Abstract
Abstract: :
Purpose: Generalised and focal narrowing of retinal arteries can occur in glaucomatous and non-glaucomatous optic neuropathies. The purpose of this longitudinal prospective study was to determine if arterial narrowing is more pronounced in patients with progressive compared to non-progressive glaucoma. Methods: Colour slides of the optic discs were projected onto graph paper (distance, 4 m). The diameter of the major arteries (superotemporal, inferotemporal, superonasal, inferonasal branches) was measured at the optic disc margin, and at the thinnest and broadest parts within 1 optic disc diameter from the disc margin, or up to the first arterial bifurcation. In a masked analysis, the percentage change in the arterial diameter between baseline and follow-up images were determined. Patients were stratified into progressing and non-progressing groups, according to visual field (Statpac Glaucoma Change Probability) or optic disc (masked assessment by 2 independent observers) criteria. Results: Forty-four patients (mean age 67.5 yrs, range 52-84 yrs; mean follow-up 4.9, range 1.3-7.5 yrs) were included. Optic disc change was observed in 24, and visual field progression in 13 patients. For all vessels, the mean change in arterial diameter at the edge of the disc was -8.0% (C.I.; -4.7 to -11.7, p<0.001) but no significant difference was observed between progressing and non-progressing patients classified either by visual field or optic disc (p=0.968 and p=0.327 respectively). In the analysis of individual vessels, there was no difference between progressing and non-progressing groups classified according to visual field change (p≷0.372). The same was true for groups classified according to optic disc progression (p≷0.327) except for the superotemporal artery where a significant change was observed at the disc margin (-14.1% in progressing and -3.3% in non-progressing groups; p=0.048). Disc progression occurred most frequently in the superotemporal quadrant. With this sample, the power to detect a 10% difference in arterial narrowing between the two groups was 68.1%. Conclusion: Arterial narrowing increased in both progressive and non-progressive glaucoma though systematic differences between the groups were not evident.
Keywords: 498 optic disc • 430 imaging/image analysis: clinical