Color Doppler imaging discloses reduced ocular blood flow velocities in nonexudative age-related macular degeneration

Thomas A. Ciulla, Alon Harris, Hak S. Chung, Ronald P. Danis, Larry Kagemann, Lissa McNulty, Linda M. Pratt, Bruce J. Martin

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Abstract

PURPOSE: To study ocular perfusion defects in age-related macular degeneration. METHODS: Twenty-five subjects with nonexudative age-related macular degeneration were compared with 25 age-matched control subjects in studies of flow velocities in several retrobulbar vessels. Color Doppler imaging, which was performed by an examiner who was masked to the subjects' assignment to the control or age-related macular degeneration group, measured peak systolic and end diastolic velocity in the ophthalmic, central retinal, and nasal and temporal posterior ciliary arteries of one eye. A resistive index was calculated from the peak systolic and end diastolic velocity. RESULTS: Subjects with nonexudative age-related macular degeneration showed a consistent trend toward lower peak systolic and end-diastolic velocities in the posterior ciliary arteries. For example, in the nasal posterior ciliary artery, the mean end diastolic velocity measured 1.45 ± 0.34 cm per sec in the age-related macular degeneration group compared with 1.96 ± 0.66 cm per sec in the control group, yielding a 26% decrease in the age-related macular degeneration group, which represented the largest difference and was highly statistically significant (P = .0012). The resistive index was not significantly altered in the nasal or temporal posterior ciliary artery. Subjects with nonexudative age-related macular degeneration did not differ from control subjects in peak systolic velocity, end diastolic velocity, or resistive index in the ophthalmic artery. In the central retinal artery, the end diastolic velocity was lower (1.37 ± 1.95 cm per sec vs 1.95 ± 0.66 cm per sec), whereas the resistive index was higher (0.83 ± 0.05 vs 0.76 ± 0.06 cm per sec), in the age-related macular degeneration group; these results were highly statistically significant (P = .0007 and P < .0001, respectively). CONCLUSIONS: Retrobulbar vascular changes in non-exudative age-related macular degeneration subjects include reduced flow velocities in the nasal and temporal posterior ciliary arteries. The reduced peak systolic velocity, combined with the reduced end diastolic velocity at a constant resistive index, seen in nonexudative age-related macular degeneration, is consistent with reduced bulk flow in these vessels, suggesting that choroidal perfusion is abnormal in this form of age-related macular degeneration. The changes in the central retinal artery suggest there may be a more generalized perfusion abnormality beyond the choroid in patients with age-related macular degeneration or that the central retinal artery exhibits a secondary autoregulatory response to a primary change elsewhere.

Original languageEnglish
Pages (from-to)75-80
Number of pages6
JournalAmerican Journal of Ophthalmology
Volume128
Issue number1
DOIs
StatePublished - Jul 1999

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Blood Flow Velocity
Macular Degeneration
Color
Ciliary Arteries
Retinal Artery
Nose
Perfusion
Ophthalmic Artery
Choroid
Blood Vessels

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Color Doppler imaging discloses reduced ocular blood flow velocities in nonexudative age-related macular degeneration. / Ciulla, Thomas A.; Harris, Alon; Chung, Hak S.; Danis, Ronald P.; Kagemann, Larry; McNulty, Lissa; Pratt, Linda M.; Martin, Bruce J.

In: American Journal of Ophthalmology, Vol. 128, No. 1, 07.1999, p. 75-80.

Research output: Contribution to journalArticle

Ciulla, Thomas A. ; Harris, Alon ; Chung, Hak S. ; Danis, Ronald P. ; Kagemann, Larry ; McNulty, Lissa ; Pratt, Linda M. ; Martin, Bruce J. / Color Doppler imaging discloses reduced ocular blood flow velocities in nonexudative age-related macular degeneration. In: American Journal of Ophthalmology. 1999 ; Vol. 128, No. 1. pp. 75-80.
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T1 - Color Doppler imaging discloses reduced ocular blood flow velocities in nonexudative age-related macular degeneration

AU - Ciulla, Thomas A.

AU - Harris, Alon

AU - Chung, Hak S.

AU - Danis, Ronald P.

AU - Kagemann, Larry

AU - McNulty, Lissa

AU - Pratt, Linda M.

AU - Martin, Bruce J.

PY - 1999/7

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N2 - PURPOSE: To study ocular perfusion defects in age-related macular degeneration. METHODS: Twenty-five subjects with nonexudative age-related macular degeneration were compared with 25 age-matched control subjects in studies of flow velocities in several retrobulbar vessels. Color Doppler imaging, which was performed by an examiner who was masked to the subjects' assignment to the control or age-related macular degeneration group, measured peak systolic and end diastolic velocity in the ophthalmic, central retinal, and nasal and temporal posterior ciliary arteries of one eye. A resistive index was calculated from the peak systolic and end diastolic velocity. RESULTS: Subjects with nonexudative age-related macular degeneration showed a consistent trend toward lower peak systolic and end-diastolic velocities in the posterior ciliary arteries. For example, in the nasal posterior ciliary artery, the mean end diastolic velocity measured 1.45 ± 0.34 cm per sec in the age-related macular degeneration group compared with 1.96 ± 0.66 cm per sec in the control group, yielding a 26% decrease in the age-related macular degeneration group, which represented the largest difference and was highly statistically significant (P = .0012). The resistive index was not significantly altered in the nasal or temporal posterior ciliary artery. Subjects with nonexudative age-related macular degeneration did not differ from control subjects in peak systolic velocity, end diastolic velocity, or resistive index in the ophthalmic artery. In the central retinal artery, the end diastolic velocity was lower (1.37 ± 1.95 cm per sec vs 1.95 ± 0.66 cm per sec), whereas the resistive index was higher (0.83 ± 0.05 vs 0.76 ± 0.06 cm per sec), in the age-related macular degeneration group; these results were highly statistically significant (P = .0007 and P < .0001, respectively). CONCLUSIONS: Retrobulbar vascular changes in non-exudative age-related macular degeneration subjects include reduced flow velocities in the nasal and temporal posterior ciliary arteries. The reduced peak systolic velocity, combined with the reduced end diastolic velocity at a constant resistive index, seen in nonexudative age-related macular degeneration, is consistent with reduced bulk flow in these vessels, suggesting that choroidal perfusion is abnormal in this form of age-related macular degeneration. The changes in the central retinal artery suggest there may be a more generalized perfusion abnormality beyond the choroid in patients with age-related macular degeneration or that the central retinal artery exhibits a secondary autoregulatory response to a primary change elsewhere.

AB - PURPOSE: To study ocular perfusion defects in age-related macular degeneration. METHODS: Twenty-five subjects with nonexudative age-related macular degeneration were compared with 25 age-matched control subjects in studies of flow velocities in several retrobulbar vessels. Color Doppler imaging, which was performed by an examiner who was masked to the subjects' assignment to the control or age-related macular degeneration group, measured peak systolic and end diastolic velocity in the ophthalmic, central retinal, and nasal and temporal posterior ciliary arteries of one eye. A resistive index was calculated from the peak systolic and end diastolic velocity. RESULTS: Subjects with nonexudative age-related macular degeneration showed a consistent trend toward lower peak systolic and end-diastolic velocities in the posterior ciliary arteries. For example, in the nasal posterior ciliary artery, the mean end diastolic velocity measured 1.45 ± 0.34 cm per sec in the age-related macular degeneration group compared with 1.96 ± 0.66 cm per sec in the control group, yielding a 26% decrease in the age-related macular degeneration group, which represented the largest difference and was highly statistically significant (P = .0012). The resistive index was not significantly altered in the nasal or temporal posterior ciliary artery. Subjects with nonexudative age-related macular degeneration did not differ from control subjects in peak systolic velocity, end diastolic velocity, or resistive index in the ophthalmic artery. In the central retinal artery, the end diastolic velocity was lower (1.37 ± 1.95 cm per sec vs 1.95 ± 0.66 cm per sec), whereas the resistive index was higher (0.83 ± 0.05 vs 0.76 ± 0.06 cm per sec), in the age-related macular degeneration group; these results were highly statistically significant (P = .0007 and P < .0001, respectively). CONCLUSIONS: Retrobulbar vascular changes in non-exudative age-related macular degeneration subjects include reduced flow velocities in the nasal and temporal posterior ciliary arteries. The reduced peak systolic velocity, combined with the reduced end diastolic velocity at a constant resistive index, seen in nonexudative age-related macular degeneration, is consistent with reduced bulk flow in these vessels, suggesting that choroidal perfusion is abnormal in this form of age-related macular degeneration. The changes in the central retinal artery suggest there may be a more generalized perfusion abnormality beyond the choroid in patients with age-related macular degeneration or that the central retinal artery exhibits a secondary autoregulatory response to a primary change elsewhere.

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