Lower baseline ophthalmic artery blood flow velocities predict glaucomatous functional progression differently according to gender

Abstract

Purpose : To examine retrobulbar blood flow parameters as they relate to functional progression in males and females with open-angle glaucoma (OAG) over a five-year period

Methods : 111 OAG patients (mean age 65 ± 10.9 years; 43 male, 68 female) were assessed for retrobulbar blood flow in the ophthalmic artery (OA), which was measured by color Doppler imaging at baseline and every six months for a five-year period. 73 patients (mean age 70 ± 10.9 years; 31 male, 42 female) were assessed at five-year follow-up. Visual field analysis was performed with Humphrey 24-2 and functional disease progression was defined as two consecutive visits with mean deviation decrease ≥2 and/or Advanced Glaucoma Intervention Study score increase ≥2 compared to baseline. Mixed-model ANCOVA was used to test for significant changes from baseline to five-year follow-up. Time to functional progression was analyzed using Cox proportional hazard models. Interactions were tested to determine if the effects of the factors on progression time differed by sex.

Results : OA end diastolic velocity (EDV) in males decreased from 5.7 (95% CI: 5.0, 6.6) at baseline to 4.6 (3.8, 5.5) at five years, mean change -1.4 (-2.7, -0.4; p=0.006). OA EDV in females decreased from 5.5 (4.9, 6.1) at baseline to 3.4 (3.1, 4.0) at five years, mean change -3.2 (-4.3, -2.2; p<0.001). Lower baseline OA EDV was associated with shorter time to functional progression in male (p=0.003), but not in female patients, leading to a significant difference between groups (p=0.040).

Conclusions : In this study, lower baseline retrobulbar blood flow was more predictive of functional vision loss after five years in males compared to females. These data suggest that blood flow may have a greater influence on time to disease progression based upon gender in certain patients with OAG.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.