STUDY OF AUTONOMIC FUNCTIONS IN PRIMARY OPEN ANGLE GLAUCOMA PATIENTS USING COLD PRESSOR TEST AND TO COMPARE THE RESULTS WITH AGE AND SEX MATCHED CONTROLS
Harminder Singh, Indu Khurana and Itika Singh*
ABSTRACT
Introduction: Primary open angle glaucoma (POAG) is a chronic condition characterized by visual loss,
glaucomatous optic atrophy, and elevated intraocular pressure in presence of open iridio-corneal angle or vascular
dysregulation leading to visual impairment. Cold pressor test (CPT) measures function of sympathetic neural
control of cardiovascular system. In CPT heart rate increases indicating cardiac sympathetic activation and rise of
blood pressure is due to a wide spread vasopressor reaction initiated through a neurogenic reflex arc. Material
and method: Study was carried out on 30 POAG patients and 30 controls. Basal intraocular pressure(IOP), mean
arterial blood pressure (MAP) and mean ocular perfusion pressure (MOPP) was tabulated. Cold pressor test was
done and changes in MAP and MOPP were compared in both the groups. Statistical analysis was done using
student t test. Results: Immediate response to CPTresulted in statistically significant rise in MAP, p < 0.05.
Insignificant decrease in MOPP was observed in POAG patients than in controls. Statistically significant rise in
MOPP in POAG patients as compared to controls (p<0.05) was observed inrecovery period. Conclusion:
Autonomic dysfunction plays significant role in pathophysiology of POAG specially sympathetic overdrive. CPT
can be used as a diagnostic tool to detect POAG in early stages to prevent ocular morbidity.
Keywords: Primary Open Angle Glaucoma, Intraocular pressure, Cold pressor test, Mean arterial pressure, Mean ocular perfusion pressure.
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