Relationship Between 24-Hour Mean Ocular Perfusion Pressure Fluctuation and Rate of Paracentral Visual Field Progression in Normal-Tension Glaucoma

Choi, Jaewan; Lee, Jong Rak; Lee, Youngrok; Lee, Kyoung Sub; Na, Jung Hwa; Han, Seungbong; Kook, Michael S.

doi:10.1167/iovs.13-12093

Cited by 51 publications

(54 citation statements)

References 36 publications

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“…76 We found that ganglion cell complex thickness in the papillomacular bundle was significantly associated with central visual function, as measured by best-corrected visual acuity and the central 4 measurement points of the Humphrey field analyzer. 77 We also found that blood flow on the temporal side of the ONH was highly associated with ganglion cell complex thickness.…”

Section: Macular Function and Obf In Glaucomamentioning

confidence: 68%

Ocular Blood Flow and Influencing Factors for Glaucoma

Nakazawa

2016

Asia-Pacific Journal of Ophthalmology

102

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Open-angle glaucoma (OAG) is characterized by optic nerve fiber atrophy and deterioration of the visual field, corresponding to damage to the optic nerve head. Intraocular pressure (IOP) is currently the only evidence-based, treatable risk factor for OAG. However, normal-tension glaucoma, the most common type of OAG in Asia, is a type of glaucoma with an unclear pathogenesis. Glaucoma is suspected to be a multifactorial disease with IOP-dependent and IOP-independent risk factors, including decreased ocular blood flow (OBF), oxidative stress, decreased axoplasmic flow, and genetic background. A number of epidemiological studies have generated strong evidence that OBF may be an especially important risk factor for the progression of glaucoma. Recent innovations in laser speckle flowgraphy and optical coherence tomography-based angiography have allowed us to noninvasively monitor changes in the microcirculation of the optic nerve head with high reproducibility. Laser speckle flowgraphy-derived measurement parameters include mean blur rate and pulse wave form parameters, whereas the main optical coherence tomography angiography-derived parameter is the vessel index. Decreases in these parameters are associated with the severity of glaucomatous damage, and changes are detectible even in the earliest, preperimetric stage of glaucoma. In the future, OBF analysis may improve significantly because of continuing progress in the development of the relevant instruments. This review will summarize possible connections between systemic and OBF abnormalities and OAG, describe the scientific rationale for these connections, and discuss their potential implications. Thus, this review will summarize the role of OBF in glaucoma pathogenesis and discuss the wide range of IOP-independent risk factors.

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Section: Macular Function and Obf In Glaucomamentioning

confidence: 68%

Ocular Blood Flow and Influencing Factors for Glaucoma

Nakazawa

2016

Asia-Pacific Journal of Ophthalmology

102

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“…38 In brief, the OAG patients were classified into two groups based on PD probability maps of SITA 24-2 VF testing. The CVFD group included patients with clusters of three significant points, with a probability of less than 5%, or two or more test points with a probability of less than 1% or smaller, on a PD probability map within the superior or inferior hemifield of the central 108 regardless of the presence of VF defects outside the central 108 (Fig.…”

Section: Classification Into Cvfd and Pvfd Groupsmentioning

confidence: 99%

Alterations of the Foveal Avascular Zone Measured by Optical Coherence Tomography Angiography in Glaucoma Patients With Central Visual Field Defects

Kwon

Choi²,

Shin

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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Citation: Kwon J, Choi J, Shin JW, Lee J, Kook MS. Alterations of the foveal avascular zone measured by optical coherence tomography angiography in glaucoma patients with central visual field defects. Invest Ophthalmol Vis Sci. 2017;58:163758: -164558: . DOI: 10.1167 PURPOSE. To investigate whether the area and shape of the foveal avascular zone (FAZ) as assessed by optical coherence tomography angiography (OCTA) are altered in glaucomatous eyes with central visual field defects (CVFDs). METHODS.A total of 78 patients with open-angle glaucoma with central or peripheral visual field defects (PVFDs) confined to a single hemifield were studied retrospectively. Foveal avascular zone area and circularity were measured using OCTA images from the superficial retinal layer. Central retinal visual field (VF) sensitivity using Swedish Interactive Threshold Algorithm 24-2 VF and macular ganglion cell-inner plexiform layer (mGCIPL) thickness were measured. The FAZ area between VF-affected hemimacular segments and VF-unaffected hemimacular segments in eyes with CVFDs and matched hemimacular segments of eyes with PVFDs were compared. Factors associated with the presence and severity of CVFD at initial presentation were determined. RESULTS.Eyes with CVFDs showed a significantly larger FAZ area, lower FAZ circularity, and lower mGCIPL thickness than the PVFD group. The mean hemi-FAZ area of VF-affected hemimaculas in eyes with CVFDs was significantly larger than that of the PVFD group (0.256 6 0.07 mm 2 vs. 0.184 6 0.07 mm 2 ) and the VF-unaffected hemimaculas of the CVFD group (0.179 6 0.06 mm 2 ; P < 0.05). Age, mean deviation, mGCIPL thickness, FAZ area, and circularity were associated with CVFDs (P < 0.05).CONCLUSIONS. Microcirculatory alterations in the perifovea are spatially correlated with central VF loss. Loss of FAZ circularity was significantly associated with presence of CVFD, whereas FAZ area was significantly associated with severity of CVFD.Keywords: foveal avascular zone, central visual field defects, optical coherence tomography angiography G laucoma is a leading cause of irreversible blindness and is characterized by progressive retinal ganglion cell (RGC) death and axonal loss.1,2 Ocular blood flow (OBF) impairment and/or abnormal microcirculation along with elevated IOP may play an important role in glaucoma, particularly in normaltension glaucoma (NTG) [3][4][5][6][7] ; however, the exact pathogenesis of glaucoma is still unknown. To assess the vascular integrity of OBF, different types of imaging modalities have been introduced, including fluorescein angiography (FA), Heidelberg retina flowmeter, and color Doppler. Although FA remains the gold standard for detecting vascular pathology in the retina, it is invasive and requires exposure to an exogenous contrast agent. Moreover, the axial and lateral resolution of FA allows for limited visualization of capillaries, especially in macula in which there are overlapping capillary networks. 8 Recently, noninvasive retinal microvascular imaging has become availab...

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“…One factor influencing this process is the ocular perfusion pressure (OPP) [13–17]. OPP is the difference between systemic blood pressure and the RVP.…”

Section: Introductionmentioning

confidence: 99%

The effect of flammer-syndrome on retinal venous pressure

2014

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BackgroundThe purpose of the study was to measure the retinal venous pressure (RVP) in the eyes of primary open-angle glaucoma (POAG) patients and healthy subjects with and without a Flammer-Syndrome (FS).MethodsRVP was measured in the following four groups of patients and age- and sex-matched healthy controls: (a) 15 patients with a POAG and a FS (POAG/FS+); (b) 15 patients with a POAG but without a FS (POAG/FS-); (c) 14 healthy subjects with a FS (healthy/FS+) and (d) 16 healthy subjects without a FS (healthy/FS-). RVP was measured in all participants bilaterally by means of contact lens ophthalmodynamometry. Ophthalmodynamometry is done by applying increasing pressure on the eye via a contact lens. The minimum force required to induce a venous pulsation is called ophthalmodynamometric force (ODF). The RVP is defined and calculated as the sum of ODF and intraocular pressure (IOP) [RVP = ODF + IOP].ResultsThe participants with a FS (whether patients with POAG or healthy subjects), had a significantly higher RVP compared to subjects without a FS (p = 0.0103). Patients with a POAG and FS (POAG/FS+) had a significantly higher RVP compared to patients without a FS (POAG/FS-) (p = 0.0301). There was a notable trend for a higher RVP in the healthy/FS + group compared to the healthy/FS - group, which did not reach statistical significance (p = 0.0898).ConclusionsRVP is higher in subjects with a FS, particularly in glaucoma patients. The causal relationship needs to be further evaluated.

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Relationship Between 24-Hour Mean Ocular Perfusion Pressure Fluctuation and Rate of Paracentral Visual Field Progression in Normal-Tension Glaucoma

Abstract: Medically treated NTG eyes with greater 24-hour MOPP fluctuations (HMF) had faster PVF defect progression than eyes with stable 24-hour MOPP (LMF). Twenty-four hour MOPP fluctuation associated significantly with PVF progression velocity.

Cited by 51 publications

References 36 publications

Ocular Blood Flow and Influencing Factors for Glaucoma

Ocular Blood Flow and Influencing Factors for Glaucoma

Alterations of the Foveal Avascular Zone Measured by Optical Coherence Tomography Angiography in Glaucoma Patients With Central Visual Field Defects

The effect of flammer-syndrome on retinal venous pressure

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