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Jenny Wang, Alon Harris, Alice Chandra Verticchio Vercellin, George Eckert, Claudia Thieme, Rehan Hussain, Willy Gama, Scott Wentz, Brent A Siesky; Lower baseline retinal capillary blood flow predicts functional glaucoma progression in obese patients with open-angle glaucoma.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2754.
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To examine the retinal capillary blood flow parameters and functional progression in patients with different Body Mass Index (BMI) with open-angle glaucoma (OAG) over a 5-year period.
112 patients with OAG (38 normal weight, BMI <25, NW; 40 overweight, BMI 25-30, OW; 34 obese, BMI>30, OB) were assessed for retinal capillary blood flow as measured by Heidelberg retinal flowmetry at baseline and every 6 months for a 5-year period. 30 patients (9 NW, 13 OW, 8 OB) were assessed at 5-year follow-up. Functional disease progression was monitored with 24-2 Swedish Interactive Thresholding Algorithm visual field exam using the Humphrey visual field machine and was defined as two consecutive visits with mean deviation decrease ≥2 and/or Advanced Glaucoma Intervention Study increase ≥2 compared to baseline. Mixed-model ANCOVA was used to test for significant change from baseline to 5-year follow-up. Time to functional progression was analyzed using Cox proportional hazards models. Interactions were tested to determine if the effects of the factors on progression time differed by BMI category.
Inferior mean flow at baseline was 413.67 (95% CI; 368.98, 461.55) for NW, 415.82 (375.76, 460.15) for OW and 403.28 (360.46, 451.18) for OB. Lower baseline inferior mean flow was associated with shorter time to structural progression in OB patients (p=0.01440) but neither in NW (p=0.2475) nor OW patients (p=0.7323), leading to a significant difference between groups (p=0.0317).
Lower baseline inferior mean flow was predictive of glaucomatous functional progression in OB but neither in NW nor in OW. These findings suggest that capillary blood flow may play a different role in the functional progression of the disease according to BMI.
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