Ocular blood flow and systemic blood pressure in patients with primary open-angle glaucoma and ocular hypertension.
OBJECTIVE
There is evidence that altered optic nerve head (ONH) blood flow may play a role in the development and progression of glaucoma. In the present study, the baseline characteristics were examined in a study population participating in a clinical trial in which the ocular hemodynamic effects of timolol and dorzolamide were compared.


METHODS
One hundred forty patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT) were included in this trial and their baseline parameters compared with those of a group of 102 age-matched control subjects. Scanning laser Doppler flowmetry was used to measure blood flow in the temporal neuroretinal rim and the cup of the ONH. Pulsatile choroidal blood flow was assessed by laser interferometric measurement of fundus pulsation amplitude. In addition, hemodynamic parameters and mean arterial pressure were calculated in both groups.


RESULTS
All ocular hemodynamic parameters were significantly lower in the POAG/OHT group compared with the healthy control group (P < 0.001 each). In addition, a significant positive correlation between laser Doppler flowmetry readings and mean arterial pressure was observed in patients with glaucoma but not in healthy control subjects. Likewise, the correlation coefficient between fundus pulsation amplitude and mean arterial pressure was higher in patients with glaucoma than in healthy control subjects.


CONCLUSIONS
The present study indicates reduced ONH and choroidal blood flow and an abnormal association between blood pressure and ocular perfusion in patients with primary open-angle glaucoma or ocular hypertension, independent of topical antiglaucoma medication. Hence, vascular dysregulation appears to be an early manifestation in glaucoma that is not caused by pharmacologic intervention.
Departments of Clinical Pharmacology and. Ophthalmology, and the. Institute of Medical Physics, University of Vienna, Vienna, Austria.
Gabriele
G
Fuchsjäger-Mayrl
Beate
B
Wally
Michael
M
Georgopoulos
Georg
G
Rainer
Karl
K
Kircher
Wolf
W
Buehl
Tina
T
Amoako-Mensah
Hans-Georg
HG
Eichler
Clemens
C
Vass
Leopold
L
Schmetterer
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000502:physiology*; D002829:Choroid / Q000098:blood supply*; D002986:Clinical Trials as Topic; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy / Q000503:physiopathology; D009898:Optic Disk / Q000098:blood supply*; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D012189:Retrospective Studies; D013449:Sulfonamides / Q000627:therapeutic use; D013876:Thiophenes / Q000627:therapeutic use; D013999:Timolol / Q000627:therapeutic use; D014794:Visual Fields
D000959:Antihypertensive Agents; D013449:Sulfonamides; D013876:Thiophenes; D013999:Timolol; C062765:dorzolamide