The role of age and cardiovascular disease in glaucomatous optic neuropathy.

The role of systemic cardiovascular disorders in glaucomatous optic neuropathy was studied experimentally in rhesus monkeys and clinically in humans. These studies suggest that, in the multifactorial phenomenon of glaucomatous optic neuropathy, among other risk factors, age, cardiovascular disease and nocturnal arterial hypotension may play an important role in the development and progression of glaucomatous optic neuropathy in many cases, independent of intraocular pressure. In glaucomatous optic neuropathy, age may be an indirect index of cardiovascular disease rather than an independent factor per se. Nocturnal arterial hypotension, particularly among hypertensive patients taking oral hypotensive medication, may be an important risk factor. Because 24-hour ambulatory blood pressure monitoring is becoming popular among ophthalmic researchers, multiple confounding factors in ambulatory blood pressure monitoring in patients with optic nerve head ischemic disorders that can produce misleading information are discussed.