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Mitra Sehi, Iman Goharian, Ranjith Kumar Konduru, Ou Tan, Sowmya Srinivas, Srinivas Sadda, David Huang, David Greenfield; Reduced Retinal Blood Flow is Associated with Thinner Retinal Nerve Fiber Layer in Glaucomatous Eyes with Single Hemifield Damage. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4457.
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To examine the hypotheses that retinal blood flow (RBF) is significantly reduced in the abnormal visual hemifield of glaucomatous eyes with single-hemifield damage; and that there are significant associations between reduced retinal sensitivity (RS) in abnormal hemifield, and RBF, retinal nerve fiber layer thickness (RNFL) and ganglion cell complex thickness (GCC) in the corresponding hemisphere.
Glaucomatous eyes with visual field loss confined to a single hemifield underwent Spectral-domain optical coherence tomography (SDOCT), Doppler SDOCT and standard automated perimetry (SAP). Using Dual Angle Protocol, a double-circle scanning pattern was applied to measure the venous BF. Disc photos were registered with Doppler images to identify the veins. RBF was derived from the recorded Doppler frequency shift and the calculated angle between the beam and the vessel. Total and hemispheric RBF values were calculated. Average, superior and inferior RNFL and GCC were measured. Shapiro-Wilk Test, ANOVA with Tukey HSD and regression analyses were performed.
30 eyes (age 61.5±9.2 yrs) were included. Mean RS was reduced in abnormal hemifield compared with the normal hemifield (22.5±7.1 vs 28.5±2.0dB, p<0.001). Mean RBF was reduced in retinal hemisphere associated with abnormal hemifield vs the opposite hemisphere (15.3±5.4 vs 19.3±8.4 μL/min, p=0.03). The RNFL was thinner in corresponding abnormal hemisphere vs the opposite hemisphere (87.0±20.2 vs 103.7±20.6μm, p=0.002). The GCC was thinner in corresponding abnormal hemisphere vs the opposite hemisphere (80.6±10.3 vs 83.6±10.1μm, p=0.04). The RBF was associated with RNFL (r=0.41, p=0.02) and GCC (r=0.43, p=0.02), but not with the RS in 1/lambert or dB (r=0.31, p=0.09; r=0.30, p=0.10 respectively) in corresponding abnormal hemisphere and abnormal hemifield.
In glaucomatous eyes with single-hemifield damage, retinal blood flow is significantly reduced in the hemisphere associated with abnormal hemifield. These findings emphasize the role of retinal blood flow in the pathogenesis of glaucoma.
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