Clinical Study on the Treatment of Hypertensive Ocular Disease with Hypotension Using Shengmai Decoction

ABSTRACT

Background: Ocular hypertension is a major risk factor for glaucoma. When combined with hypotension, it further reduces ocular perfusion pressure, exacerbates optic nerve hypoperfusion, and increases the risk of optic nerve damage. Current clinical treatments primarily focus on lowering intraocular pressure, lacking intervention strategies specifically targeting hypoperfusion caused by hypotension. Shengmai Decoction, a traditional Chinese medicine formula, possesses pressor and microcirculation-enhancing effects, potentially offering synergistic therapeutic benefits for patients with elevated intraocular pressure and concomitant hypotension.
Methods: This study enrolled 60 patients with elevated intraocular pressure and hypotension, randomly assigned to Group A (intraocular pressure-lowering eye drops + Shengmai Decoction oral solution) or Group B (intraocular pressure-lowering eye drops alone). The treatment period lasted 3 months. Blood pressure, intraocular pressure (IOP), and optical coherence tomography angiography (OCTA) retinal vascular density were measured before treatment, 7 days post-treatment, and at 1 and 3 months post-treatment to evaluate Shengmai Decoction's effects on blood pressure, IOP, and retinal blood flow. Results: Group A patients exhibited significantly higher blood pressure at all post-treatment time points compared to Group B (P<0.05), with an overall efficacy rate of 86.67%. Intraocular pressure decreased significantly in both groups compared to baseline (P<0.05), though no statistically significant difference existed between groups. OCTA revealed significantly higher vascular density in the inner, outer, and overall layers of the macular region in Group A compared to Group B (P<0.05), with no significant changes in central vascular density.
Conclusion: Shengmai Decoction safely and effectively elevates blood pressure in patients with ocular hypertension complicated by hypotension, significantly improves retinal blood flow perfusion, and may exert optic nerve protection by enhancing ocular perfusion pressure. This study provides novel insights for integrated Chinese and Western medicine in treating ocular hypertension and holds clinical application value.