Relationship of cerebral blood flow and central visual function in primary open-angle glaucoma.
OBJECTIVE
To investigate the relations between middle cerebral artery (MCA) blood flow velocities and central visual function measured by foveal cone electroretinograms (ERG) and visual field.


METHODS
Fifteen primary open-angle glaucoma patients were recruited. The eye with the more severe visual field defect (full threshold 24-2) and/or optic disc damage was chosen. Measurements included brachial arterial pressure, heart rate, visual acuity (logMAR), contrast sensitivity (CSV-1000), central visual field (Humphrey SITA 10-2), foveal cone ERG, and transcranial Doppler. Pearson correlation coefficients were estimated to assess the strength of the linear relationship between the MCA flow velocity and the other measured parameters.


RESULTS
Visual field was successfully completed in 12 eyes. We were unable to obtain ERG responses and MCA velocity readings for 1 patient. A significant correlation was observed between MCA mean flow velocity and focal cone ERG amplitude [r=0.69, n=13, confidence interval (CI) 0.22, 0.90, P=0.009], but correlation between mean foveal cone ERG implicit time and middle cerebral was not statistically significant (r=0.011, n=13, CI 0.47, 0.63). A significant correlation was also observed between MCA mean flow velocity and mean sensitivity (r=0.76, n=12, CI 0.32, 0.93, P=0.005), and mean defect (r=0.73, n=12, CI 0.28, 0.92, P=0.007) of the central visual field, logMAR visual acuity (r=0.57, n=14, CI 0.05, 0.84, P=0.036), and contrast sensitivity (r=0.61, n=13, CI 0.09, 0.87, P=0.027).


CONCLUSIONS
Our findings suggest that in certain primary open-angle glaucoma patients diminished central visual function may be one manifestation of widespread cerebrovascular insufficiency.
Harris
Alon
A
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN 46202, USA. alharris@indiana.edu
Siesky
Brent
B
Zarfati
Drora
D
Haine
Charles L
CL
Catoira
Yara
Y
Sines
Daniel T
DT
McCranor
Lynne
L
Garzozi
Hanna J
HJ
D001783:Blood Flow Velocity; D001794:Blood Pressure; D001921:Brain / Q000098:blood supply*; D002536:Cerebral Arteries / Q000502:physiology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D015350:Contrast Sensitivity / Q000502:physiology; D004596:Electroretinography; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007429:Intraocular Pressure; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000503:physiopathology; D012160:Retina / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology*; D014794:Visual Fields / Q000502:physiology*