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Glaucomatous eyes with no defects or borderline visual field defects as well as glaucomatous eyes in an advanced disease stage show significantly decreased optic nerve head and juxtapapillary retinal capillary blood flow.

Aim-The eVect of breathing 100% oxygen on retinal and optic nerve head capillary blood flow in smokers and non-smokers was investigated using scanning laser Doppler flowmetry (SLDF) as a new noninvasive method to visualise and quantify ocular blood flow. Method-10 eyes of 10 young healthy nonsmoking volunteers (mean age 26 (SD 3) years) and nine eyes of nine young healthy smoking volunteers (mean age 26 (4) years) were investigated. All participants were asked not to smoke or consume caVeine containing drinks for at least 4 hours before the measurements. Blood flow measurements were performed before and after 100% oxygen was applied to the subjects through a mask over a period of 5 minutes (6 litres per minute). Juxtapapillary retinal and optic nerve head blood flow were determined in arbitrary units using SLDF representing a combination of laser Doppler flowmetry and a scanning laser system allowing visualisation and quantification of the retinal and optic nerve head blood flow. Blood flow was determined in an area of 100 µm × 100 µm. The level of carboxyhaemoglobin was determined in all subjects. A Wilcoxon matched pairs signed ranks test (nonparametric) was used for statistical evaluation. Results-In the non-smoking group, retinal 'flow' was reduced by 33% (p = 0.005), optic nerve head 'flow' by 37% (p = 0.005). In the smoking group retinal flow was reduced by 10% (p = 0.01), optic nerve head flow by 13% (p <0.008). The diVerence in reactivity to oxygen breathing between smokers and non-smokers was highly significant (p <0.00001). Increased carboxyhaemoglobin levels were not found in either of the groups. A significant reduction of the mean arterial blood pressure of 6% (5%) (p <0.02) was observed in the non-smoking group after administration of oxygen. Conclusion-These results indicate that hyperoxia leads to a decrease in capillary blood flow of the retina and optic nerve head secondary to vasoconstriction, and that smokers do not respond to oxygen breathing as non-smokers do. The findings might be based on factors such as long term eVects of nicotine on the sympathetic and parasympathetic nervous system. (Br J Ophthalmol 1997;81:365-369)