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M.E. Hajee, R. Kumar, T. Brevetti, K.C. Greenidge, G. Jean–Louis, B. Siesky, H. Choi, L. Thompson, L. Kagemann, A. Harris; Increased Heterogeneity in Retinal Blood Flow of Glaucoma Patients . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3930.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Previous studies have suggested that deficits in ocular blood flow may play a role in the pathogenesis of glaucoma. This study examined differences in retinal blood flow patterns between medicated glaucoma patients and healthy controls. Methods: Data for this study were obtained from patients receiving glaucoma treatment and healthy adults free of any pharmacological agents. We compared nine eyes of healthy subjects and 10 eyes of primary open–angle glaucoma (POAG) patients (mean age 62.45 ± 8.36 and 60.78 ± 14.63 years, respectively). Using images obtained from the Heidelberg Retinal Flowmeter, "pixel–by–pixel" analysis was done in an area adjacent to the optic disc with approximately 1600 pixels. Flow values were then divided into percentile flow and "percentage zero flow" values. Comparisons were made between groups by means of analysis of variance. Results: Mean age for POAG patients did not differ significantly from that of healthy controls, [F = 0.10]. Mean IOP of healthy controls and POAG patients was 15.33 ± 3.50 mmHg and 16.13 ± 4.05 mmHg, respectively with no significant difference between groups [F = 0.19]. POAG patients showed significantly greater "percentage zero flow" values than did healthy controls [19.56 ± 4.63 vs. 14.94 ± 4.48; F = 7.35, p < 0.01]. Ocular blood flow measures at the 10th percentile were not significantly different [82 ± 21 vs. 66 ± 21; F = 2.74, p = 0.12], but the following percentile parameters were significantly greater : 25th [182 ± 44 vs. 142 ± 39; F = 3.96, p < 0.05]; 50th [342 ± 94 vs. 254 ± 67; F = 5.32, p < 0.05]; 75th [547 ± 148 vs. 379 ± 97; F = 8.35, p < 0.01]; 90th [771 ± 206 vs. 546 ± 139; F = 7.52, p < 0.01]. Conclusions: The overall blood flow of medicated POAG patients is elevated compared to normal controls. The elevation occurs in a heterogenic pattern. The POAG group demonstrated significantly elevated "percentage zero flow" values. The 10th percentile flow area was transitional with no significant difference between the two groups and the 25th to 90th percentile flow areas were significantly elevated in the POAG group compared to normals. The impact of medication use and the clinical implication of these findings warrant further investigation.
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