The Relationship Between Interocular Asymmetry of Visual Field Defects and Optic Nerve Head Blood Flow in Patients With Glaucoma

Abstract

Purpose: To investigate the association between asymmetry of visual field (VF) defects and optic nerve head (ONH) blood flow in patients with glaucoma using laser speckle flowgraphy. Methods: In total, 170 eyes of 85 patients with primary open-angle glaucoma were included. Intraocular pressure, VF (Humphrey 24-2, SITA program), mean blur rate in the tissue area (MBR-T) of the ONH measured by laser speckle flowgraphy, axial length, circumpapillary retinal nerve fiber layer thickness (cpRNFLT), disc area, cup/disc area ratio, and parapapillary atrophy (PPA) area was measured in each eye. The paired eyes were divided into better and worse eyes according to the mean deviation (MD) of VF, and intereye differences of various parameters (better MD eye minus worse MD eye) were examined. Factors associated with MD difference, MBR-T difference, or cpRNFLT difference were investigated. Results: MD of the VF in better and worse eyes were −10.2±7.3 dB and −16.8±7.4 dB, respectively. In stepwise multiple regression analysis, MBR-T differences, cpRNFLT differences and sex (male) were significantly correlated with MD differences (β, 0.26, 0.21, 0.20; P=0.01, 0.04, 0.047, respectively). MD differences were significantly associated with MBR-T differences (β, 0.28; P=0.01). For cpRNFLT differences, differences in β-PPA area and MD differences were identified as significant factors (β, −0.26, 0.22; P=0.02, 0.04, respectively). Conclusions: Asymmetry of ONH blood flow is significantly associated with asymmetry of visual field defects in patients with glaucoma independently of cpRNFLT.

Retinal Oxygen Extraction in Patients with Primary Open-Angle Glaucoma

“…This is in keeping with a previous smaller-scale study in glaucoma patients [ 21 ]. Whereas several previous studies have shown that there is an association between ONH and/or retinal blood flow with glaucoma damage [ 22 , 23 , 24 , 25 , 26 , 27 ], our study links RGC damage to oxygen metabolism.…”

Intereye Comparison of Focal Lamina Cribrosa Defect in Normal-Tension Glaucoma Patients with Asymmetric Visual Field Loss

“…Firstly, asymmetric NTG was defined as an MD difference of at least 3 dB in the present study. The definition of asymmetric VF loss was inconsistent in previous articles with an MD difference from 0.01 to 6 dB [40,41]. The greater the difference of MD, the more the reliable risk factors can be found.…”

Associations between the red blood cell distribution width and primary angle-closure glaucoma: a potential for disease prediction

“…Although the underlying mechanisms leading to glaucomatous atrophy in PACG cases are not fully understood, several mechanisms have been suggested. For example, inflammation [3], microangiopathy [4][5][6][7][8][9] and oxidative stress [10,11] are all currently being discussed in terms of the leading factors causing PACG, which can damage the optic nerve and lead to the progressive loss of retinal ganglion cells and their axons.…”