May 2006
Volume 47, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2006
Relatonship Between Glaucomatous Visual Field Progression, Vasospasticity, and Changes in Optic Nerve Head Topography and Blood Flow at the Time of Initial IOP Reduction: A Prospective Pilot Study
Author Affiliations & Notes
  • M.R. Lesk
    Department of Ophthalmology, University of Montreal, Maisonneuve Rosemont Hospital, PQ, Canada
  • D. Papamatheakis
    Department of Ophthalmology, University of Montreal, Maisonneuve Rosemont Hospital, PQ, Canada
  • D. Descovich
    Department of Ophthalmology, University of Montreal, Maisonneuve Rosemont Hospital, PQ, Canada
  • A.S. Hafez
    Department of Ophthalmology, University of Montreal, Maisonneuve Rosemont Hospital, PQ, Canada
  • Footnotes
    Commercial Relationships  M.R. Lesk, None; D. Papamatheakis, None; D. Descovich, None; A.S. Hafez, None.
  • Footnotes
    Support  E.A. Baker Foundation–Canadian National Institute for the Blind; Glaucoma Res. Society of Canada
Investigative Ophthalmology & Visual Science May 2006, Vol.47, 4782. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      M.R. Lesk, D. Papamatheakis, D. Descovich, A.S. Hafez; Relatonship Between Glaucomatous Visual Field Progression, Vasospasticity, and Changes in Optic Nerve Head Topography and Blood Flow at the Time of Initial IOP Reduction: A Prospective Pilot Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4782.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: : Our recent data (ARVO, 2004) suggests that, compared to those with thicker corneas, glaucoma and ocular hypertensive patients with thin corneas had larger reductions in optic nerve head (ONH) cup depth and smaller improvements in neuroretinal rim blood flow when undergoing a sustained IOP reduction. Now we asked whether these ONH changes correlated with long term visual field stability.

Methods: : 26 glaucoma and pre–perimetric glaucoma patients had Heidelberg retina tomography and scanning laser Doppler flowmetry (SLDF software v3.3) of the ONH before and 2–6 months following sustained therapeutically indicated IOP reduction. Peripheral vasospasticity was measured with finger Doppler during cold water immersion. Ultrasound pachymetry was performed. Visual field stability was monitored over the following 4.2+/– 1.0 years using modified Hodapp–Anderson–Parrish criteria.

Results: : 8 patients progressed, 16 were stable , 2 were indeterminate (these were excluded from analysis). At initial IOP reduction, patients that eventually progressed had 89+/– 144 µm mean shallowing of cup depth vs. 1+/– 50 µm in the stable group (p=0.029), and were more vasospastic (minimum finger flow 4.1+/–2.3 tpu vs. 10.3+/–8.2 tpu, p=0.017). Progressing patients had insignificantly thinner corneas (546 +/–50µm vs 569 +/–59µm, p=0.4) and had insignificantly smaller initial increases in neuroretinal rim blood flow than stable patients (32 +/–96 au vs. 70+/– 119 au, p=0.44). Both progressing and stable groups had the same initial IOP reduction and the progressing group had slightly lower IOPs during follow–up.

Conclusions: : Greater movement of the base of the cup, interpreted as a sign of a more compliant lamina cribrosa, appears to be linked to an increased risk of progressive glaucoma. Vasospasticity also appears to be linked to an increased risk of progression in this pilot series.

Keywords: lamina cribrosa • optic disc • optic flow 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×