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A Population-Based Assessment

James M. Tielsch, PhD; Joanne Katz, ScD; Alfred Sommer, MD, MHSc; Harry A. Quigley, MD; Jonathan C. Javitt, MD, MPH

Arch Ophthalmol. 1995;113(2):216-221.

Abstract
Objective
To evaluate the association of vascular factors with primary open-angle glaucoma (POAG).

Design
A population-based prevalence survey of ocular disease among black and white residents.

Setting
Communities of east Baltimore, Md.

Participants
A stratified cluster sample of 5308 residents 40 years of age or older.

Main Outcome Measures
Primary open-angle glaucoma as defined by demonstrable glaucomatous optic nerve damage based on visual fields and/or optic disc findings. Intraocular pressure level was not a criterion for diagnosis.

Results
Systolic and diastolic blood pressure showed modest, positive association with POAG. The effect of blood pressure on POAG was modified by age, with a stronger association among older subjects. Lower perfusion pressure (blood pressure-intraocular pressure) was strongly associated with an increased prevalence of POAG, with a sixfold excess for those in the lowest category of perfusion pressure.

Conclusion
These results suggest that POAG is associated with an alteration in factors related to ocular blood flow and a breakdown of autoregulation.

Author Affiliations
From the Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, The Johns Hopkins University Schools of Medicine and Public Health, Baltimore, Md (Drs Tielsch, Katz, Sommer, and Quigley); the Worthen Center, Department of Ophthalmology, Georgetown University School of Medicine, Washington, DC (Dr Javitt); and the Office of the Dean, The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md (Dr Sommer).

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