Abstract
Purpose :
Acute angle-closure glaucoma (AACG) is an ocular emergency that without treatment may lead to blindness. Intraocular pressure may be controlled by immediate surgical treatment to prevent visual fields loss. However, even when there is no visual field loss, some patients have unexplained symptoms such as pain, blurriness or notice a difference between their two eyes. Therefore we investigated retinal ganglion cell complex (GCC) thickness and optic nerve blood flow of the affected eye and included patients with or without any visual field loss following AACG.
Methods :
Ten eyes of nine patients (average age 81±7.6 years) who were being followed up for AACG were evaluated. Laser speckle blood flowgraphy imaging (LSFG-NAVI; Softcare Ltd, Fukuoka Japan) and optical coherence tomography (RS-3000, NIDEK, Gamagori Japan) were performed to measure optic nerve blood flow and GCC thickness when intraocular pressure had been stabilized at 20 mm Hg or less for at least 1 year after surgical treatment was performed at the time of glaucomatous attack and/or after topical glaucoma therapy. These values for the affected eye were compared with those of the fellow eye or average value of three age-gender matched normal subjects as control. We also considered the correlation of GCC thickness and optic nerve blood flow.
Results :
Average GCC thickness of the affected eye was significantly thinner (76.1%, p<0.001) than that of the control eye especially in nasal inferior outside area. Optic nerve blood flow of the affected eye was significantly lower (MBR: 57%, p=0.002) than that of the control eye. There was a strong significantl correlation between GCC thickness and optic nerve flow (r=0.63, p<0.01). (Percentage of values for the control eye)
Conclusions :
The retinal GCC thickness and the optic nerve flow of the affected eye were significantly lower in patients with AACG compared to that of the control eye. We also found a strong relationship between GCC thickness and optic nerve flow. These facts indicate that decreasing consumption of oxygen associated with thinning of GCC thickness may lead to decrease optic nerve blood flow and lead to patient’s symptoms.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.