Carotid Arterial Flow in Pseudoexfoliation Glaucoma and its Role in Diagnosing the Disease

Uz, Burçin; Durum, Yasemin; Kocatürk, Tolga; Dayanir, Volkan; Bilgen, Mehmet

doi:10.1097/ijg.0000000000000546

Cited by 5 publications

(13 citation statements)

References 12 publications

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“…19 The same cut-off on the RI of CCA produced 90% sensitivity and 73% specificity. 7 Our study had limitations. It included small sample size and selection bias.…”

Section: Discussionmentioning

confidence: 90%

“…Specifically, peak systolic velocity (PSV, cm/s) and end‐diastolic velocity (EDV, cm/s) were measured at the intersection of OA with optic nerve (ie, 20–25 mm behind the eyeball in the nasal section of the orbit), and at 1 to 3 mm distance beyond the posterior pole of the eyeball, respectively. Then, resistivity index (RI) was calculated via RI = (PSV − EDV)/PSV for both OA and CRA 7 . Figures 1 and 2 depict example scans demonstrating the anatomical images of an eye and Doppler‐based measurements.…”

Section: Methodsmentioning

confidence: 99%

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Correlation of Measurements From Doppler Ultrasound and Optical Coherence Tomography in Glaucoma

Polat

Kocatürk

Abdullayev

et al. 2021

J of Ultrasound Medicine

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Objectives To relate the changes in ocular structure and hemodynamic response in primary open‐angle glaucoma (POAG). Methods Patients with POAG (n = 46) and control subjects (n = 53) were recruited. Retinal nerve fiber layer and ganglion cell complex were evaluated using optical coherence tomography (OCT). Blood flow was characterized in ophthalmic artery (OA) and central retinal artery (CRA) using color Doppler ultrasonography (CDU), and resistivity index (RI) was calculated. Measurements from CDU and OCT were statistically correlated and the degree of the association was examined. Receiver operating characteristics was produced based on RI and optimal threshold was determined. Results In POAG patients, OCT revealed neuronal damage and CDU indicated increased resistance to arterial flow. Flow dynamics correlated negatively with the ocular tissue dimensions, sufficiently establishing an association between the ocular structure and its hemodynamic response. Based on the possibility of indirect POAG diagnosis with CDU, threshold 0.7 for RI of OA yielded 73.9% sensitivity and 77.4% specificity in distinguishing the cases of POAG from the controls. Threshold of 0.66 for RI of CRA, had higher specificity of 83%, but lower sensitivity of 52.1%. Conclusions Ocular flow exhibits different characteristics in individuals with POAG than normal. The changes associated with the underlying neuronal structure, suggesting the possibility of a potential new diagnostic biomarker for POAG. This justifies further studies with a larger cohort, examining the ocular flow with CDU in POAG and comparing it against OCT findings for establishing the power of CDU in differential diagnosis or glaucoma progression.

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“…19 The same cut-off on the RI of CCA produced 90% sensitivity and 73% specificity. 7 Our study had limitations. It included small sample size and selection bias.…”

Section: Discussionmentioning

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Correlation of Measurements From Doppler Ultrasound and Optical Coherence Tomography in Glaucoma

Polat

Kocatürk

Abdullayev

et al. 2021

J of Ultrasound Medicine

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“…Overall, our results corroborate in part previous studies that have pointed out vascular alterations (accessed by different methods) and ET-1 elevation in patients with glaucoma, especially in those with normal tension glaucoma. 19,35 Regarding the main ndings of our study (ET1, LDI and NC results), we will separately address and contextualize each of our main ndings. Firstly, about ET-1, Grieshaber and Flammer had previously associated serum ET-1 levels with the pathogenesis of DH in these eyes with low-IOPs, within a more systemic context of primary vascular dysregulation.…”

Section: Discussionmentioning

confidence: 99%

Vascular Parameters and Endothelin 1 Measurements in Glaucoma Patients With Low and High-tension Optic Disc Hemorrhages

Almeida

Taniguchi

Tito

et al. 2022

Preprint

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Purpose: To compare vascular parameters, assessed by endothelin-1 (ET-1) blood levels, Laser Doppler Imaging (LDI) of distal phalanx, and nailfold capillaroscopy (NC), between open-angle glaucoma (OAG) patients with low (LTDH) and high-tension optic disc hemorrhages (HTDH). Methods: In this prospective study, patients were classified as LTDH if presenting an IOP<16 mmHg and HTDH if an IOP³16 mmHg at the time of DH detection. Demographic and ophthalmological data, ET-1 concentration, LDI (before and after 1, 10 and 20 minutes after cold stimulation) and NC findings were evaluated. Results: Thirty-tree patients were included (mean age, 62.3±13 years). Regarding ET-1 blood level, it was 65% higher in the LTDH group (2.27±1.46 pg/ml) compared to the HTDH (1.37±0.57 pg/ml; p=0.03). In addition, there was a significant negative correlation between ET-1 blood concentration and IOP at the time of DH detection (r=-0.45; p=0.02). Blood flow measurement in LTDH patients were lower than those observed in patients with HTDH 10 and 20 minutes after cold stimulus (p<0.01). Conclusion: Patients developing DH with lower IOPs have higher ET-1 blood levels and more peripheral vascular dysfunction (than those with higher IOPs), as estimated by LDI. These findings suggest that distinct underling mechanisms maybe involved in patients developing DH with different IOP ranges.

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“…When considering the patient-specific treatment schemes has gained importance in glaucoma management recently, the vascular parameters are gradually becoming important in terms of diagnosis, progression, and treatment algorithms especially in XFG, which is known to affect the vascular system more and cause increased vascular resistance. [18][19][20][21][22][23][24] Even a comprehensive slit-lamp examination is sufficient to diagnose XFS, and XFG is a clinical diagnosis depends on detection of glaucomatous damage; in particular cases with XFS it is hard to determine whether the VF defect is related with glaucoma or related with other co morbidities. Yarmohammadi et al 25 have found that that OCTA potentially shows promise for identifying focal glaucomatous damage before the first VF defect develops.…”

Section: Discussionmentioning

confidence: 99%

Cut-Off Values of Foveal Vascular Indices in Exfoliation Glaucoma

Kocatürk¹,

Zivkovic²,

Dayanir³

2021

OPTH

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Purpose To compare the vascular measurements obtained from fovea including foveal avascular zone (FAZ) with optical coherence tomography angiography (OCTA) between patients with exfoliation glaucoma (XFG) and healthy controls. Methods This cross-sectional comparative study included 54 XFG patients and 94 healthy subjects. All subjects were given a complete ophthalmological examination including visual field testing, retinal nerve fiber layer and macular ganglion cell complex analysis. OCTA was performed to evaluate the vascular features of fovea including FAZ. The measurements of vessel density (VD), perfusion density (PD) and FAZ values were segmented and calculated using the inbuilt software on OCTA. Receiver operating characteristic (ROC) analyses were performed to determine the best cut-off values to detect the disease. Results In the XFG group, decreased VD, PD and FAZ values were observed. ROC analysis showed an obvious separation, differentiating the patients with XFG from the healthy controls at cut-off value of 19.55 with a sensitivity (sen) of 92.3% and a specificity (spe) of 81.9%) for VD total and 21.20 (sen:100 and spe:78.7) for VD parafoveal; 0.36 (sen:98.1and spe:76.6) for PDtotal and 0.378 (sen:96.2and spe:84) for PDparafoveal; 0.635 (sen: 79.3 and spe:72) for FAZ circulatory index. Conclusion The results support the findings of decreased microvascular density on foveal region in XFG. The cut off values of the changes in the foveal parameters in patients with exfoliation may be useful in evaluation of future glaucoma management to show how far a particular exfoliative eye is positioned from an healthy eye and how close to XFG.

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Carotid Arterial Flow in Pseudoexfoliation Glaucoma and its Role in Diagnosing the Disease

Cited by 5 publications

References 12 publications

Correlation of Measurements From Doppler Ultrasound and Optical Coherence Tomography in Glaucoma

Correlation of Measurements From Doppler Ultrasound and Optical Coherence Tomography in Glaucoma

Vascular Parameters and Endothelin 1 Measurements in Glaucoma Patients With Low and High-tension Optic Disc Hemorrhages

Cut-Off Values of Foveal Vascular Indices in Exfoliation Glaucoma

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