Ocular perfusion pressure and glaucoma: a review

Glaucoma is one of the leading causes of blindness globally. Increasing evidence shows that the disease is secondary to optic nerve head hypoperfusion and autonomic dysfunction. Ocular perfusion pressure, representing ocular blood flow, is a key factor that should be evaluated in the management of glaucoma. Ocular perfusion pressure is subject to influence by a myriad of factors, and its calculation has been conventionally simplified as the difference between mean arterial blood pressure and intraocular pressure. Nonetheless, the direct effect of various factors on blood pressure and intraocular pressure should not be neglected. Bearing in mind the regional prevalence of normal-tension glaucoma, we review the literature and summarize the pathophysiology of glaucoma, definition of ocular perfusion pressure, relationship between ocular perfusion pressure and glaucoma development and progression, and key factors that influence ocular perfusion pressure. We also highlight the potentials of home monitoring of ocular perfusion pressure, and promote interdisciplinary management of glaucoma.