Ocular Hemodynamics and Glaucoma Prognosis

Abstract

To evaluate the effect of optic nerve circulation, using color Doppler imaging (CDI), on the progression of visual field damage in primary open-angle glaucoma. Methods: The relationship between the results of retrobulbar CDI, performed shortly after the diagnosis of primary open-angle glaucoma, and the progression of visual field loss for 7 years was evaluated in 44 glaucoma patients. Color Doppler imaging variables in patients with a stable and deteriorating clinical course were compared, and the pattern of increasing risk for different CDI values was analyzed using an additive logistic model. Based on this nonparametric analysis, we arrived at a discriminant CDI value identifying glaucoma patients with a poor prognosis. On the basis of the discriminant value, patients were divided into 2 groups, and the odds ratio of visual field loss for each group was then estimated. Results: Patients with a stable visual field had a higher diastolic velocity and a lower resistivity index in the ophthalmic artery (PϽ.001 for both) compared with those with a deteriorating visual field during the study. The odds of visual field deterioration in patients with an ophthalmic artery resistivity index of 0.78 or higher was about 6 times that of patients with an ophthalmic artery resistivity index lower than 0.78. Conclusion: Color Doppler imaging variables of the ophthalmic artery correlate with the risk of visual field deterioration in patients with primary open-angle glaucoma.

Blood flow in the peripapillary retina in exfoliation glaucoma

“…In the present study, we divided the patients into two groups as with either progressive or stable ExG based on a change in AGIS VF scoring or a glaucomatous change in the ONH evaluated from ONH stereophotographs. In contrast to findings for patients with POAG and NTG, 38–42 we failed to show any significantly different flow values between progressive ExG and stable ExG. The reason for this is unknown, but may implicate a different glaucoma pathogenesis in ExG versus POAG and NTG.…”

Blood flow in the peripapillary retina in exfoliation glaucoma

“…In the present study, we divided the patients into two groups as with either progressive or stable ExG based on a change in AGIS VF scoring or a glaucomatous change in the ONH evaluated from ONH stereophotographs. In contrast to findings for patients with POAG and NTG, 38–42 we failed to show any significantly different flow values between progressive ExG and stable ExG. The reason for this is unknown, but may implicate a different glaucoma pathogenesis in ExG versus POAG and NTG.…”

Assessment of Choroidal Thickness in Healthy and Glaucomatous Eyes Using Swept Source Optical Coherence Tomography

“…However, when differences in age and axial length between glaucomatous and healthy subjects were accounted for there was no association between glaucoma and CT. Although we found no relationship between glaucoma and CT, prior studies have indicated an association between glaucoma and both impaired choroidal circulation and decreased blood flow to the ONH [52] , [54] – [55] . It may be that CT is a poor marker of functional integrity of the choroid, particularly as the choroid has an extravascular space that could explain much thickness variability.…”

Age-Related Changes in Ocular Blood Velocity in Suspects with Glaucomatous Optic Disc Appearance. Comparison with Healthy Subjects and Glaucoma Patients

“…While there is general consensus that ocular blood velocity is reduced in glaucoma, the precise relationship among visual field loss, ocular hemodynamics and structural damage remains debatable. Our data are in agreement with data obtained by Yamazaki et al [ 50 ] and Galassi et al [ 51 ], who found lower ocular blood velocities in glaucoma patients with progressive visual field loss compared with those with a stable clinical course. Additionally, Satilmis et al [ 52 ], showed patients with progressive POAG to have EDV of the CRA inversely correlated to the rate of progression of the visual field MD, which is in agreement with our data.…”

Blood flow in the peripapillary retina in exfoliation glaucoma

“…In the present study, we divided the patients into two groups as with either progressive or stable ExG based on a change in AGIS VF scoring or a glaucomatous change in the ONH evaluated from ONH stereophotographs. In contrast to findings for patients with POAG and NTG, 38–42 we failed to show any significantly different flow values between progressive ExG and stable ExG. The reason for this is unknown, but may implicate a different glaucoma pathogenesis in ExG versus POAG and NTG.…”

Assessment of Choroidal Thickness in Healthy and Glaucomatous Eyes Using Swept Source Optical Coherence Tomography

“…However, when differences in age and axial length between glaucomatous and healthy subjects were accounted for there was no association between glaucoma and CT. Although we found no relationship between glaucoma and CT, prior studies have indicated an association between glaucoma and both impaired choroidal circulation and decreased blood flow to the ONH [52] , [54] – [55] . It may be that CT is a poor marker of functional integrity of the choroid, particularly as the choroid has an extravascular space that could explain much thickness variability.…”

Age-Related Changes in Ocular Blood Velocity in Suspects with Glaucomatous Optic Disc Appearance. Comparison with Healthy Subjects and Glaucoma Patients

“…While there is general consensus that ocular blood velocity is reduced in glaucoma, the precise relationship among visual field loss, ocular hemodynamics and structural damage remains debatable. Our data are in agreement with data obtained by Yamazaki et al [ 50 ] and Galassi et al [ 51 ], who found lower ocular blood velocities in glaucoma patients with progressive visual field loss compared with those with a stable clinical course. Additionally, Satilmis et al [ 52 ], showed patients with progressive POAG to have EDV of the CRA inversely correlated to the rate of progression of the visual field MD, which is in agreement with our data.…”

Blood flow in the peripapillary retina in exfoliation glaucoma

“…In the present study, we divided the patients into two groups as with either progressive or stable ExG based on a change in AGIS VF scoring or a glaucomatous change in the ONH evaluated from ONH stereophotographs. In contrast to findings for patients with POAG and NTG, 38–42 we failed to show any significantly different flow values between progressive ExG and stable ExG. The reason for this is unknown, but may implicate a different glaucoma pathogenesis in ExG versus POAG and NTG.…”

Assessment of Choroidal Thickness in Healthy and Glaucomatous Eyes Using Swept Source Optical Coherence Tomography

“…However, when differences in age and axial length between glaucomatous and healthy subjects were accounted for there was no association between glaucoma and CT. Although we found no relationship between glaucoma and CT, prior studies have indicated an association between glaucoma and both impaired choroidal circulation and decreased blood flow to the ONH [52] , [54] – [55] . It may be that CT is a poor marker of functional integrity of the choroid, particularly as the choroid has an extravascular space that could explain much thickness variability.…”

Age-Related Changes in Ocular Blood Velocity in Suspects with Glaucomatous Optic Disc Appearance. Comparison with Healthy Subjects and Glaucoma Patients

“…While there is general consensus that ocular blood velocity is reduced in glaucoma, the precise relationship among visual field loss, ocular hemodynamics and structural damage remains debatable. Our data are in agreement with data obtained by Yamazaki et al [ 50 ] and Galassi et al [ 51 ], who found lower ocular blood velocities in glaucoma patients with progressive visual field loss compared with those with a stable clinical course. Additionally, Satilmis et al [ 52 ], showed patients with progressive POAG to have EDV of the CRA inversely correlated to the rate of progression of the visual field MD, which is in agreement with our data.…”