Glaucoma progression is associated with decreased blood flow velocities in the short posterior ciliary artery

Abstract

Background: An altered perfusion of the optic nerve head has been proposed as a pathogenic factor in glaucoma. Aim: To investigate potential differences in the ocular haemodynamics of patients having glaucoma with progressive versus stable disease, as well as healthy volunteers. Methods: Peak-systolic velocity (PSV), end-diastolic velocity (EDV) and resistivity index in the short posterior ciliary artery (SPCA), central retinal artery (CRA) and ophthalmic artery were recorded in 114 consecutive patients having glaucoma with an intraocular pressure (IOP) (21 mm Hg, as well as in 40 healthy volunteers, by colour Doppler imaging (CDI). Results: Of the 114 patients with glaucoma, 12 showed glaucoma progression (follow-up period: mean 295 (standard deviation (SD) (18) days). CDI measurements in these patients showed decreased PSV and EDV in the SPCA (p,0.001 and p,0.05, respectively) and decreased PSV in the CRA compared with patients with stable glaucoma and healthy controls (p,0.05). No differences in flow velocities were found for the ophthalmic artery. IOP and systemic blood pressure was similar in all the three groups. Conclusions: Progressive glaucoma is associated with decreased blood flow velocities in the small retrobulbar vessels supplying the optic nerve head. The detected difference could represent a risk factor for progression of glaucomatous optic neuropathy.

Disturbed correlation between arterial resistance and pulsatility in glaucoma patients

“…Glaucoma patients, both POAG and NTG, revealed lower velocities (PSV, EDV and MFV) when compared to healthy individuals. Lower PSVs have been consistently found in glaucoma populations (Galassi et al 1992) (Michelson et al 1995) (Harris et al 1994) and are associated with both structural and functional damage, including defects in both retinal nerve fibre layer (Januleviciene et al 2008) and visual field (Zeitz et al 2006). Our findings regarding MFV are consistent with other results in POAG patients that found reduced flow velocities on retrobulbar arteries (Garho¨fer et al 2010) and in the cerebral circulation (Harris et al 2003).…”

“…Stratification of risk of glaucoma progression has been proposed by studying variables such as RI and PSV (Zeitz et al 2006) (Martı´nez & Sa´n-chez 2005). Resistive index has been used as an indirect measure of peripheral vascular resistance.…”

Glaucoma and ocular blood flow: an anatomical perspective

“…For instance, the retrobulbar vessels in both NTG and POAG patients exhibit increased RI during CDI [54,65]. Also, there is a correlation between glaucomatous VF progression and decreased blood flow velocities in the SPCAs [62,66] and an increased OA RI [66]. The rate of progression of VF defects also relates to blood flow, with more rapid progression correlating with a lower CRA velocity and a higher RI in the CRA [61,63].…”

Pseudoexfoliation and Blood Flow Abnormalities

“…45 Altered ocular blood flow has been widely reported in glaucoma patients and with glaucoma progression. [49][50][51] Patients with pseudoexfoliation syndrome and iris transillumination have a significantly higher resistive index of the ophthalmic artery than controls. 52 Pulsatile ocular blood flow, a representation of choroidal blood flow, was found to be decreased in pseudoexfoliation glaucoma compared to controls.…”