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Abstract #6398 Published in IGR 3-2
Color Doppler imaging study of retrobulbar hemodynamics in chronic angle-closure glaucoma
Cheng CY; Liu CJ; Chiou HJ; Chou JC; Hsu WM; Liu JHOphthalmology 2001; 108: 1445-1451
PURPOSE: To evaluate the retrobulbar hemodynamics in patients with chronic angle-closure glaucoma (CACG) by using color Doppler imaging (CDI), and to correlate the degree of glaucomatous visual field loss with the hemodynamic parameters. DESIGN: A prospective case series. PARTICIPANTS AND CONTROLS: Twenty-six Chinese patients with CACG and 26 age-matched and gender-matched normal subjects were recruited. All CACG patients had a history of chronic intraocular pressure (IOP) elevation and asymmetric visual field defects between their fellow eyes. After receiving laser peripheral iridotomy and/or filtration surgery, they all had bilateral medication-free controlled IOP before enrolling in the study. METHODS: Each subject underwent CDI measurement in the central retinal artery (CRA) and the nasal and temporal short posterior ciliary arteries (PCA). Visual fields of the CACG patients were obtained with the Humphrey 24-4 program. The visual field defects were scored with the Advanced Glaucoma Intervention Study (AGIS) system. For each CACG patient, the eye with the lower AGIS score was defined as the better eye, and the eye with the higher score the worse eye. MAIN OUTCOME MEASURES: Peak-systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI), were determined. RESULTS: The EDV in the CRA and temporal PCA was significantly decreased (p = 0.041 and 0.023, respectively) in the worse eyes of CACG patients compared with those in the control eyes. The better eyes of CACG patients showed no significant change in hemodynamic parameters compared with the control eyes. When comparing the fellow eyes of CACG patients, the worse eyes had significantly lower EDV in the temporal PCA (p = 0.012) than the contralateral better eyes. In 11 CACG patients with a difference of at least 8 in AGIS visual field scores between their fellow eyes, the worse eyes had significantly lower EDV (p = 0.041) in the CRA, and lower PSV (p = 0.018) and EDV (p = 0.018) in the temporal PCA compared with those in the contralateral eyes. On multivariate regression analysis, the AGIS scores were significantly correlated with the PSV in the CRA (p = 0.015), and with the EDV (p < 0.001) and RI (p = 0.027) in the temporal PCA in patients with CACG. CONCLUSIONS: Patients with well-controlled CACG may have decreased retrobulbar blood flow velocity and increased vascular resistance in the CRA and temporal PCA. The degree of retrobulbar hemodynamic impairment was well correlated with the degree of glaucomatous visual field loss.
Dr C.J. Liu, Department of Ophthalmology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan
Classification:
6.11 Bloodflow measurements (Part of: 6 Clinical examination methods)
9.3.2 Chronic primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)