Evaluation of systemic vascular regulation using flow mediated dilatation method in patients with glaucoma

Objective: Glaucoma is one of the most common causes of irreversible blindness worldwide. The incidence of glaucoma increases depending on factors such as age. Today, there are important findings showing that there may be vascular causes in the development of glaucoma, and it has been shown that there is a relationship between glaucoma and vascular diseases. In the diagnosis of vascular diseases, endothelial function measurement with photoplethysmography flow-mediated dilatation (PPG-FMD) method provides clinicians with useful information. The aim of this dissertation by an expert ophthalmologist included/excluded in accordance with the criteria of being pseudoexfoliation syndrome (PES), pseudoexfoliation glaucoma (PEG) and primary open angle glaucoma (POAG) of healthy participants between the participants in fotopletismografi endothelial function, flow-mediated dilatation (PPG-FMD) is to be measured by the method and compare the results. Method: Endothelial function was measured by the PPG-FMD method of all participants. In addition, detailed ophthalmological examination measurements including anterior and posterior segment biomicroscopy, intraocular pressure measurement, central corneal thickness, ganglion cell complex, and peripapillary nerve fiber thickness measurements were performed. Data were recorded electronically for statistical analysis and statistical analyzes were performed. Results: A total of 55 individuals who met the participation criteria and volunteered were included in our study. The study was conducted with 16 participants from PES group (mean age 66.4 ± 8.2), 14 from PEG group (mean age 69.5 ± 5.5), POAG group (mean age 63.7 ± 7.7) and 13 (mean age 62 ± 8.4) with healthy similar demographics. There was no statistically significant difference between the groups in demographic measurements, anthropometric, vital and categorical measurements. In the study, it was determined that there was a significant difference between the groups in endothelial function measurements. Endothelial function measurement results were 124.5% ± 10.1 in the control group, 118.6% ± 8.6 in the PES group, 85.4% ± 6 in the POAG group, and 82.5% ± 4.3 in the PEG group (p<0.001). Endothelial function values were found to be significantly lower than the control group. In addition, it was determined that endothelial function values were correlated with intraocular pressure measurement, ganglion cell complex, and peripapillary nerve fiber thickness. Conclusion: There is no study on endothelial function measurement using the PPG-FMD method in patients with glaucoma and pseudoexfoliation syndrome. As a result of further studies, endothelial function measurement with PPG-FMD has the potential to be used as an important method for clinical diagnosis. Keywords: endothelial function, flow-mediated dilation, glaucoma, nitric oxide, vasodilation