Ambulatory blood pressure monitoring: a case of normotensive glaucoma with nocturnal blood pressure dips

Abstract

Normotensive glaucoma is a form of primary open angle glaucoma in which intraocular pressure remains within the normal range. A normotensive glaucoma patient with extreme nocturnal blood pressure dipping is herein presented. A 75-year-old male patient who had a history of drug use for benign prostate hyperplasia admitted to our glaucoma clinic. Optic disc examination of both eyes showed peripapillary atrophy and glaucomatous cupping. Intraocular pressures were 12 mmHg in the right eye and 11 mmHg in the left eye. Bilateral nasal steps and early superior arcuate defect were observed in visual field testing. In our case the mean blood pressure fell by %24 at night. Ambulatory blood pressure monitoring exhibited excessive dips between 03:15 and 06:45 AM. This case report emphasizes the importance of determining nocturnal blood pressure dips due to systemic medication in normotensive glaucoma patients.