We appreciate the opportunity to respond to the letter by Hayreh et al about our study of BP monitoring in patients with AION.1Because clinical hypotheses can best be tested by comparing patients and control subjects, we measured the 24-hour BP curves of patients with AION and matched controls. The BPs of patients with AION were neither hypertensive nor hypotensive. However, compared with matched controls, patients with AION had a lower mean systolic BP during the day. The most striking difference between the diurnal BP curves of patients with AION and the controls occurred in the morning after awakening, when patients with AION had a slower, more irregular increase in BP. We found the nocturnal nadir was no lower in patients with AION than in controls. Our study shows that patients with AION have a chronic tendency toward lower BP, predisposing them to hypoperfusion, perhaps because of
Landau K, Winterkorn JMS, Napolitano B. Nonarteritic Anterior Ischemic Optic Neuropathy: Role of Nocturnal Arterial Hypotension-Reply. Arch Ophthalmol. 1997;115(7):943–945. doi:10.1001/archopht.1997.01100160112032
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