Role of Color Doppler Imaging in Early Diagnosis and Prediction of Progression in Glaucoma

Abstract

This longitudinal and prospective study analyzes the ability of orbital blood flow measured by color Doppler imaging (CDI) to predict glaucoma progression in patients with glaucoma risk factors. Patients with normal perimetry but having glaucoma risk factors and patients in the initial phase of glaucoma were prospectively included in the study and divided, after a five-year follow-up, into two groups: “Progression” and “No Progression” based on the changes in the Moorfields regression analysis (MRA) classification of Heidelberg retina tomograph (HRT). An orbital CDI was performed in all patients and the parameters obtained were correlated with changes in HRT. A logistic discrimination function (LDF) was calculated for ophthalmic artery (OA) and central retinal artery (CRA) parameters. Receiver operating characteristics curves (ROC) were used to assess the usefulness of LDFs to predict glaucomatous progression. A total of 71 eyes were included. End-diastolic velocity, time-averaged velocity, and resistive index in the OA and CRA were significantly different (P < 0.05) between the Progression and No Progression groups. The area under the ROC curves calculated for both LDFs was of 0.695 (OA) and 0.624 (CRA). More studies are needed to evaluate the ability of CDI to perform early diagnosis and to predict progression in glaucoma in eyes.

Optical Coherence Tomography Angiography of the Peripapillary Retina in Primary Angle-Closure Glaucoma

“…These findings are similar to those in studies of POAG eyes where the peripapillary microcirculation was highly correlated with VF pattern standard. 18,27–29 In contrast with the PACG eyes in our study, there were no correlations between peripapillary retinal VD and other glaucoma parameters in the unaffected eyes. This indicated that loss of peripapillary retinal VD is associated with acute PACG.…”

Baseline retrobulbar blood flow is associated with both functional and structural glaucomatous progression after 4 years

“…These findings are supported by previous studies where Calvo et al reported that OA EDV and mean velocity were reduced in subjects who converted to glaucoma based on Moorfields Regression Analysis 22. Jimenez-Aragon et al found that the EDV and RI of the OA and CRA were significantly different between subjects who structurally progressed compared with those who did not progress 23. Additionally, Calvo et al reported that an OA RI value higher than 0.75 was associated with the development of glaucoma 22.…”

Reductions in Retrobulbar and Retinal Capillary Blood Flow Strongly Correlate With Changes in Optic Nerve Head and Retinal Morphology Over 4 Years in Open-angle Glaucoma Patients of African Descent Compared With Patients of European Descent

“…found that the EDV and RI of the OA and CRA were significantly different between subjects who structurally progressed compared to those who did not progress. 55 Zeitz et al . showed that the EDV and PSV of the short posterior ciliary arteries were decreased in subjects who structurally progressed.…”