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M. A. Pickett, A. Harris, B. Siesky, R. Ehrlich, A. Moss, L. Cantor, L. McCranor, J. Abrams, D. WuDunn; The Indianapolis Glaucoma Progression Study: Reproducibility of Color Doppler Imaging. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5864.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the reproducibility of color Doppler imaging (CDI) measurements performed on primary open angle glaucoma (OAG) patients participating in the Indianapolis Glaucoma Progression Study (IGPS).
Retrobulbar blood flow velocities and Pourcelot’s vascular resistance index (RI) in OAG patients were measured with CDI as part of the IGPS. Two baseline measurements were obtained 1-2 weeks apart at the same time of day for all participants. Peak systolic and end diastolic blood flow velocities (PSV/EDV) were measured in the ophthalmic (OA), central retinal (CRA), and nasal and temporal short posterior ciliary arteries (N/TPCA) and RI was calculated. Reproducibility of CDI was assessed by estimating the intra-class correlation coefficient (ICC) and 95% confidence intervals (CI) between the two measurements. Limits of agreement were determined for quantifying the stability of the data. Bland-Altman plots of the difference between the two measurements versus the average of the two measurements for each parameter were created.
93 patients were examined to date with a mean age of 65.8 (SD9.9) years (58% female). In the OA the ICC for the PSV, EDV, and RI were 0.939 (0.908-0.959), 0.885 (0.826-0.923), and 0.914 (0.870-0.943), respectively. In the CRA the ICC for the PSV, EDV, and RI were 0.882 (0.822-0.922), 0.763 (0.642-0.843), and 0.900 (0.849-0.943). The ICC for the PSV, EDV and RI were 0.931 (0.896-0.954), 0.902 (0.852-0.935), 0.835 (0.751-0.890) in the NPCA and 0.927 (0.891-0.952), 0.934 (0.901-0.956), 0.919 (0.877-0.946) in the TPCA, respectively. Natural variation was largest for OA PSV (4.0) and smallest for TPCA RI (0.028).
In this study CDI measurements of the OA, CRA and PCAs conducted at one to two week intervals were shown to be highly reproducible. The analysis suggests a trained CDI operator can reliably measure the retrobulbar blood vessels in OAG patients.
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