The Relationship Between Progression of Visual Field Defects and Retrobulbar Circulation in Patients with Glaucoma

Hesse, Richard J.

doi:10.1016/s0002-9394(14)70820-7

Cited by 174 publications

(116 citation statements)

References 20 publications

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“…In POAG and NTG patients, ONH and retinal tissue perfusion are chronically reduced, 7,8 and there is increasing evidence that reduced blood flow is directly associated with progression of visual field loss. 56 A significant correlation between ONH blood volume, as assessed by SLDF, and visual field loss in POAG was reported in a recent longitudinal study by Zink et al…”

Section: Eyementioning

confidence: 76%

The effects of dorzolamide 2% and dorzolamide/timolol fixed combination on retinal and optic nerve head blood flow in primary open-angle glaucoma patients

Rolle

Tofani

Brogliatti

et al. 2008

Eye

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Purpose To compare the effect of dorzolamide hydrochloride 2%, timolol maleate 0.5%, and their fixed combination on intraocular pressure (IOP) and retinal and optic nerve head haemodynamics in primary open-angle glaucoma patients. Methods Twenty-eight patients with early-moderate glaucomatous damage treated with b-blockers (46 months) with IOP values ranging from 18 to 22 mmHg at trough participated in this trial. After a 4-week washout period, patients were randomized in two groups: group I started with dorzolamide 2% monotherapy and group II with timolol 0.50% monotherapy for 4 weeks. After this period, both groups switched to dorzolamide/ timolol fixed combination for 4 weeks. IOP, ocular diastolic perfusion pressure (ODPP), heart rate, and Scanning Laser Doppler Flowmetry measurements at the peripapillary retina and neuroretinal rim were taken at T0 (enrolment), T1 (wash out), T2 (monotherapy), and T3 (dorzolamide/timolol). Data were compared between different study times. Statistical analysis was conducted using a paired t-test. Results Between T1 and T3, IOP decreased significantly in group I (À21.40%) (Po0.001) and in group II (À21.25%) (Po0.001). At the same time intervals, blood flow increased significantly at rim level for group I ( þ 30.03%) (Po0.05) and also when all patients were considered (rim þ 17.99%) (Po0.05). Between T1 and T3, we also observed a significant increase of ODPP in group I ( þ 7.24%) (Po0.01) and in group II ( þ 6.08%) (Po0.05) and when all patients were considered ( þ 8.43%) (Po0.01). Conclusions Dorzolamide/timolol fixed combination increased blood flow significantly at the neuroretinal rim showing a combination of hypotensive and haemodynamic effects.

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Section: Eyementioning

confidence: 76%

The effects of dorzolamide 2% and dorzolamide/timolol fixed combination on retinal and optic nerve head blood flow in primary open-angle glaucoma patients

Rolle

Tofani

Brogliatti

et al. 2008

Eye

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“…The CDI measurements were performed at the final visual field examination after a follow-up of 5 years. 35 36 found patients with progressive POAG to have EDV of the CRA inversely correlated to the rate of progression of the visual field MD. Martinez and Sanchez prospectively investigated the prognostic value of CDI of the OA and PCA in a 3-year follow-up study in POAG patients.…”

Section: Eyementioning

confidence: 99%

Performance of colour Doppler imaging discriminating normal tension glaucoma from healthy eyes

Plange

Kaup

Weber

et al. 2007

Eye

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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.

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“…In the optic nerve, evidence of decreased blood flow correlating with visual field damage has been reported in glaucoma patients. 40,41,[49][50][51][52] Many of these studies remain controversial, as the validity of the various hemodynamic measurement techniques remains under investigation, but the hypothesis that circulatory abnormalities are related to the development of GON is well supported by these clinical associations. However, as attractive as this hypothesis may be, ischemia has never actually been definitively demonstrated to cause, or even contribute to, GON.…”

Section: Glaucoma and Systemic Vascular Diseasementioning

confidence: 99%

“…105 Local defects in the circulation have also been found in regions of peripapillary atrophy (beta-zone atrophy), 106 and zones of nonperfusion have been demonstrated with fluorescein angiography. 52 Beta-zone peripapillary atrophy is associated with localized neuroretinal rim thinning (focal axonal loss) and progressive glaucomatous damage. In addition, even in normal human subjects, fluorescein filling rates are significantly different among the four quadrants of the optic disc.…”

Section: Regional Optic Nerve Damage In Glaucomamentioning

confidence: 99%

Ischemic model of optic nerve injury

Cioffi

2006

American Journal of Ophthalmology

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The Relationship Between Progression of Visual Field Defects and Retrobulbar Circulation in Patients with Glaucoma

Cited by 174 publications

References 20 publications

The effects of dorzolamide 2% and dorzolamide/timolol fixed combination on retinal and optic nerve head blood flow in primary open-angle glaucoma patients

The effects of dorzolamide 2% and dorzolamide/timolol fixed combination on retinal and optic nerve head blood flow in primary open-angle glaucoma patients

Performance of colour Doppler imaging discriminating normal tension glaucoma from healthy eyes

Ischemic model of optic nerve injury

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