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Abstract #49153 Published in IGR 14-1
Impaired ocular blood flow regulation in patients with open angle glaucoma and diabetes
Shoshani Y; Harris A; Shoja MM; Arieli Y; Ehrlich R; Primus S; Ciulla T; Cantor A; Wirostko B; Siesky BAClinical and Experimental Ophthalmology 2012; 40: 697-705
BACKGROUND: To elucidate the potential impact of diabetes mellitus on primary open angle glaucoma (OAG) pathology through vascular deficiency. DESIGN: Cross section analysis from a longitudinal, prospective study. PARTICIPANTS: 84 OAG patients (20 diabetic OAG patients and 64 non-diabetic OAG patients) METHODS: Patients were analyzed for optic nerve head morphology and peripapillary retinal nerve fiber layer (RNFL)thickness, ocular perfusion pressure (OPP), retrobulbar blood flow and retinal capillary perfusion. Statistical analysis was performed by SPSS version 18.0. Comparisons between groups were made as well as multivariate linear regression analysis. A p value < 0.05 was considered statistically significant. Main outcome measure: Retrobulbar blood flow and the retinal microcirculation. RESULTS: Central retinal artery (CRA) peak systolic velocity (PSV) was 13.5% lower in diabetic patients (p=0.007). In diabetic OAG patients, OPP positively correlated with CRA and temporal posterior ciliary artery (TPCA) PSV (R=0.476, p=0.039 and R=0.529, p=0.02 respectively), and with CRA and nasal posterior ciliary artery resistance index (R=0.537, p=0.018 and R=0.566, p=0.012 respectively). Average RNFL positively correlated with CRA PSV and TPCA end diastolic velocity (EDV) (R=0.501, p=0.029 and R=0.553, p=0.019 respectively), and negatively correlated with superior and inferior retinal avascular space in the diabetic group (R=-0.498, p=0.030 and R=-0.700, p=0.001 respectively); no correlations were found in the non-diabetic group. Negative correlations between retrobulbar and retinal circulations were only found in the diabetic OAG patients, whereas positive correlations between retinal flow and non-flow were only found in non-diabetic OAG patients. CONCLUSION: Diabetes may interfere with normal vascular regulation and contribute to glaucoma progression. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.
Department of Ophthalmology, Indiana School of Medicine, Indianapolis, IN, USA.
Full articleClassification:
6.11 Bloodflow measurements (Part of: 6 Clinical examination methods)
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
