September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Ocular neurovascular changes during head-down posture predict future retinal nerve fiber layer loss in glaucoma suspects.
Author Affiliations & Notes
  • Giacinto Triolo
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
    Ophthalmology, University Scientific Institute San Raffaele, Milan, Italy
  • William J Feuer
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Pedro F Monsalve
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Luis E Vazquez
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • John Joseph McSoley
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Lori Ventura
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Vittorio Porciatti
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Giacinto Triolo, None; William Feuer, None; Pedro Monsalve, None; Luis Vazquez, None; John McSoley, None; Lori Ventura, None; Vittorio Porciatti, None
  • Footnotes
    Support  National Institute of Health-National Eye Institute (NIH-NEI) RO1 EY014957, NIH Center Grant P30-EY014801, and an unrestricted grant to Bascom Palmer Eye Institute from Research to Prevent Blindness, Inc.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2993. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Giacinto Triolo, William J Feuer, Pedro F Monsalve, Luis E Vazquez, John Joseph McSoley, Lori Ventura, Vittorio Porciatti; Ocular neurovascular changes during head-down posture predict future retinal nerve fiber layer loss in glaucoma suspects.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2993.

      Download citation file:


      © 2017 Association for Research in Vision and Ophthalmology.

      ×
  • Supplements
Abstract

Purpose : To investigate posture-induced neuro-vascular changes predictive of optic nerve tissue loss in glaucoma suspects (GS).

Methods : Mean peripapillary retinal fiber layer thickness (RNFLT) was measured with OCT two times/year in 29 GS aged 58 ± 8.9 years over 5.0 ± 0.73 years. GS, together with 11 age-matched controls aged 54.2 ± 10 years, also had a baseline pattern electroretinogram (PERG), IOP and brachial blood pressure measurements in the seated and - 10 degrees head-down-body-tilt position (HDT). An additional group of 17 young, healthy subjects aged 20.4 ± 10 years was used to investigate age-dependent changes in hemodynamic parameters during HDT.

Results : While all GS had baseline RNFLT in the normal range, 10/29 (34%) of them developed significant (P<0.05) thinning over the follow-up period. There was no correlation between initial RNFLT and corresponding change (R2 = 0.008). RNFL-thinners, RNFL-non-thinners, and controls tended to differ in a number of measurements such as HDT-PERG amplitude, seated PERG phase, seated systolic blood pressure (SBP), HDT-diastolic blood pressure (DBP), and calculated HDT-ocular perfusion pressure (OPP). Backward stepwise logistic regression including seated and HDT-induced changes of all variables determined a prediction equation discriminating (P=0.007) thinners from non-thinners with 90% sensitivity and 79% specificity (AUROC=0.91) with 2 false negatives and 1 false positive.

Conclusions : HDT is a non-invasive provocative procedure that can disclose neuro-vascular deficits in glaucoma suspects predictive of future loss of optic nerve tissue. This study provides a proof of concept that the HDT-PERG provocative test may have a role in the clinical management of glaucoma.

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

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×