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M.E. Hajee, T. Brevetti, R. Kumar, B. Siesky, K. Greenidge, D. Lazzaro, L. Thompson, P. Chamnongvongse, L. Kagemann, A. Harris; Decreased Ocular Blood Flow in Patients with Advanced Optic Nerve Cupping . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4499.
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Previous studies have suggested that ocular blood flow may play a role in the pathogenesis of glaucoma. This study examined differences in peripappillary blood flow amongst patients with various degrees of optic nerve cupping.
Both groups had healthy, glaucoma suspects, and glaucoma patients. We compared seventeen eyes of patients with optic nerve cupping >60% (Group A) and 45 eyes of patients with optic nerve cups <= 60%(Group B). Using images obtained from the Heidelberg Retinal Flowmeter, "pixel–by–pixel" analysis was done in an area adjacent to the optic disc with a minimum of 1600 pixels. Flow values were then divided into percentile flow and "percentage zero flow" values. Comparisons were made between groups by means of T–test.
Both groups had patients with the diagnosis of healthy normals, glaucoma suspects and glaucoma. Mean age for both groups A and B were 53 and 47 years respectively (p=0.0003). Mean IOP of group A and group B was 15.76 mmHg and 14.22 mmHg, respectively with no significant difference between groups (p>0.10). Group A showed a mean "percentage zero flow" value of 17.51% while Group B was 14.02% (p=0.01).
The mean percentage zero flow was found to be significantly greater in patients with optic nerve cupping greater than 60% as compared with patients with <=60% cupping. In addition to cupping, age may also be a contributory factor to this phenomenon. It is unclear if the lack of perfusion causes the cupping or enlarged cups causes a lack of perfusion of the peripappillary retina.
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