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Rehan Hussain, Alon Harris, Alice Chandra Verticchio Vercellin, George Eckert, Claudia Thieme, Annahita Amireskandari, Noa Geffen, Scott Wentz, Jenny Wang, Brent A Siesky; Lower baseline central retinal artery blood flow velocities predict structural progression in male patients with open-angle glaucoma. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2755.
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To examine the retrobulbar blood flow parameters and structural progression in males and females with open-angle glaucoma (OAG) over a 5-year period.
111 OAG patients (Mean age 65 yr; 43 male, 68 female) were assessed for retrobulbar blood flow in the ophthalmic (OA) and central retinal (CRA) arteries as measured by color Doppler flowmetry at baseline and every 6 months for a 5 year period. 73 patients (Mean age 70 yr; 31 male, 42 female) were assessed at 5-year follow-up. Structural progression was monitored with optical coherence tomography, and Heidelberg retinal tomography and was defined as two consecutive visits with Retinal Nerve Fiber Layer thickness decrease ≥8% and/or horizontal or vertical cup/disk ratio increase ≥0.2 compared to baseline. Mixed-model ANCOVA was used to test for significant change from baseline to 5-year follow-up. Time to structural progression was analyzed using Cox proportional hazards models. Interactions were tested to determine if the effects of the factors on progression time differed by sex.
In male and female patients from baseline over a 5-year period, CRA Peak Systolic Velocity (PSV) decreased with changes of -0.13 (-0.87, 0.60; p= 0.7233) in males and -0.96 (-1.51, -0.40; p=0.0008) in females. CRA End Diastolic Velocity (EDV) significantly decreased with changes of -0.98 (-1.45, -0.57; p<0.0001) in males and -0.66 (-1.00, -0.36; p<0.0001) in females. Lower baseline CRA PSV and EDV were associated with shorter time to structural progression in male (p=0.01) but not in female patients, leading to a significant difference between groups (p≤0.01).
In this group of patients, lower baseline CRA blood flow velocities were predictive of glaucomatous structural progression after 5 years in males but not in females. These data suggest that retrobulbar blood flow velocities may play a different role in the structural progression of the disease according to sex.
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