Diagnostic compatibility of structural and haemodynamic parameters in open-angle glaucoma patients

Ingrida Janulevičiene, Ieva Sliesoraityte, Brent Siesky, Alon Harris

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Purpose: Current evidence indicates that alteration in ocular blood flow may be relevant in open-angle glaucoma (OAG) patients independent of intraocular pressure (IOP). Presently, the lack of an adequate methodology capable of assessing all vascular beds limits the clinical role of blood flow parameters in glaucoma management. We aimed to compare differences in retinal nerve fibre layer (RNFL) thickness and retrobulbar haemodynamics between OAG patients and healthy age-matched control subjects. Methods: Sixty eyes of 30 OAG patients and 30 healthy age-matched controls were enrolled into the prospective, randomized study. Retinal nerve fibre layer thickness was analysed by scanning laser polarimetry (SLP). Standard SLP parameters were determined, including: average temporal, superior, nasal, inferior thickness (TSNIT); superior and inferior averages; TSNIT standard deviation (TSNIT-SD), and nerve fibre indicator (NFI). Retrobulbar haemodynamics were assessed using colour Doppler imaging (CDI). Peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI) and resistivity index (RI) in the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary artery (SPCA) were evaluated. Results: The RNFL in OAG patients was statistically significantly thinner compared with that in age-matched controls: the NFI was 24.9 ± 10.24 in OAG patients and 16.13 ± 7.95 in healthy controls (p < 0.05). Statistically significant differences were observed: CRA PSV was 20.54 ± 7.84 cm/second in OAG subjects and 16.5 ± 6.19 cm/second in healthy controls (p = 0.0038); OA EDV was 8.99 ± 4.71 cm/second in OAG subjects and 5.93 ± 3.23 cm/second in healthy controls (p = 0.0048). Correlation analysis of NFI was in positive association with CRA EDV (r = 0.395; p < 0.05) and CRA PI (r = 0.403; p < 0.05) in OAG subjects, but no statistically significant association was seen in healthy controls. Conclusion: Statistically significant thinning of the RNFL in association with reduced retrobulbar blood flow velocities was observed in OAG patients. Combining ocular structural alterations with ocular circulation assessment may increase our ability to elucidate potential IOP-independent glaucomatous risk factors.

Original languageEnglish
Pages (from-to)552-557
Number of pages6
JournalActa Ophthalmologica
Volume86
Issue number5
DOIs
StatePublished - Aug 2008

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Open Angle Glaucoma
Nerve Fibers
Hemodynamics
Retinal Artery
Scanning Laser Polarimetry
Ophthalmic Artery
Intraocular Pressure
Nose
Ciliary Arteries
Blood Flow Velocity
Glaucoma
Blood Vessels
Color
Prospective Studies

Keywords

  • Nerve fibre layer thickness
  • Ocular blood flow
  • Open-angle glaucoma

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Diagnostic compatibility of structural and haemodynamic parameters in open-angle glaucoma patients. / Janulevičiene, Ingrida; Sliesoraityte, Ieva; Siesky, Brent; Harris, Alon.

In: Acta Ophthalmologica, Vol. 86, No. 5, 08.2008, p. 552-557.

Research output: Contribution to journalArticle

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abstract = "Purpose: Current evidence indicates that alteration in ocular blood flow may be relevant in open-angle glaucoma (OAG) patients independent of intraocular pressure (IOP). Presently, the lack of an adequate methodology capable of assessing all vascular beds limits the clinical role of blood flow parameters in glaucoma management. We aimed to compare differences in retinal nerve fibre layer (RNFL) thickness and retrobulbar haemodynamics between OAG patients and healthy age-matched control subjects. Methods: Sixty eyes of 30 OAG patients and 30 healthy age-matched controls were enrolled into the prospective, randomized study. Retinal nerve fibre layer thickness was analysed by scanning laser polarimetry (SLP). Standard SLP parameters were determined, including: average temporal, superior, nasal, inferior thickness (TSNIT); superior and inferior averages; TSNIT standard deviation (TSNIT-SD), and nerve fibre indicator (NFI). Retrobulbar haemodynamics were assessed using colour Doppler imaging (CDI). Peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI) and resistivity index (RI) in the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary artery (SPCA) were evaluated. Results: The RNFL in OAG patients was statistically significantly thinner compared with that in age-matched controls: the NFI was 24.9 ± 10.24 in OAG patients and 16.13 ± 7.95 in healthy controls (p < 0.05). Statistically significant differences were observed: CRA PSV was 20.54 ± 7.84 cm/second in OAG subjects and 16.5 ± 6.19 cm/second in healthy controls (p = 0.0038); OA EDV was 8.99 ± 4.71 cm/second in OAG subjects and 5.93 ± 3.23 cm/second in healthy controls (p = 0.0048). Correlation analysis of NFI was in positive association with CRA EDV (r = 0.395; p < 0.05) and CRA PI (r = 0.403; p < 0.05) in OAG subjects, but no statistically significant association was seen in healthy controls. Conclusion: Statistically significant thinning of the RNFL in association with reduced retrobulbar blood flow velocities was observed in OAG patients. Combining ocular structural alterations with ocular circulation assessment may increase our ability to elucidate potential IOP-independent glaucomatous risk factors.",
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AU - Sliesoraityte, Ieva

AU - Siesky, Brent

AU - Harris, Alon

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N2 - Purpose: Current evidence indicates that alteration in ocular blood flow may be relevant in open-angle glaucoma (OAG) patients independent of intraocular pressure (IOP). Presently, the lack of an adequate methodology capable of assessing all vascular beds limits the clinical role of blood flow parameters in glaucoma management. We aimed to compare differences in retinal nerve fibre layer (RNFL) thickness and retrobulbar haemodynamics between OAG patients and healthy age-matched control subjects. Methods: Sixty eyes of 30 OAG patients and 30 healthy age-matched controls were enrolled into the prospective, randomized study. Retinal nerve fibre layer thickness was analysed by scanning laser polarimetry (SLP). Standard SLP parameters were determined, including: average temporal, superior, nasal, inferior thickness (TSNIT); superior and inferior averages; TSNIT standard deviation (TSNIT-SD), and nerve fibre indicator (NFI). Retrobulbar haemodynamics were assessed using colour Doppler imaging (CDI). Peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI) and resistivity index (RI) in the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary artery (SPCA) were evaluated. Results: The RNFL in OAG patients was statistically significantly thinner compared with that in age-matched controls: the NFI was 24.9 ± 10.24 in OAG patients and 16.13 ± 7.95 in healthy controls (p < 0.05). Statistically significant differences were observed: CRA PSV was 20.54 ± 7.84 cm/second in OAG subjects and 16.5 ± 6.19 cm/second in healthy controls (p = 0.0038); OA EDV was 8.99 ± 4.71 cm/second in OAG subjects and 5.93 ± 3.23 cm/second in healthy controls (p = 0.0048). Correlation analysis of NFI was in positive association with CRA EDV (r = 0.395; p < 0.05) and CRA PI (r = 0.403; p < 0.05) in OAG subjects, but no statistically significant association was seen in healthy controls. Conclusion: Statistically significant thinning of the RNFL in association with reduced retrobulbar blood flow velocities was observed in OAG patients. Combining ocular structural alterations with ocular circulation assessment may increase our ability to elucidate potential IOP-independent glaucomatous risk factors.

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KW - Nerve fibre layer thickness

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