Key result
Patients with normal tension glaucoma exhibited a significantly higher LF/HF ratio (2.51 vs 1.97, p<0.000) during head-up tilt testing compared to healthy controls, indicating sympatho-vagal imbalance.
Why the study?
Do patients with normal tension glaucoma have altered autonomic balance compared to healthy controls?
Case-Control (n=40)
No
Do patients with normal tension glaucoma have altered autonomic balance compared to healthy controls?
Patients with normal tension glaucoma exhibit sympatho-vagal imbalance characterized by parasympathetic withdrawal and relative sympathetic overactivity during orthostatic stress.
Supports association of normal tension glaucoma with orthostatic sympatho-vagal imbalance; hypothesis-generating and should not yet change practice.
Objective: To study autonomic imbalance if any in normal tension glaucoma (NTG)patients by heart rate variability (HRV)and head-up tilt (HUT)test.Methods: The study subjects of age between 45 and 65 years of either sex comprised 20 patients with NTG (Group ІІ)and 20 age- and sex-matched healthy controls (Group І). Different variables of time and frequency domain of HRV were analyzed at rest, during HUT and the recovery period.Results: Highly significant decrease in value of root mean square successive difference observed in Group ІІ (p<0.000)in comparison to controls. The high-frequency variables (HF [nu]and HF [ms2])were significantly less (p<0.000)and low frequency (LF)/HF ratio was significantly high (p<0.000) in Group ІІ.Conclusion: During stress test, i.e., HUT there was the greater withdrawal of parasympathetic input to heart; hence, there was relatively oversympathetic activity due to sympatho-vagal imbalance.
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Banerjee et al. (2017) conducted a case-control in Normal tension glaucoma (n=40). Normal tension glaucoma vs. Healthy controls was evaluated on LF/HF ratio during head-up tilt test (p=<0.000). Patients with normal tension glaucoma exhibited a significantly higher LF/HF ratio (2.51 vs 1.97, p<0.000) during head-up tilt testing compared to healthy controls, indicating sympatho-vagal imbalance.
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