ABSTRACT
Background:During hemodialysis there is decrease in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) and hence Mean Arterial Pressure (MAP) due to decrease in body fluid volume. Due to reduc?on in MAP there is decrease in Mean Ocular Perfusion Pressure (MOPP) and also there is increase in IOP during dialysis. Objec?ve:To study changes in MOPP and IOP among pa?ents undergoing hemodialysis Methods:An observa?onal study was carried out among 100 pa?ents undergoing hemodialysis Under asep?c condi?on, Proparacaine eye drops were ins?lled in both eyes, IOP was measured by Schiotz Indenta?on Tonometer 30 min before, during hemodialysis and 30 min a?er hemodialysis in supine posi?on. Tonometer was sterilized by Isopropyl alcohol and was washed with normal saline before using on next pa?ent. Systolic and diastolic blood pressure were measured by using sphygmomanometer 30 min before, during and 30 min a?er hemodialysis. Results:The varia?ons in the SBP, DBP and MAP before, during and a?er hemodialysis were not sta?s?cally significant (p>0.05). There was significant differences for IOP between before, during and a?er hemodialysis and same for MOPP except before and 30 min a?er hemodialysis (p < 0.0001). Conclusion:Significant fluctua?ons were seen from the present study in the intra-ocular pressure and mean ocular perfusion pressure during, before and a?er hemodialysis.
ABSTRACT
Purpose: To study the relationship between intraocular pressure (IOP) and mean ocular perfusion pressure (MOPP) in patients with POAG and NTG. The secondary objective was to identify other contributory ischemic factors. Methods: This was an observational cross?sectional study from a tertiary eye hospital in patients who underwent full?day diurnal variation of tension (DVT). Blood pressure (BP) and IOP measurements were done every 3 h over 24 h. Mean arterial pressure (MAP) and MOPP were calculated. The nocturnal dip in BP was assessed; patients were classified as non?dippers, dippers, and over?dippers. The circadian MOPP fluctuation (CMF) was calculated using the Kruskal–Wallis test, and its relationship with type and severity of visual field was assessed. Results: In total, 149 patients were evaluated; 109 were classified as NTG, and 40 were classified as POAG. A nocturnal dip in BP was noted in 20% of NTG and 17.5% of POAG. The MAP was found to be lower in patients with NTG than POAG. In the NTG subgroup, we found that 20% of patients were over?dippers, 32% were dippers, and 48% were non?dippers. The CMF showed a greater fluctuation for over?dippers (P = 0.004 for the RE and 0.003 for the LE) than dippers and non?dippers. A weak positive correlation of CMF with the severity of fields was found. Conclusion: A 24?h monitoring of IOP, BP, MOPP, and assessment of systemic risk factors for primary glaucoma acts as an invaluable tool for the comprehensive management of NTG despite the limitations posed by DVT and BP recording