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M. Sehi, J.G. Flanagan, L. Zeng, R.J. Cook, G.E. Trope; The Association between Diurnal Variation of Optic Nerve Head Topography and Intraocular Pressure, Systemic Blood Pressure and Optic Nerve Head Capillary Blood Flow in Untreated POAG . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2549.
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Purpose: To define the association between diurnal variation of optic nerve head (ONH) topography and intraocular pressure (IOP), systemic blood pressure (BP) and ONH capillary blood flow (BF) in untreated (u)POAG and normals. Methods: Fourteen uPOAG patients (7 women, age range 40–79, mean 56.7, SD 11.2) and 14 healthy volunteers (9 women, age range 40–73, mean 57.6, SD 9.9) were examined. IOP, BP, ONH topography (HRTII) and ONH BF (HRF) were measured between 07:00 and 22:00 hours on a single day. Local BF at the rim sector of maximum fluctuation was measured, using the HRF analysis. Mean, global, rim BF (MRBF) was calculated using AFFPIA. A random effect repeated measures analysis was performed. Results: The temporal and temporal–inferior cup volume (p<0.001, p=0.002) and the reference height (p<0.001) gave a significant diurnal change in uPOAG. However, there was a significant interaction between reference height and cup volume (p<0.016). Diurnal change in IOP, BP and BF had no significant effect on reference height in uPOAG or normals. Change in IOP had a significant effect on the cup shape measure in the temporal–inferior sector in uPOAG and normals (p<0.050). Local BF significantly changed during the day in uPOAG (p=0.006) but not in normals (p=0.065). MRBF did not significantly change in either group (p=0.13, p=0.60). Conclusions: The temporal and temporal–inferior sectors of the ONH demonstrated significant diurnal fluctuation in uPOAG but not in the normal group. These changes were associated with fluctuations in the reference height.
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