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Wulff-Dieter Ulrich, Klaus-Dieter Wernecke, Andrea Moeller, Christa Ulrich, Konstantin E Kotliar, Carl Erb; Choroidal Blood Flow Baroregulation in Primary Open Angle Glaucoma (POAG). Invest. Ophthalmol. Vis. Sci. 2019;60(9):5625.
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© ARVO (1962-2015); The Authors (2016-present)
To determine wether there are differences in choroidal blood flow baroregulation (ChBF-B) in untreated and treated POAG patients and to prove the hypothesis that testing ChBF-B with the Ocular Pressure Blood Flow Analyzer (OPFA) is suitable for therapy control in glaucoma.
In a retrospective observational clinical study we investigated with the OPFA device (tpm, Lüneburg, Germany) pulsatile choroidal blood flow (pChBF), ocular perfusion pressure (OPP), ocular blood pressure (OBP) and ocular perfusion reserve (OPR) noninvasively in 38 POAG patients prior to and during treatment. PChBF is measured as pulse volume in µl and calculated per beat (PV) and per minute (PMV). Comparisons were performed between the glaucoma patients before and during treatment as well as with age-matched healthy subjects with a nonparametric multivariate analysis of longitudinal data in a two-factorial design.
Outcome of 38 POAG patients (mean ±SD, pressures in mmHg, IOP measured with Goldmann applanation tonometer) : Untreated Treated Healthy SubjectsIOP 22.5 ± 2.5 15.5 ± 2.4 15.8 ± 2.8MOBP 78.6 ± 8.72 69.5 ± 8.79 67.6 ± 7.09MOPP 57.3 ± 9.12 55.9 ± 8.80 51.8 ± 6.17PV 1.19 ± 0.46 0.98 ± 0.41 0.87 ± 0.20PMV 85.7 ± 33.73 70.07 ± 24.88 64.6 ± 17.04OPR 23.1 ± 6.16 24.9 ± 6.84 23.2 ± 4.65MOBP=mean OBP, MOPP=mean OPP, PV=choroidal pulse volume per beat, PMV=pulse volume per minute, OPR=ocular perfusion reserveIn untreated POAG patients IOP, MOBP, and pCHBF were significantly increased compared with age-matched healthy subjects, while OPP and OPR remained in the normal range. During treatment (medically or surgically) IOP, MOBP, and pChBF went down, i.e., they were normalized or continued to be only slightly increased.
In POAG patients ChBF baroregulation can be examined with the OPFA device. In untreated POAG patients choroidal blood flow and OBP are increased and keep up OPP and OPR. Effective glaucoma treatment aims at normalizing ChBF and reduces increased IOP and OBP. The OPFA examination is appropriate for recognizing defective ChBF baroregulation and consequently is also suitable for therapy control in glaucoma.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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