Patients with asymmetric glaucomatous visual field loss exhibit asymmetric flow velocities of the CRA and OA. Patients with more severe damage display reduced flow velocities in retrobulbar vessels in POAG.

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Purpose Previous studies have shown decreased retrobulbar blood flow in normal tension glaucoma (NTG) compared to healthy controls. This study evaluates the ability of colour Doppler imaging (CDI) to identify patients with NTG. Methods Sixty-two patients with untreated NTG (mean age 57714 years) and 40 agematched controls (mean age 5879 years) were included in a prospective cross-sectional institutional study. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive indices (RI ¼ (PSV-EDV)/PSV) of the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (PCAs) were measured by means of CDI. Using receiver operating characteristic (ROC) curves, sensitivity was determined at 90% specificity. Results Patients with NTG showed significantly decreased PSV (Po0.0001) and EDV (Po0.0001) of the CRA, significantly decreased EDV of the nasal (P ¼ 0.004) and temporal (P ¼ 0.002) PCA, and significantly increased RI of the temporal (P ¼ 0.003) PCAs compared to healthy controls. Sensitivity values at 90% specificity were calculated: PSV of the CRA, 30.6%; EDV of the CRA, 48.4%; EDV of the nasal PCA, 43.9%; EDV of the temporal PCA, 45.9%; and RI of the temporal PCA, 39.3%. Conclusions The power to identify NTG using CDI reaches 48% sensitivity at 90% specificity. Further longitudinal studies are needed to determine the prognostic value of CDI in glaucoma.

Aim: To compare retrobulbar haemodynamics in patients with acute non-arteritic anterior ischaemic optic neuropathy (NAION) and age-matched controls by colour Doppler imaging (CDI). Methods: 25 patients with acute NAION and 35 agematched controls participated in this study. By means of CDI, the blood flow velocities of the ophthalmic artery, central retinal artery (CRA), and nasal and temporal short posterior ciliary arteries (PCAs) were measured. Peak-systolic velocity (PSV) and end-diastolic velocity (EDV) and Pourcelot's resistive index were determined. Results: In the ophthalmic artery, no marked differences between patients with NAION and controls were detected. PSV and EDV of the CRA (p,0.001, p = 0.002) and PSV of the nasal PCA (p,0.05) were significantly decreased in patients with NAION compared with healthy controls. No marked differences between patients and controls were detectable for temporal PCAs. Conclusion: Blood flow velocities of the nasal PCA and the CRA are considerably reduced in patients with acute NAION compared with controls. Patients with NAION in part showed markedly different retrobulbar haemodynamics.

Fluorescein angiography revealed significantly increased vascular leakage of glaucomatous optic nerve heads. An endothelial disruption and fluorescein leakage might be the result of mechanical stress at the level of the lamina cribrosa and/or a sign of ischemic damage. This measurement approach might enable us to judge the severity of optic nerve head leakage, and it is a potential way to evaluate therapeutic regimens.

Fluorescein filling defects of the optic disc representing capillary dropout are present in NTG and POAG. The extent of these filling defects is correlated to visual field loss and morphological damage. Fluorescein angiography may be useful in the diagnosis and management of NTG and POAG.

Background: Previous studies confirmed reduced retrobulbar haemodynamics in primary open-angle glaucoma (POAG). Aim: To investigate a correlation between retrobulbar haemodynamics and morphometric neuroretinal rim analysis in patients with POAG. Methods: 51 patients with POAG (mean (standard deviation (SD)) age 65 (11) years) were included in this clinical study. Blood flow velocities (peak systolic velocity (PSV) and end-diastolic velocity (EDV)) of the ophthalmic artery, central retinal artery (CRA), posterior ciliary arteries (PCA) and central retinal vein were measured using colour Doppler imaging (Siemens Sonoline Sienna, Erlangen, Germany). Optic disc morphometry was carried out using scanning laser tomography (Heidelberg Retinal Tomograph II Heidelberg Egineering Heidelberg, Germany). The stereometric parameters of the neuroretinal rim (rim area, rim volume, cup shape measure and retinal nerve fibre layer (RNFL) cross-sectional area) were used for analysis.

To evaluate absolute filling defects of the optic nerve head in normal tension glaucoma (NTG) and primary open-angle glaucoma (POAG) and to compare the filling defects with topographic analysis of the optic disc. Methods: Twenty-five patients with NTG, 25 patients with POAG, and 25 age-matched controls were included. Fluorescein angiograms were performed by means of a scanning laser ophthalmoscope. The extent of absolute filling defects of the optic nerve head was assessed using digital image analysis of early-phase angiograms. Topographic measurements of the optic disc were acquired using the Heidelberg Retina Tomograph II. Results: Absolute filling defects were significantly larger (P = .001) and were seen more often (PϽ.001) in patients with NTG (n = 18) and POAG (n = 19) compared with controls (n = 3). Rim area (P = .006), rim volume (P=.007), cup-disc area ratio (P =.008), linear cup-disc ratio (P=.005), maximum cup depth (P=.002), cup shape measure (P=.03), and nerve fiber layer thickness (P=.008) and cross-sectional area (P=.006) were significantly different between patients with glaucoma and controls. Absolute filling defects were significantly correlated with cup area (r=0.31; P=.007), rim area (r=−0.38; PϽ.001), rim volume (r = −0.35; P = .002), cup-disc area ratio (r=0.49; PϽ.001), linear cup-disc ratio (r=0.48; PϽ.001), cup shape measure (r=0.27; P=.02), and nerve fiber layer thickness (r = −0.33; P = .004) and cross-sectional area (r=−0.30; P =.009). Conclusions: Fluorescein filling defects of the optic disc are present in NTG and POAG. The extent of these filling defects is correlated with the morphologic disc damage.