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Karin R Pillunat, Sylvana Georgii, Eberhard Spoerl, Richard P Stodtmeister, Lutz E Pillunat; Central retinal venous pressure in patients with large discs. Invest. Ophthalmol. Vis. Sci. 2017;58(8):732. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate central retinal venous pressure (CRVP) in patients with macrodiscs and to investigate a possible association with retinal nerve fiber layer parameters.
A total of 59 eyes with macrodiscs was included in this cross-sectional study. None of the eyes were treated with intraocular pressure (IOP) lowering medication or had visual field defects. IOP was measured with Goldmann applanation tonometry and CRVP with contactlens dynamometry calibrated in mmHg (Imedos, Jena, Germany). CRVP was considered to be elevated, if it was higher than IOP+2x standard deviation which approximately equaled IOP+5mmHg. Rim parameters were examined with the glaucoma modul of OCT (Spectralis; Heidelberg Engineering GmbH, Heidelberg, Germany). Student’s t tests were used to test for differences between the groups.
CRVP was within the range of IOP+5mmHg in 37 eyes (63%). The mean CRVP in this group was 12.8±2.5 mmHg and the mean IOP 12.7±2.3 mmHg. 22 eyes (37%) showed an elevated CRVP. The mean CRVP in this group was 32.1±8.5 mmHg and the mean IOP 13.7±1.6 mmHg. The difference of CRVP between the two groups was statistically significant (P<0.001), the difference between IOP was not significant (P=0.088). There was no difference regarding age (49.5±13.8y; 48.9±10.6; P=0.849) and mean BMO (2.92±0.64 mm2; 2.82±0.38 mm2; P=0.536). Minimal rim width parameters showed no difference. Retinal nerve fiber layer parameters showed a statistically significant reduction in the group with elevated CRVP in the temporal inferior segment (154.8±13.7µm vs. 141.9±15.8µm; P=0.004) and the temporal superior segment (130.9±16.4µm vs. 116.9±19.0 µm; P=0.008).
An elevated CRVP leads to reduced ocular perfusion pressures, which represent a risk factor for the prevalence and progression of primary open-angle glaucoma. Therefore, an elevated CRVP (>IOP+5mmHg) in clinically normal macrodiscs might be a sign of beginning glaucoma and could help discriminate normals from glaucoma suspects. The measurement of CRVP might be beneficial to detect patients with macrodiscs being at risk for developing glaucomatous damage.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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