LAUSR

PRCIS Multiple systemic vascular-associated conditions including systemic hypertension and hypotension, diabetes mellitus, migraine headache, peripheral vascular disease, Raynaud's Syndrome, anemia were associated with low tension glaucoma. PURPOSE To identify systemic risk factors associated with low tension glaucoma. MATERIALS METHODS A retrospective case-control study design was employed to identify patients seen at the Mayo Clinic Department of Ophthalmology between 2005 and 2015 with low tension glaucoma and an age & sex matched control group, each containing 277 patients. RESULTS The low tension glaucoma group had more myopic refractive errors in diopters (-1.6 vs. -1.0, P<0.001), lower intraocular pressure (14.2 vs. 15.2▒mmHg, P<0.001), and a higher cup-to-disc ratio (0.7 vs. 0.3, P<0.001). The low tension glaucoma group was significantly less likely to be obese (BMI >30, P=0.03). They had a significantly higher prevalence of systemic hypertension (OR: 1.64, P=0.004), diabetes mellitus (OR 3.01, P=<0.001), peripheral vascular disease (OR 2.61, P=0.009), migraine headache (OR 2.12, P=0.02), anemia (OR 2.18, P=0.003), systemic hypotension (OR 4.43, P=<0.001), Raynaud's Syndrome (OR 3.09, P=0.05), angiotensin converting enzyme inhibitor (OR 1.64, P=0.01), and calcium channel blocker use (OR 1.98, P=0.004). After adjusting for systemic hypertension, calcium channel blocker use remained significant (OR 1.70, P=0.03). No significant difference was found with respect to hyperlipidemia, obstructive sleep apnea, coronary artery disease, carotid stenosis, stroke, statin, ACE inhibitor, angiotensin receptor blocker, beta blocker, or metformin use. CONCLUSIONS Multiple vascular-associated conditions were associated with low tension glaucoma including systemic hypertension, diabetes mellitus, peripheral vascular disease, migraine headaches, Raynaud's Syndrome, anemia, systemic hypotension, and calcium channel blocker use. This study strengthens evidence for the vascular hypothesis of low tension glaucoma.