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Joshua Paschall, Alon Harris, Brent Siesky, Leslie Tobe, Annahita Amireskandari, Nathaniel Kim, Chi-Wah Yung, Brian Marek, Darrell WuDunn, John Abrams; Optic Nerve Head Morphology and Retrobulbar Blood Flow; Differences between Glaucoma Patients with and without Diabetes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4467.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate retrobulbar blood flow in relation to optic nerve head (ONH) morphology over time in open-angle glaucoma (OAG) patients with and without diabetes.
77 patients (17 diabetic, 60 non-diabetic) with OAG were assessed for ONH morphology utilizing Heidelberg retinal tomography and optical coherence tomography (cup/disc (C/D) ratio, cup shape, cup depth, disc area, rim area, rim width, rim volume, height variation contour). Retrobulbar blood flow was measured using Color Doppler imaging (CDI) in the ophthalmic artery (OA), central retinal artery (CRA) and nasal (NPCA) and temporal (TPCA) posterior ciliary arteries. Pearson correlations were calculated to evaluate the associations between measurements at baseline and between the changes in measurements between baseline and 3 years.
Changes in OA peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) in OAG patients with diabetes strongly correlated (r=-0.95 to 0.78) with changes in multiple ONH parameters, and were significantly different compared to OAG patients without diabetes (p<0.0043). Changes in CRA PSV and EDV were more strongly correlated in diabetics with ONH changes than non-diabetics (r=-0.78 to -0.56: r=0.43 to 0.31; p<0.0023). Changes in NPCA EDV were strongly and significantly correlated (r=-0.87 to -0.59; p=0.02 to 0.25) with ONH changes in diabetics and weakly correlated in non-diabetics (r=0.34 to 0.18) with significant differences between groups (p<0.002). NPCA RI changes strongly correlated with ONH changes in diabetics (r=-0.91 to -0.72), and weakly correlated in non-diabetics (r=0.35 to -0.14) with significant differences between groups (p<0.001).
In this cohort of OAG patients, changes in ONH morphology were strongly correlated to retrobulbar blood flow changes in diabetics. This data indicates that changes in ONH morphology may be more influenced by ocular blood flow in for OAG patients with diabetes.
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