September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Retrobulbar blood flow predicts functional and structural progression in open-angle glaucoma patients with greater body mass indices
Author Affiliations & Notes
  • Leslie Abrams Tobe
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Alon Harris
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Brent A Siesky
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Nicholas Moore
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Amelia Huang
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Colin Ridenour
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Yara Catoira-Boyle
    Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • George Eckert
    Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Alice Chandra Verticchio Vercellin
    University Eye Clinic, IRCCS Policlinico San Matteo, Pavia, Italy
  • Footnotes
    Commercial Relationships   Leslie Tobe, None; Alon Harris, AdOM (I), AdOM (C), Biolight (C), Isama therapeutics (C), Nano Retina (C), Ono (C), Oxymap (I), Science Based Health (C), Stemnion Inc. (C); Brent Siesky, None; Nicholas Moore, None; Amelia Huang, None; Colin Ridenour, None; Yara Catoira-Boyle, None; George Eckert, None; Alice Chandra Verticchio Vercellin, None
  • Footnotes
    Support  Research to Prevent Blindness NY, NY
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2989. doi:
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      Leslie Abrams Tobe, Alon Harris, Brent A Siesky, Nicholas Moore, Amelia Huang, Colin Ridenour, Yara Catoira-Boyle, George Eckert, Alice Chandra Verticchio Vercellin; Retrobulbar blood flow predicts functional and structural progression in open-angle glaucoma patients with greater body mass indices. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2989.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To examine ocular blood flow as it relates to functional and structural disease progression in normal weight (NW: body mass index (BMI) <25), overweight (OW: BMI 25-30) and obese (OB: BMI >30) patients with open-angle glaucoma (OAG) over five years

Methods : 112 patients with OAG (38 NW; 40 OW; 34 OB) were assessed for retrobulbar blood flow as measured by color Doppler imaging at baseline and every six months for a five-year period. 76 patients (30 NW; 25 OW; 21 OB) were assessed at five-year follow-up. Functional progression was monitored with Humphrey 24-2 visual fields, defined as two consecutive visits with mean deviation decrease ≥2 and/or Advanced Glaucoma Intervention Study score increase ≥2 compared to baseline. Structural progression was monitored with optical coherence tomography and Heidelberg retinal tomography, defined as two consecutive visits with retinal nerve fiber layer decrease ≥8% and/or horizontal or vertical cup/disc ratio increase ≥0.2 compared to baseline. Mixed-model ANCOVA and Cox proportional hazards models were utilized for significance and time to functional progression, respectively.

Results : All results are reported from baseline to five years. Ophthalmic artery (OA) resistivity index (RI) increased in NW from 0.77 to 0.83, change of 0.09 (95% CI: 0.04, 0.13), in OW from 0.76 to 0.81, change of 0.06 (0.02, 0.10), and in OB from 0.75 to 0.81, change of 0.07 (0.03, 0.13) (all p<0.05). Central retinal artery (CRA) RI increased in NW from 0.71 to 0.76, change of 0.04 (0.02, 0.07), in OW from 0.71 to 0.76, change of 0.05 (0.02, 0.09), and in OB from 0.70 to 0.78, change of 0.08 (0.05, 0.12) (all p<0.05). Higher OA RI and CRA RI were predictive of functional progression in OW patients (p<0.05). Lower CRA RI was predictive of functional progression in OB patients. Nasal posterior ciliary artery (NPCA) peak systolic velocity (PSV) did not change significantly within any weight group, however lower NPCA PSV was predictive of structural progression in OB patients (p<0.05).

Conclusions : Retrobulbar blood flow parameters may have a greater influence on functional and structural progression in OAG patients with a higher BMI.

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

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