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John Ling, Alon Harris, Brent A Siesky, George Eckert, Barbara Wirostko, Priyanka Kanakamedala, Tara Schaab, Annahita Amireskandari; Changes in retinal capillary blood flow correlate with changes in optic nerve head morphology in glaucoma patients with diabetes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2941.
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To examine the relationship between changes in retinal capillary blood flow and changes in optic nerve head structure (ONH) in open angle glaucoma (OAG) patients with and without diabetes (DM).
77 patients with OAG (15 with DM, 62 without DM) were assessed for changes in retinal capillary blood flow as measured by Heidelberg retinal flowmetry and optic nerve head morphology as measured by Heidelberg retinal topography after 4 years. Pearson correlations were used to test for associations between measurements, with p<0.05 considered statistically significant.
In OAG patients with DM, change in inferior 75th percentile blood flow correlated strongly with changes in rim volume and cup to disc (C/D) area ratio (p<0.03) but not in patients without DM, resulting in a significant difference between groups (p<0.05). Inferior 90th percentile flow was significantly correlated to changes in cup area, rim area, rim volume, C/D area ratio, linear C/D ratio and cup shape (p<0.001). These relationships were not significant in patients without DM leading to a significant difference between the two groups (p<0.02). Additionally, change in inferior mean flow was strongly correlated with change in rim area, rim volume, C/D area ratio and linear C/D ratio (p<0.02) in patients with DM but not in those without DM, resulting in a significant difference between groups (p<0.03).
In OAG patients with diabetes, change in inferior retinal blood flow was significantly correlated with changes in ONH after 4 years. OAG patients of ED had weaker correlations, suggesting OAG patients with and without diabetes may have differences in the vascular contribution to glaucomatous structural damage. Additionally, this data suggests that there may also be regional differences in the retinal capillary beds.
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