Evidence of Retinal Vascular Narrowing in Glaucomatous Eyes in an Asian Population

Amerasinghe, Nishani; Aung, Tin; Cheung, Ning; Fong, Chee Weng; Wang, Jie Jin; Mitchell, Paul; Saw, Seang‐Mei; Wong, Tien Yin

doi:10.1167/iovs.08-2142

Cited by 99 publications

(105 citation statements)

References 43 publications

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“…In an Asian population, evidence of retinal vascular narrowing was recently reported in glaucomatous eyes after adjusting for age [65]. These findings support an association of narrower retinal arteriolar and venular caliber changes with glaucomatous optic neuropathy independent of IOP after adjusting for age [65]. These findings are consistent with two other populationbased studies: the Blue Mountains Eye Study [66] and the Fig.…”

Section: Age-related Ocular Blood Flow and Vascular Changes In Glaucomasupporting

confidence: 90%

Age-related ocular vascular changes

Ehrlich

Kheradiya

Winston

et al. 2008

Graefes Arch Clin Exp Ophthalmol

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Section: Age-related Ocular Blood Flow and Vascular Changes In Glaucomasupporting

confidence: 90%

Age-related ocular vascular changes

Ehrlich

Kheradiya

Winston

et al. 2008

Graefes Arch Clin Exp Ophthalmol

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“…The Singapore Malay Eye Study showed that both arteriolar and venular narrowing were associated with the presence of glaucoma. 49 The Beijing Eye Study showed that a narrower arteriolar caliber was associated with a higher prevalence of glaucoma. 50 Furthermore, in the Blue Mountains Eye Study, Kawasaki et al 51 reported that during the 10-year follow-up period, narrowing of the retinal arterioles occurred before the development of earlystage glaucoma and was associated with a long-term risk of OAG.…”

Section: Vessel Narrowing In Glaucomamentioning

confidence: 99%

Ocular Blood Flow and Influencing Factors for Glaucoma

Nakazawa

2016

Asia-Pacific Journal of Ophthalmology

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Open-angle glaucoma (OAG) is characterized by optic nerve fiber atrophy and deterioration of the visual field, corresponding to damage to the optic nerve head. Intraocular pressure (IOP) is currently the only evidence-based, treatable risk factor for OAG. However, normal-tension glaucoma, the most common type of OAG in Asia, is a type of glaucoma with an unclear pathogenesis. Glaucoma is suspected to be a multifactorial disease with IOP-dependent and IOP-independent risk factors, including decreased ocular blood flow (OBF), oxidative stress, decreased axoplasmic flow, and genetic background. A number of epidemiological studies have generated strong evidence that OBF may be an especially important risk factor for the progression of glaucoma. Recent innovations in laser speckle flowgraphy and optical coherence tomography-based angiography have allowed us to noninvasively monitor changes in the microcirculation of the optic nerve head with high reproducibility. Laser speckle flowgraphy-derived measurement parameters include mean blur rate and pulse wave form parameters, whereas the main optical coherence tomography angiography-derived parameter is the vessel index. Decreases in these parameters are associated with the severity of glaucomatous damage, and changes are detectible even in the earliest, preperimetric stage of glaucoma. In the future, OBF analysis may improve significantly because of continuing progress in the development of the relevant instruments. This review will summarize possible connections between systemic and OBF abnormalities and OAG, describe the scientific rationale for these connections, and discuss their potential implications. Thus, this review will summarize the role of OBF in glaucoma pathogenesis and discuss the wide range of IOP-independent risk factors.

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“…[3][4][5][6] Decreased retinal perfusion has also been demonstrated angiographically in glaucoma patients using fluorescein angiography.…”

mentioning

confidence: 99%

“…tudies have shown that peripapillary retinal blood flow 1,2 and retinal vessel caliber 3,4 are reduced in glaucoma patients compared with healthy subjects, using laser Doppler flowmetry, 1 Doppler optical coherence tomography (OCT), 2 and measurements of retinal vessel caliber. [3][4][5][6] Decreased retinal perfusion has also been demonstrated angiographically in glaucoma patients using fluorescein angiography.…”

mentioning

confidence: 99%

OCT Angiography of the Peripapillary Retina in Primary Open-Angle Glaucoma

Lee

et al. 2016

Invest. Ophthalmol. Vis. Sci.

147

107

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PURPOSE. The purpose of this study was to investigate the topographic relationship between the decreased parapapillary retinal microvasculature as assessed by optical coherence tomography angiography (OCTA) and retinal nerve fiber layer (RNFL) defect in eyes with primary open-angle glaucoma (POAG) and a localized RNFL defect.METHODS. The peripapillary retinal circulation was evaluated using the OCTA centered on the optic nerve head in 98 POAG eyes having a localized RNFL defect and 45 healthy control eyes. A vascular impairment (VI) was identified in OCTA by the presence of a sign indicating decreased microvasculature. The frequencies of VI were compared between the POAG and control groups, and the topographic correlation between the VI and the RNFL defect identified in red-free fundus photographs was determined in the POAG group.RESULTS. The VI was observed as an area of decreased density of the microvascular network of the retina in 100% of the POAG eyes. The VI exactly coincided with the RNFL defect evident in red-free fundus photographs in terms of both the location and extent (Pearson's correlation coefficient ¼ 0.997 and 0.988, respectively, all P < 0.001). None of the control eyes exhibited VI in OCTA.CONCLUSIONS. Decreased parapapillary microvasculature of the retina determined by OCTA was found at the location of RNFL defect in POAG patients. This finding suggests that the decreased retinal microvasculature is likely secondary loss or closure of capillaries at the area of glaucomatous RNFL atrophy.Keywords: primary open-angle glaucoma, optical coherence tomography angiography, retinal microvasculature S tudies have shown that peripapillary retinal blood flow 1,2 and retinal vessel caliber 3,4 are reduced in glaucoma patients compared with healthy subjects, using laser Doppler flowmetry, 1 Doppler optical coherence tomography (OCT), 2 and measurements of retinal vessel caliber. [3][4][5][6] Decreased retinal perfusion has also been demonstrated angiographically in glaucoma patients using fluorescein angiography.7-10 These findings has raised the interest in the potential role of decreased ocular perfusion as an etiopathogenic factor for the glaucomatous optic neuropathy (GON), together with epidemiologic or clinical data that demonstrated the association of low blood pressure [11][12][13] or nocturnal blood pressure dips 14-16 with glaucoma. In contrast, Quigley et al. 17 demonstrated that the density of capillaries remained constant across a wide range of neural tissue losses within the optic nerve head (ONH) in both experimental and human glaucoma eyes. In addition, Cull et al. 18 showed that the ONH blood flow measured by laser speckle flowgraphy increased during the earliest stage of glaucoma followed by a linear decline that was strongly correlated with thickness reduction of the retinal nerve fiber layer (RNFL) thickness. These findings suggest that the reduced retinal perfusion could simply result from ONH degeneration and a consequently diminished metabolic demand.1,2,4-6 It therefore remains unc...

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Evidence of Retinal Vascular Narrowing in Glaucomatous Eyes in an Asian Population

Abstract: These findings support an association of narrower retinal arteriolar and venular caliber changes with glaucomatous optic neuropathy, independent of intraocular pressure.

Cited by 99 publications

References 43 publications

Age-related ocular vascular changes

Age-related ocular vascular changes

Ocular Blood Flow and Influencing Factors for Glaucoma

OCT Angiography of the Peripapillary Retina in Primary Open-Angle Glaucoma

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