title: Retinal blood flow in glaucomatous eyes with single-hemifield damage.
abstract: OBJECTIVE
  To examine the hypotheses that in glaucomatous eyes with single-hemifield damage, retinal blood flow (RBF) is significantly reduced in the retinal hemisphere corresponding with the abnormal visual hemifield and that there are significant associations among reduced retinal sensitivity (RS) in the abnormal hemifield, RBF, and structural measurements in the corresponding hemisphere.
  
  
  METHODS
  Prospective, nonrandomized, case-control study.
  
  
  METHODS
  Thirty eyes of 30 patients with glaucoma with visual field loss confined to a single hemifield and 27 eyes of 27 controls.
  
  
  METHODS
  Normal and glaucomatous eyes underwent spectral-domain optical coherence tomography (SD-OCT) and standard automated perimetry. Doppler SD-OCT with a double-circle scanning pattern was used to measure RBF. The RBF was derived from the recorded Doppler frequency shift and the measured angle between the beam and the vessel. Total and hemispheric RBF, retinal nerve fiber layer (RNFL), and ganglion cell complex (GCC) values were calculated. The RS values were converted to 1/Lambert. Analysis of variance and regression analyses were performed.
  
  
  METHODS
  Total and hemispheric RS, RBF, RNFL, and GCC values.
  
  
  RESULTS
  The total RBF (34.6±12.2 μl/minute) and venous cross-sectional area (0.039 ± 0.009 mm(2)) were reduced (P<0.001) in those with glaucoma compared with controls (46.5 ± 10.6 μl/minute; 0.052 ± 0.012 mm(2)). Mean RBF was reduced in the abnormal hemisphere compared with the opposite hemisphere (15.3 ± 5.4 vs. 19.3 ± 8.4 μl/minute; P = 0.004). The RNFL and GCC were thinner in the corresponding abnormal hemisphere compared with the opposite hemisphere (87.0 ± 20.2 vs. 103.7 ± 20.6 μm, P = 0.002; 77.6 ± 12.1 vs. 83.6 ± 10.1 μm, P = 0.04). The RBF was correlated with RNFL (r = 0.41; P = 0.02) and GCC (r = 0.43; P = 0.02) but not the RS (r = 0.31; P = 0.09) in the abnormal hemisphere. The RBF (19.3 ± 8.4 μl/minute), RNFL (103.7 ± 20.6 μm), and GCC (83.6 ± 10.1 μm) were reduced (P<0.05) in the hemisphere with apparently normal visual field in glaucomatous eyes compared with the mean hemispheric values of the normal eyes (23.2 ± 5.3 μl/minute, 124.8 ± 9.6 μm, and 96.1 ± 5.7 μm, respectively).
  
  
  CONCLUSIONS
  In glaucomatous eyes with single-hemifield damage, the RBF is significantly reduced in the hemisphere associated with the abnormal hemifield. Reduced RBF is associated with thinner RNFL and GCC in the corresponding abnormal hemisphere. Reduced RBF and RNFL and GCC loss also are observed in the perimetrically normal hemisphere of glaucomatous eyes.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida. Electronic address: msehi@med.miami.edu.
authors.forename: Mitra
authors.initials: M
authors.lastname: Sehi
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida.
authors.forename: Iman
authors.initials: I
authors.lastname: Goharian
authors.affiliation: Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Ranjith
authors.initials: R
authors.lastname: Konduru
authors.affiliation: Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.
authors.forename: Ou
authors.initials: O
authors.lastname: Tan
authors.affiliation: Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Sowmya
authors.initials: S
authors.lastname: Srinivas
authors.affiliation: Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Srinivas R
authors.initials: SR
authors.lastname: Sadda
authors.affiliation: Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Francis
authors.affiliation: Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.
authors.forename: David
authors.initials: D
authors.lastname: Huang
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida.
authors.forename: David S
authors.initials: DS
authors.lastname: Greenfield
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology*; D006423:Hemianopsia / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D011446:Prospective Studies; D012039:Regional Blood Flow; D012165:Retinal Ganglion Cells / Q000473:pathology; D012171:Retinal Vessels / Q000502:physiology*; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014786:Vision Disorders / Q000503:physiopathology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology