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A. C. Belliveau, R. P. LeBlanc, B. C. Chauhan, M. T. Nicolela; Pulsatile Ocular Blood Flow in Glaucoma Patients With Different Optic Disc Phenotypes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4385.
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To evaluate the baseline pulsatile ocular blood flow measurements (POBF) of open-angle glaucoma patients enrolled in a prospective longitudinal study exhibiting focal, diffuse, or sclerotic optic disc phenotypes.
Forty eight patients with focal, 44 patients with diffuse and 44 patients with sclerotic optic disc damage were enrolled in a prospective study to determine rates of progression of the disease in each group. Among the baseline measurements performed, patients had their POBF measured in the study eye with the Ocular Blood Flow Tonograph (Orb Diagnostics and Therapeutics, Brooklandville, ML). The average POBF value is automatically calculated by the computer after an observer selected a cluster of at least five regular and uniform ocular pulse curves. In a few patients (less than 6%) the measurements were of poor quality and not used in this analysis.
Good quality POBF measurements were obtained in 47, 41 and 41 patients with focal, diffuse and sclerotic damage respectively. Patients from the three groups had similar functional levels of glaucomatous damage as assessed by mean deviation of automated visual field examinations. The mean age of patients in the focal, diffuse and sclerotic groups was 68.7 +12.2, 63.8 + 10.8 and 71.3 + 8.8 respectively (p<0.05). POBF measurements were positively correlated with age (R=0.18; p=0.04), central corneal thickness (R=0.17; p=0.05) and spherical equivalent (R=0.38; p<0.001). The mean + SD POBF was 542 + 203 µl/min in the focal group, 617 + 194 µl/min in the diffuse group and 508 + 171 µl/min in the sclerotic group (p = 0.03; post hoc analysis showed significant difference between diffuse and sclerotic groups). These differences in POBF remained statistically significant in an analysis utilizing age, CCT and spherical equivalent as covariates.
Patients with sclerotic optic discs have lower values of POBF than the other two groups, significantly lower than the diffuse group. These findings, as well as previously reported findings from colour Doppler ultrasound and fluorescein angiography studies, suggest that deficient ocular blood flow is associated with sclerotic optic disc appearance in glaucoma.
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