September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Systemic blood and ocular perfusion pressures influence retrobulbar blood flow in open-angle glaucoma patients with diabetes mellitus
Author Affiliations & Notes
  • Betul Kaskan
    Ophthalmology, Indiana University School of Medicine, Istanbul, Turkey
  • Alon Harris
    Ophthalmology, Indiana University School of Medicine, Istanbul, Turkey
  • Nicholas Moore
    Ophthalmology, Indiana University School of Medicine, Istanbul, Turkey
  • Alice Chandra Verticchio Vercellin
    University Eye Clinic, IRCCS Policlinico San Matteo, Pavia, Italy
  • Rachel Frantz
    Ophthalmology, Indiana University School of Medicine, Istanbul, Turkey
  • Christian Jonescu-Cuypers
    Ophthalmology, Indiana University School of Medicine, Istanbul, Turkey
  • George Eckert
    Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Brent A Siesky
    Ophthalmology, Indiana University School of Medicine, Istanbul, Turkey
  • Footnotes
    Commercial Relationships   Betul Kaskan, None; Alon Harris, AdOM (I), AdOM (C), Biolight (C), Isama therapeutics (C), Nano Retina (C), Ono (C), Oxymap (I), Science Based Health (C), Stemnion Inc. (C); Nicholas Moore, None; Alice Chandra Verticchio Vercellin, None; Rachel Frantz, None; Christian Jonescu-Cuypers, None; George Eckert, None; Brent Siesky, None
  • Footnotes
    Support  Research to Prevent Blindness NY, NY and American Diabetes Association Grant 1-12-IN-20
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2978. doi:
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      Betul Kaskan, Alon Harris, Nicholas Moore, Alice Chandra Verticchio Vercellin, Rachel Frantz, Christian Jonescu-Cuypers, George Eckert, Brent A Siesky; Systemic blood and ocular perfusion pressures influence retrobulbar blood flow in open-angle glaucoma patients with diabetes mellitus. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2978.

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Abstract

Purpose : To examine the relationship between blood pressure (BP) and ocular perfusion pressure (OPP) and changes in retrobulbar blood flow in open-angle glaucoma (OAG) patients with and without diabetes mellitus (DM)

Methods : 73 patients with OAG (13 DM, 60 without DM) were assessed for BP, OPP, and nasal posterior ciliary artery (NPCA) resistivity index (RI) by color Doppler imaging every six months for a four-year period. Systolic and diastolic blood pressure (SBP, DBP), mean arterial pressure (MAP), systolic and diastolic perfusion pressure (SPP, DPP), and mean perfusion pressure (MPP) were recorded at each visit. Additionally, 78 patients with OAG (12 DM, 66 without DM) were assessed for SBP, DBP, MAP, and ophthalmic artery (OA) peak systolic velocity (PSV) every six months over a four-year period. Pearson correlations were used to test for associations between measurements, with p<0.05 considered statistically significant.

Results : In the group of 73 OAG patients (13 DM, 60 without DM), baseline SBP (r=-0.68, p=0.010), DBP (r=-0.66, p=0.012), MAP (r=-0.76, p=0.002), SPP (r=-0.72, p=0.004), DPP (r=-0.71, p=0.005), OPP (r=-0.82, p<0.001), and MPP (r=-0.81, p<0.001) negatively correlated with changes in NPCA RI in DM patients. In patients without DM, these correlations were weak and non-significant (r=0.06-0.19, all p>0.05); leading to a significant difference between groups (SBP: p=0.008; DBP: p=0.013, MAP: p=0.002; SPP: p=0.002; DPP: p=0.002; OPP: p<0.001; MPP: p<0.001). In DM OAG patients: SBP had a mean change of 2.9 (95% CI: -8.3, 14.1; p=0.604), DBP had a mean change of -1.6 (-8.3, 5.2; p=0.648), and MAP had a mean change of 0.0 (-7.7, 7.7; p=0.995). Changes in SBP (r=0.80, p=0.001), DBP (r=0.71, p=0.008), and MAP (r=0.77, p=0.002) strongly and positively correlated with changes in OA PSV. In OAG patients without DM, changes in SBP, DBP, and MAP weakly correlated with changes in OA PSV (r=0.0 to 0.06, all p>0.05); leading to a significant difference between groups (SBP: p=0.002; DBP: p=0.020; MAP: p=0.006).

Conclusions : In OAG patients with DM, BP and OPP correlated with larger increases in retrobulbar vascular resistance and changes in retrobulbar blood flow after four years, compared to non-DM patients. This data suggests that mechanisms influencing the systemic vasculature may also affect localized ocular blood vessels more strongly in OAG patients with DM.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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