The influence of retinal blood flow on open-angle glaucoma in patients with and without diabetes

Eric Lee, Alon Harris, Brent Siesky, Tara Schaab, Nathaniel Mcintyre, Leslie Abrams Tobe, John Ling

Research output: Contribution to journalArticle

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Abstract

Purpose: To evaluate the impact of retinal blood flow on optic nerve head (ONH) morphology in patients with open-angle glaucoma (OAG) with and without diabetes mellitus (DM). Methods: A total of 66 patients with OAG (14 with DM, 52 without DM) were assessed at baseline and 3-year follow-up for retinal capillary blood flow using confocal scanning laser Doppler and ocular structure using Heidelberg retinal tomography and optical coherence tomography. Results: Change in retinal tissue with zero blood flow in the superior and inferior retina was found to have a strong correlation with ONH changes in diabetic patients (r≥0.90, p≤0.03); however, no relation was found in the nondiabetic cohort. There were also significant changes in inferior mean flow that strongly correlated with changes in cup area (r = 0.97, p = 0.0029), cup/disc area ratio (r = 0.96, p = 0.0070), linear cup/disc ratio (r = 0.93, p = 0.0172), rim area (r = -0.97, p = 0.0036), and rim volume (r = -0.95, p = 0.0084) in diabetic patients only, while changes in the superior mean flow were only significantly associated with cup area (r = -0.30, p = 0.0498), cup volume (r = -0.36, p = 0.0178), and rim volume (r = 0.35, p = 0.0193) in nondiabetic patients. Conclusions: In this cohort of patients with OAG, changes in retinal capillary blood flow correlated more strongly with changes in ONH morphology in patients with DM than in those without DM. These data suggest that changes in retinal blood flow may play a larger role in glaucomatous ONH progression in patients with OAG with DM.

Original languageEnglish
Pages (from-to)542-549
Number of pages8
JournalEuropean Journal of Ophthalmology
Volume24
Issue number4
DOIs
StatePublished - Dec 20 2013

Fingerprint

Open Angle Glaucoma
Diabetes Mellitus
Optic Disk
Optical Coherence Tomography
Retina
Lasers
Tomography

Keywords

  • Blood flow
  • Comorbidity
  • Diabetes
  • Glaucoma

ASJC Scopus subject areas

  • Ophthalmology

Cite this

The influence of retinal blood flow on open-angle glaucoma in patients with and without diabetes. / Lee, Eric; Harris, Alon; Siesky, Brent; Schaab, Tara; Mcintyre, Nathaniel; Tobe, Leslie Abrams; Ling, John.

In: European Journal of Ophthalmology, Vol. 24, No. 4, 20.12.2013, p. 542-549.

Research output: Contribution to journalArticle

Lee, Eric ; Harris, Alon ; Siesky, Brent ; Schaab, Tara ; Mcintyre, Nathaniel ; Tobe, Leslie Abrams ; Ling, John. / The influence of retinal blood flow on open-angle glaucoma in patients with and without diabetes. In: European Journal of Ophthalmology. 2013 ; Vol. 24, No. 4. pp. 542-549.
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N2 - Purpose: To evaluate the impact of retinal blood flow on optic nerve head (ONH) morphology in patients with open-angle glaucoma (OAG) with and without diabetes mellitus (DM). Methods: A total of 66 patients with OAG (14 with DM, 52 without DM) were assessed at baseline and 3-year follow-up for retinal capillary blood flow using confocal scanning laser Doppler and ocular structure using Heidelberg retinal tomography and optical coherence tomography. Results: Change in retinal tissue with zero blood flow in the superior and inferior retina was found to have a strong correlation with ONH changes in diabetic patients (r≥0.90, p≤0.03); however, no relation was found in the nondiabetic cohort. There were also significant changes in inferior mean flow that strongly correlated with changes in cup area (r = 0.97, p = 0.0029), cup/disc area ratio (r = 0.96, p = 0.0070), linear cup/disc ratio (r = 0.93, p = 0.0172), rim area (r = -0.97, p = 0.0036), and rim volume (r = -0.95, p = 0.0084) in diabetic patients only, while changes in the superior mean flow were only significantly associated with cup area (r = -0.30, p = 0.0498), cup volume (r = -0.36, p = 0.0178), and rim volume (r = 0.35, p = 0.0193) in nondiabetic patients. Conclusions: In this cohort of patients with OAG, changes in retinal capillary blood flow correlated more strongly with changes in ONH morphology in patients with DM than in those without DM. These data suggest that changes in retinal blood flow may play a larger role in glaucomatous ONH progression in patients with OAG with DM.

AB - Purpose: To evaluate the impact of retinal blood flow on optic nerve head (ONH) morphology in patients with open-angle glaucoma (OAG) with and without diabetes mellitus (DM). Methods: A total of 66 patients with OAG (14 with DM, 52 without DM) were assessed at baseline and 3-year follow-up for retinal capillary blood flow using confocal scanning laser Doppler and ocular structure using Heidelberg retinal tomography and optical coherence tomography. Results: Change in retinal tissue with zero blood flow in the superior and inferior retina was found to have a strong correlation with ONH changes in diabetic patients (r≥0.90, p≤0.03); however, no relation was found in the nondiabetic cohort. There were also significant changes in inferior mean flow that strongly correlated with changes in cup area (r = 0.97, p = 0.0029), cup/disc area ratio (r = 0.96, p = 0.0070), linear cup/disc ratio (r = 0.93, p = 0.0172), rim area (r = -0.97, p = 0.0036), and rim volume (r = -0.95, p = 0.0084) in diabetic patients only, while changes in the superior mean flow were only significantly associated with cup area (r = -0.30, p = 0.0498), cup volume (r = -0.36, p = 0.0178), and rim volume (r = 0.35, p = 0.0193) in nondiabetic patients. Conclusions: In this cohort of patients with OAG, changes in retinal capillary blood flow correlated more strongly with changes in ONH morphology in patients with DM than in those without DM. These data suggest that changes in retinal blood flow may play a larger role in glaucomatous ONH progression in patients with OAG with DM.

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KW - Comorbidity

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