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Alfred Sommer, MD, MHS; James Tielsch, PhD

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The causal relationship between blood and perfusion pressures and the risk of open-angle glaucoma remains enigmatic. The recent article from the Rotterdam Study¹ adds new insights by exploring these relationships separately for those with presumptive normal- and high-tension glaucoma. The results are, as they often are, confusing. The seemingly strong relationship we observed between diastolic perfusion pressure and the risk of primary open-angle glaucoma in the Baltimore Eye Study² was most apparent from examining the association between perfusion pressure as a continuous variable. Similarly, we also did not find an overall relationship between blood pressure and the risk of glaucoma when all patients were pooled, but when they were stratified for age, a potentially important relationship was revealed: younger patients with systemic hypertension had a reduced risk of glaucoma, while risk was increased in older patients. This was consistent with our prior hypothesis: . . . [Full Text of this Article]

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