Optic nerve blood flow is diminished in eyes of primary open-angle glaucoma suspects☆
Section snippets
Methods
Laser Doppler flowmetry measurements were obtained prospectively in 21 eyes (21 patients) with elevated intraocular pressure and normal automated visual fields (“primary open-angle glaucoma suspect eyes”), and were compared with a previously studied cohort of 15 eyes (15 patients) of age-matched controls and 22 eyes (22 patients) with primary open-angle glaucoma. Patients were referred from one author’s (J.R.P.-S.) university-based referral practice. The study protocol was approved by the
Results
No significant difference was noted in age, mean blood pressure, and perfusion pressure between the primary open-angle glaucoma suspect, control, and primary open-angle glaucoma groups (Table 1). Intraocular pressure was significantly higher in the primary open-angle glaucoma suspect group than controls (P < .005) or primary open-angle glaucoma (P < .0008).
Flow3, Vel3, and Vol3 are shown in Table 3. Compared with controls, Flow3 was 24% lower in primary open-angle glaucoma suspect eyes (P <
Discussion
In comparison to controls, we detected a significantly lower average blood flow in the optic nerve of subjects suspected of having primary open-angle glaucoma. As we previously identified in the primary open-angle glaucoma eyes,1 significantly lower blood flow was noted in the areas most sensitive to glaucoma damage, namely the superotemporal and inferotemporal neuroretinal rims. The largest decrease in flow was seen in the cup of primary open-angle glaucoma suspect eyes, which was also similar
Acknowledgements
The authors thank Maureen Maguire, PhD, Professor of Ophthalmology, Director of the Center for Preventative Ophthalmology and Biostatistics, University of Pennsylvania School of Medicine, for her assistance with the statistical analysis.
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This investigation was supported by the National Institutes of Health grants NEI EY11479 and R21 EY10964, Bethesda, Maryland, the Vivian Simkins Lasko Research Fund, the Paul and Evanina Mackall Trust, and an unrestricted grant from Research to Prevent Blindness, New York, New York.