Sectoral Differences in the Association of Optic Nerve Head Blood Flow and Glaucomatous Visual Field Defect Severity and Progression

Abstract

PURPOSE. To investigate sectoral differences in the relationship between optic nerve head tissue blood flow, anatomically corresponding visual field defect severity, and future progression. METHODS. This retrospective longitudinal medical chart review comprised 508 eyes of 319 open-angle glaucoma patients (mean deviation: À9.2 6 7.0 dB), followed for an average of 4.7 6 1.1 years; an average 11.7 6 3.7 visual field tests were performed. Average total deviation (TD) was calculated in the superior, central, and inferior sectors of the Humphrey 24-2 program. The optic nerve head was divided to obtain inferior, temporal, and superior tissue-area mean blur rate (MT), derived from laser speckle flowgraphy. At baseline, the correlation between MT and TD was compared in anatomically corresponding sectors. We performed a multivariate analysis to determine the contribution of baseline MT to corresponding TD slope and to determine background factors influencing superior to temporal MT. We used a linear-mixed effect model for the statistical analysis. RESULTS. At baseline, the highest b coefficients were found between MT-superior and TDinferior, MT-temporal and TD-central, and between MT-inferior and TD-superior, in that order (b ¼ 0.38, b ¼ 0.27, b ¼ 0.26, respectively). MT-superior and MT-temporal independently contributed to corresponding TD slope (P < 0.05). Male sex, high body mass index, and the prevalence of sleep apnea syndrome were contributing factors to lower superior to temporal MT (P < 0.05). CONCLUSIONS. Review of medical history, measurements of systemic variables, and laser speckle flowgraphy parameters might help clinicians to predict visual field defect severity and progression. Keywords: retinal blood flow, glaucoma, visual field the ONH near the lamina cribrosa and has been found to be usable for interindividual comparisons. 21,28,29 In addition to these advantages, the LSFG software provides pulse waveform

Measuring optic nerve head perfusion to monitor glaucoma: a study on structure–function relationships using laser speckle flowgraphy

“…2019; Kiyota et al. 2019; Kuroda et al. 2020), our study is the first to measure it in the sectors of Garway‐Heath (Garway‐Heath et al.…”

“…Using a variety of techniques, studies showed that the ocular circulation is altered in glaucoma (Michelson et al 1996;Grunwald et al 1998;Findl et al 2000;Yoshioka et al 2020), and that VF sensitivity is correlated with ocular perfusion levels (Resch et al 2011;Hwang et al 2012;Yarmohammadi et al 2016;Gardiner et al 2019;Kiyota et al 2019;Kuroda et al 2020). In particular, OCT angiography (OCTA) has recently emerged as a promising tool to assist glaucoma diagnosis and monitoring (Yarmohammadi et al 2016;Sakaguchi et al 2017;Kiyota et al 2018;Moghimi et al 2019;Liu et al 2020).…”

“…By enabling a quick and reproducible assessment of ONH perfusion in a sectoral manner, LSFG is a promising technique for glaucoma monitoring (Aizawa et al 2011). Laser speckle flowgraphy (LSFG) has been widely used to assess ONH perfusion in glaucoma and other optic neuropathies, but mostly in Japanese subjects (Koseki et al 2008;Kiyota et al 2018;Gardiner et al 2019;Kiyota et al 2019;Calzetti et al 2020a;Kuroda et al 2020;Mursch-Edlmayr et al 2020). Furthermore, a direct comparison between LSFG and OCT in terms of floor effect has yet to be performed.…”

The association of primary aldosteronism with glaucoma-related fundus abnormalities

“…Thus, some subtypes of glaucoma might share this pathophysiology with non-arteritic anterior ischemic optic neuropathy [37]. Kiyota et al also reported that sleep apnea syndrome was significantly associated with lower blood flow at superior to temporal optic nerve head tissue [37]. Moreover, a previous report suggested a relationship between PA and sleep apnea syndrome [38].…”

“…Nonarteritic anterior ischemic optic neuropathy often involves the inferior visual field defects given that the upper anastomosis appears to be less proficient than the lower. Thus, some subtypes of glaucoma might share this pathophysiology with non-arteritic anterior ischemic optic neuropathy [37]. Kiyota et al also reported that sleep apnea syndrome was significantly associated with lower blood flow at superior to temporal optic nerve head tissue [37].…”