Altitudinal visual field asymmetry is coupled with altered retinal circulation in patients with normal pressure glaucoma

O. Arend, A. Remky, L. B. Cantor, A. Harris

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Aim - To compare the effect of altitudinal asymmetric glaucomatous damage on retinal microcirculation in patients with normal pressure glaucoma (NPG). Methods - In a prospective cross sectional study patients with NPG (washed out for antiglaucomatous therapy) and altitudinal asymmetric perimetric findings between the superior and inferior hemisphere (Humphrey 24-2) (n=18) were included and compared with 20 NPG patients with symmetrical field defects and 18 healthy subjects. Fluorescein angiograms were performed using a scanning laser ophthalmoscope. Using digital image analysis, arteriovenous passage time (AVP) and vessel diameters were assessed for comparison of corresponding affected and less affected temporal arcades. Results - Both affected and less affected hemispheres showed significantly prolonged AVP times (p<0.001) when compared with healthy subject data. In hemispheres with more severe glaucomatous field loss the AVP times were significantly (p=0.04) prolonged compared with the less affected hemisphere (AVP affected 3.1 (SD 7) seconds v AVP less affected 2.61 (1.4) seconds). There was no asymmetry effect on arterial and venous diameter measurements. Conclusion - Altitudinal visual field defects are linked together with circulatory deficits of the retinal tissue. The attenuated circulation seems to be a considerable factor in the natural course of glaucomatous optic neuropathy.

Original languageEnglish (US)
Pages (from-to)1008-1012
Number of pages5
JournalBritish Journal of Ophthalmology
Issue number9
StatePublished - 2000

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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