Association between lower optic nerve laser Doppler blood volume measurements and glaucomatous visual field progression

Aim: To perform a preliminary assessment of the relation between optic nerve circulatory parameters and glaucomatous visual field progression. Methods: This study included 29 eyes of 23 patients with open angle glaucoma that had typical glaucomatous nerve fibre bundle visual field defects and increa...

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Bibliographic Details
Published in:	British journal of ophthalmology Vol. 87; no. 12; pp. 1487 - 1491
Main Authors:	Zink, J M, Grunwald, J E, Piltz-Seymour, J, Staii, A, Dupont, J
Format:	Journal Article
Language:	English
Published:	BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01-12-2003 BMJ BMJ Publishing Group LTD Copyright 2003 British Journal of Ophthalmology
Subjects:	Adult Aged Aged, 80 and over Biological and medical sciences Blood Blood Flow Velocity Blood Pressure blood supply Blood Volume Clinical Science - Extended Reports Defects Disease Progression Glaucoma Glaucoma and intraocular pressure Glaucoma, Open-Angle - physiopathology glaucomatous progression Humans Laser-Doppler Flowmetry Lasers Medical imaging Medical sciences Middle Aged Ophthalmology optic disc optic flow Optic nerve Optic Nerve - blood supply Regional Blood Flow Regression Analysis Retrospective Studies Standard deviation Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the eye and orbit Visual Fields Doppler ultrasound study Human Measurement Association Optic nerve Prognosis Blood volume Glaucoma (eye) Visual field Laser Evolution
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Summary:	Aim: To perform a preliminary assessment of the relation between optic nerve circulatory parameters and glaucomatous visual field progression. Methods: This study included 29 eyes of 23 patients with open angle glaucoma that had typical glaucomatous nerve fibre bundle visual field defects and increased cup to disc ratios. Laser Doppler flowmetry (Oculix) was used to measure relative optic nerve blood volume (Vol), velocity (Vel) and flow in the superior temporal (ST) and inferior temporal (IT) neuroretinal rim of the optic nerve. After blood flow measurements patients were followed for 6–62 months (mean 33 (SD 17) months) and 2–11 Humphrey visual fields (4.7 (2.6) fields) were obtained. Progression of glaucoma was assessed by the slope of the corrected pattern standard deviation (CPSD) values versus time, which was calculated manually for each eye using regression analysis. Results: A significant negative correlation was observed between Vol in the IT rim and the CPSD slope (r = −0.56, p = 0.002); patients with lower Vol tended to show faster progression of glaucomatous field damage than those with higher Vol. When the eyes were arbitrarily divided into two groups according to lower Vol (0.32 (0.06) arbitrary units, AU, n = 15) or higher Vol (0.49 (0.06) AU, n = 14), those with lower Vol had significantly worse mean CPSD slopes (0.50 (0.48) dB/year) than those with higher Vol (−0.67 (1.38) dB/year; Student’s t test, p = 0.009). Conclusions: In the IT rim, the area most prone to develop glaucomatous field damage, lower Vol is associated with subsequently faster CPSD progression. These measurements suggest that circulatory abnormalities may have a role in the development of glaucoma.
Bibliography:	PMID:14660459 istex:8776E725C7B2A490811B12BC8395204FB08BA7A4 Correspondence to: Juan E Grunwald MD, Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, 51 North 39th Street, Philadelphia, PA 19104, USA; juangrun@mail.med.upenn.edu local:0871487 ark:/67375/NVC-8SVRB5Z3-M href:bjophthalmol-87-1487.pdf ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Correspondence to: Juan E Grunwald MD, Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, 51 North 39th Street, Philadelphia, PA 19104, USA; juangrun@mail.med.upenn.edu Commercial relationships: None.
ISSN:	0007-1161 1468-2079
DOI:	10.1136/bjo.87.12.1487