Value of retinal vein pulsation characteristics in predicting increased optic disc excavation

Abstract

Background: Retinal vein pulsation is often absent in glaucoma, but can be induced by applying a graded ophthalmodynamometric force (ODF) to the eye, which is elevated in glaucoma. Aim: To assess whether ODF has a predictive value in determining glaucoma progression. Methods: 75 patients with glaucoma and suspected glaucoma were examined prospectively in 1996, and then re-examined at a mean of 82 months later. All subjects had intraocular pressure, visual fields, stereo optic disc photography and ODF measured on their initial visit. When venous pulsation was spontaneous, the ODF was said to be 0 g. At re-examination, central corneal thickness and blood pressure were also measured. Initial and subsequent optic disc photographs were compared and graded into those that had increased excavation and those that had remained stable. The relationship between increased excavation (recorded as a binary response) and the measured variables was modelled using a multiple mixed effects logistic regression. Results: ODF at the initial visit was strongly predictive of increased excavation (p = 0.004, odds ratio 1.16/g, range 0-60 g), with greater predictive value in women than in men (p = 0.004). Visual field mean deviation was predictive of increased excavation (p = 0.044), as was optic nerve haemorrhage in association with older age (p = 0.038). Central corneal thickness was not significantly predictive of increased excavation (p = 0.074) after having adjusted for other variables. Conclusion: ODF measurement seems to be strongly predictive of the patient's risk for increased optic disc excavation. This suggests that ODF measurement may have predictive value in assessing the likelihood of glaucoma progression.

Spontaneous Retinal Venous Pulsation and Disc Hemorrhage in Open-Angle Glaucoma

“…Our finding is in line with the results of a previous investigation by Balaratnasingam et al, 27 who examined the influence of the ophthalmodynamometric force (ODF) to the future optic disc excavation. ODF was compared in patients with and without DH as a subgroup analysis and no significant difference between the DH group and non-DH group was found.…”

Quantitative Analysis of Fundus-Image Sequences Reveals Phase of Spontaneous Venous Pulsations

“…7 Various associations have also been reported between SVP and glaucoma: (1) venous pulsation evoked by ophthalmodynamometry indicates higher venous pressure in glaucoma subjects, [8][9][10] (2) SVP incidence is lower in glaucoma, [11][12][13][14] (3) SVP is related to the severity of functional damage, 11,13,15,16 and (4) SVP is predictive of disease progression. [17][18][19] Obviously, SVP could be employed more efficiently if its etiology was better understood.…”

Central retinal artery and vein collapse pressure in giant cell arteritis versus nonarteritic anterior ischaemic optic neuropathy

“…The study may add to the clinical application of modern ophthalmodynamometry as already demonstrated in previous investigations on glaucoma, measurement of intracerebral pressure, assessment of tissue pressure in the orbit in patients with endocrine orbitopathy, ischaemic ophthalmopathy and retinal vein occlusions. [4][5][6][7][8][9][10][11][12] …”