pulsation was seen, CRVPP was considered to be equal to IOP. Visual fields were tested with the Humphrey 30-2 SST programme. The ocular perfusion pressure was conventionally calculated as OPP1=2/3MAP - IOP (MAP=systemic mean arterial blood pressure) and, using the measured CRVPP in the formula, as OPP2=2/3MAP - CRVPP. Statistical analysis was performed using the Kruskal-Wallis and the Mann-Whitney U test.Results: Median CRVPP was 14.0 mm Hg (IQR 12.0-16.0) in controls, 15.0 mm Hg (IQR 14.0-17.0) in early, 38.9 mm Hg (IQR 29.9-48.4) in moderate and 34.6 mm Hg (IQR 23.9-51.0) in advanced glaucoma cases. The conventionally calculated OPP1 was 49.8 mm Hg (IQR 42.7-57.6) for controls, 56.9 mm Hg (IQR 55.3-58.8) for early, 56.6 mm Hg (IQR 51.2-64.4) for moderate and 59.3 mm Hg (IQR 53.9-61.6) for advanced cases. OPP2 was equal to OPP1 in the control group, 56.1 mm Hg (IQR 54.5-57.9) in early, 25.1 mm Hg (IQR 15.7-38.6) and 34.2 mm Hg (IQR 20.4-47.5) in moderate and advanced cases. This difference was statistically significant for moderate (OPP2 lower; p=0.003) and advanced (OPP2 lower; p=0.002) cases.Conclusions: In more advanced cases of glaucoma, CRVPP seems to be much higher than previously thought. This might further compromise the perfusion pressure in the prelaminar region of the optic nerve head and be of clinical importance, especially in IOP-controlled more advanced cases. This should be considered as a possible risk factor for progression.
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机译：背景：为了评估眼内压（IOP）控制的早期，中度和晚期开角型青光眼患者以及健康对照组的视网膜中央静脉搏动压力（CRVPP）方法：使用校正后的接触镜测力计测量CRVPP mm Hg（Meditron GmbH，Voelklingen，Germany）在34例IOP控制的开角型青光眼患者中，根据他们的视野阶段和27位年龄相匹配的健康对照进行了选择。如果看到自发性静脉搏动，则认为CRVPP等于IOP。视野通过Humphrey 30-2 SST程序进行了测试。眼灌注压通常按OPP1 = 2 / 3MAP-IOP（MAP =全身平均动脉血压）计算，并使用公式中测得的CRVPP计算为OPP2 = 2 / 3MAP-CRVPP。使用Kruskal-Wallis和Mann-Whitney U检验进行统计分析。结果：对照组中位数CRVPP为14.0 mm Hg（IQR 12.0-16.0），早期为15.0 mm Hg（IQR 14.0-17.0），38.9 mm Hg（ IQR 29.9-48.4）（中度汞柱）和34.6 mm Hg（IQR 23.9-51.0）（晚期青光眼病例）。常规计算得出的OPP1对照为49.8 mm Hg（IQR 42.7-57.6），早期为56.9 mm Hg（IQR 55.3-58.8），中度为56.6 mm Hg（IQR 51.2-64.4）和59.3 mm Hg（IQR 53.9-61.6）对于高级案例。对照组的OPP2等于OPP1，早期为56.1 mm Hg（IQR 54.5-57.9），中度和晚期病例为25.1 mm Hg（IQR 15.7-38.6），34.2 mm Hg（IQR 20.4-47.5）。在中度（OPP2降低; p = 0.003）和晚期（OPP2降低; p = 0.002）病例中，这种差异具有统计学意义。结论：在青光眼的晚期病例中，CRVPP似乎比以前认为的要高得多。这可能会进一步损害视神经乳头前区的灌注压力，并且具有临床重要性，尤其是在IOP控制的晚期病例中。应将其视为可能进展的危险因素。
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