Baseline retrobulbar blood flow is associated with both functional and structural glaucomatous progression after 4 years.
Previous studies suggest that vascular abnormalities are involved in the pathogenesis of open-angle glaucoma. This study aims to examine the relationship of baseline retrobulbar blood flow measurements with functional and structural glaucomatous progression in patients with open-angle glaucoma over 4 years.



In this study, 112 patients with open-angle glaucoma were examined at baseline and 78 with retrobulbar blood flow assessments were followed to 4 years. Colour Doppler imaging was used to evaluate retrobulbar blood flow. Structural disease progression was examined with optical coherence tomography and Heidelberg Retinal Tomography III. Functional disease progression was monitored with automated perimetry using Humphrey visual fields. Mixed-model analysis of covariance was used to test for significance of changes from baseline to 4-year follow-up. Two-sample t tests and χ2tests were used to test for baseline blood flow differences between patients who progressed and those who did not progress.



Patients who progressed structurally had a statistically significant lower baseline mean ophthalmic artery peak systolic velocity (PSV) (p=0.024) and ophthalmic artery end diastolic velocity (EDV) (p=0.012) compared with those who did not progress. Similarly, a lower baseline mean ophthalmic artery PSV (p=0.031) and ophthalmic artery EDV (p=0.005) were associated with patients who progressed functionally compared with those who did not progress after 4 years.



In this study population, lower baseline ophthalmic artery blood flow velocities were associated with simultaneous structural and functional glaucoma progression after 4 years.
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Nicholas A
NA
Moore
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Alon
A
Harris
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Scott
S
Wentz
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Alice Chandra
AC
Verticchio Vercellin
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Priyanka
P
Parekh
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Joshua
J
Gross
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Rehan M
RM
Hussain
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Claudia
C
Thieme
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Brent
B
Siesky
D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D019842:Ciliary Arteries / Q000502:physiology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009880:Ophthalmic Artery / Q000502:physiology*; D012039:Regional Blood Flow / Q000502:physiology; D012161:Retinal Artery / Q000502:physiology*; D012165:Retinal Ganglion Cells / Q000473:pathology; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology
Glaucoma; Imaging; Optic Nerve; Physiology