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Lars Wagenfeld, Maren Klemm, Peter Galambos, Ralf Praga, Anne Wiermann, Gisbert Richard, Oliver Zeitz; Altered Ocular Perfusion In Glaucoma Patients: Differences Of Blood Flow Velocities In Retrobulbar Vessels. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6026.
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Primary open angle glaucoma is associated with impaired ocular perfusion. This diminished blood flow can be detected when its regulation is challenged, e.g. by flicker stimulation of the retina or after posture change. As this requires a combination of a method for measurement of ocular perfusion with a procedure to challenge ocular blood flow regulation, examination of this is very extensive and associated with discomfort for the patient. As this limits the application of such methods in clinical routine and in studies, the present work aims to investigate ocular perfusion without any stimulation of regulation mechanisms to get insight whether a simple measurement of ocular blood flow can be used in clinical routine.
N=298 glaucoma patients and N=86 control subjects were examined in a supine position by color Doppler imaging. A Siemens Elegra device with a 7.5L40 ultrasound transducer was used. The peak systolic velocity (PSV), the end diatolic velocity (EDV), and the resistivity index (RI) were measured in the central retinal artery (CRA) and the ophthalmic artery (OA).
Blood flow parameters were measured as follows:CRA/PSV: 10.1+/-1.2 in controls vs. 8.7+/-1.2 cms-1 in glaucoma patients (P<0.001)CRA/EDV: 2.0+/-1.9 in controls vs. 1.6+/-1.4 cms-1 in glaucoma patients (P<0.001)CRA/RI: 0.8 +/- 0.01 in controls vs. 0.83 +/- 0.02 in glaucoma patients (P=0.388)OA/PSV: 31.1+/-2.1 in controls vs. 31.1+/-2.2 cms-1 in glaucoma patients (P=0.541)OA/EDV: 3.9 +/- 1.4 in controls vs. 3.7 +/- 1.3 cms-1 in glaucoma patients (P=0.488)OA/RI: 0.88 +/- 0.01 in controls vs. 0.87 +/- 0.01 in glaucoma patients (P=0.86)
A significant difference of blood flow velocities was seen in the CRA but no difference could be detected in the OA. This implies that blood flow alterations are more pronounced in the smaller vessels and that the measurement of these vessels is of major importance.
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