title: The influence of retinal blood flow on open-angle glaucoma in patients with and without diabetes.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Ophthalmology, Indiana University School of Medicine, Indianapolis - USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Lee
authors.forename: Alon
authors.initials: A
authors.lastname: Harris
authors.forename: Brent
authors.initials: B
authors.lastname: Siesky
authors.forename: Tara
authors.initials: T
authors.lastname: Schaab
authors.forename: Nathaniel
authors.initials: N
authors.lastname: McIntyre
authors.forename: Leslie Abrams
authors.initials: LA
authors.lastname: Tobe
authors.forename: John
authors.initials: J
authors.lastname: Ling
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000098:blood supply*; D012039:Regional Blood Flow; D012160:Retina / Q000503:physiopathology; D012171:Retinal Vessels / Q000502:physiology*; D041623:Tomography, Optical Coherence