Predictive Value of Retrobulbar Blood Flow Velocities in Glaucoma Suspects

Abstract

PURPOSE. To determine whether retrobulbar blood flow (RBF) velocities are predictive of conversion to glaucoma. METHODS.A total of 262 glaucoma suspects were prospectively selected. Participants had normal visual field, increased intraocular pressure, and glaucomatous optic disc appearance at baseline. Topographic analysis of the optic nerve head was performed using a confocal laser scanning ophthalmoscope and the blood flow velocity of retrobulbar vessels was measured by color Doppler imaging. Conversion to glaucoma was assessed according to the changes in the color-coded Moorfields Regression Analysis (MRA) classification of the confocal laser scanning system during a 48-month follow-up period. Survival curves and hazard ratios (HRs) for the association between RBF parameters and conversion to glaucoma were calculated.RESULTS. End-diastolic velocity and mean velocity in the ophthalmic artery were reduced in subjects that converted to glaucoma based on MRA (36 individuals, 13.7%), while resistivity (RI) and pulsatility indices were increased in the same vessel. Patients with RI values lower than 0.75 in the ophthalmic artery had a survival rate (MRA-converters versus nonconverters) of 93.9%, whereas individuals with RI values greater than 0.75 had a survival rate of 81.7% (HR ¼ 3.306; P ¼ 0.002).CONCLUSIONS. Abnormal RBF velocities measured by color Doppler ultrasound may be a risk factor for conversion to glaucoma. An RI value higher than 0.75 in the ophthalmic artery was associated with the development of glaucoma.

Baseline retrobulbar blood flow is associated with both functional and structural glaucomatous progression after 4 years

“…Jimenez-Aragon et al found that the EDV and RI of the OA and CRA were significantly different between subjects who structurally progressed compared with those who did not progress 23. Additionally, Calvo et al reported that an OA RI value higher than 0.75 was associated with the development of glaucoma 22. In support of this reported finding, the OA mean RI was >0.75 in our patient population that progressed both functionally and structurally.…”

“…These findings are supported by previous studies where Calvo et al reported that OA EDV and mean velocity were reduced in subjects who converted to glaucoma based on Moorfields Regression Analysis 22. Jimenez-Aragon et al found that the EDV and RI of the OA and CRA were significantly different between subjects who structurally progressed compared with those who did not progress 23.…”

Reductions in Retrobulbar and Retinal Capillary Blood Flow Strongly Correlate With Changes in Optic Nerve Head and Retinal Morphology Over 4 Years in Open-angle Glaucoma Patients of African Descent Compared With Patients of European Descent

“…For instance, Calvo et al reported that OA EDV and mean velocities were reduced in subjects who converted to glaucoma based on Moorfields Regression Analysis. 54 Jimenez-Aragon et al . found that the EDV and RI of the OA and CRA were significantly different between subjects who structurally progressed compared to those who did not progress.…”

Enhanced depth imaging optical coherence tomography of the choroid in migraine patients: implications for the association of migraine and glaucoma

“…Thus, alterations in these structures may be associated with diseases of the optic nerve. In fact, decreased blood flow in the ophthalmic and posterior ciliary arteries was shown to be associated with glaucoma progression 25. Additionally, alterations in the ocular and systemic circulation have been demonstrated in patients with POAG and NTG 26.…”