Patients with asymmetric glaucomatous visual field loss exhibit asymmetric flow velocities of the CRA and OA. Patients with more severe damage display reduced flow velocities in retrobulbar vessels in POAG.

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Purpose Previous studies have shown decreased retrobulbar blood flow in normal tension glaucoma (NTG) compared to healthy controls. This study evaluates the ability of colour Doppler imaging (CDI) to identify patients with NTG. Methods Sixty-two patients with untreated NTG (mean age 57714 years) and 40 agematched controls (mean age 5879 years) were included in a prospective cross-sectional institutional study. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive indices (RI ¼ (PSV-EDV)/PSV) of the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (PCAs) were measured by means of CDI. Using receiver operating characteristic (ROC) curves, sensitivity was determined at 90% specificity. Results Patients with NTG showed significantly decreased PSV (Po0.0001) and EDV (Po0.0001) of the CRA, significantly decreased EDV of the nasal (P ¼ 0.004) and temporal (P ¼ 0.002) PCA, and significantly increased RI of the temporal (P ¼ 0.003) PCAs compared to healthy controls. Sensitivity values at 90% specificity were calculated: PSV of the CRA, 30.6%; EDV of the CRA, 48.4%; EDV of the nasal PCA, 43.9%; EDV of the temporal PCA, 45.9%; and RI of the temporal PCA, 39.3%. Conclusions The power to identify NTG using CDI reaches 48% sensitivity at 90% specificity. Further longitudinal studies are needed to determine the prognostic value of CDI in glaucoma.

Aim: To compare retrobulbar haemodynamics in patients with acute non-arteritic anterior ischaemic optic neuropathy (NAION) and age-matched controls by colour Doppler imaging (CDI). Methods: 25 patients with acute NAION and 35 agematched controls participated in this study. By means of CDI, the blood flow velocities of the ophthalmic artery, central retinal artery (CRA), and nasal and temporal short posterior ciliary arteries (PCAs) were measured. Peak-systolic velocity (PSV) and end-diastolic velocity (EDV) and Pourcelot's resistive index were determined. Results: In the ophthalmic artery, no marked differences between patients with NAION and controls were detected. PSV and EDV of the CRA (p,0.001, p = 0.002) and PSV of the nasal PCA (p,0.05) were significantly decreased in patients with NAION compared with healthy controls. No marked differences between patients and controls were detectable for temporal PCAs. Conclusion: Blood flow velocities of the nasal PCA and the CRA are considerably reduced in patients with acute NAION compared with controls. Patients with NAION in part showed markedly different retrobulbar haemodynamics.

Fluorescein angiography revealed significantly increased vascular leakage of glaucomatous optic nerve heads. An endothelial disruption and fluorescein leakage might be the result of mechanical stress at the level of the lamina cribrosa and/or a sign of ischemic damage. This measurement approach might enable us to judge the severity of optic nerve head leakage, and it is a potential way to evaluate therapeutic regimens.