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Abstract #9803 Published in IGR 5-3
Pulsatile ocular blood flow in primary open-angle glaucoma and ocular hypertension
Kerr J; Nelson P; O'Brien CAmerican Journal of Ophthalmology 2003; 136: 1106-1113
PURPOSE: To compare pulsatile ocular blood flow measurements in untreated ocular hypertensive (OHT) subjects and primary open-angle glaucoma (POAG) patients. DESIGN: A prospective observational study in an institutional setting. METHODS: A total of 97 subjects were recruited to the study (50 ocular hypertensives, 24 glaucoma patients, and 23 normal subjects). 'High-risk' OHT had intraocular pressure (IOP) > 25 mmHg; 'low-risk' OHT had IOP ≤ 25 mmHg. Pulsatile ocular blood flow (POBF) measurements were made with a pneumotonometer in sitting, standing, and supine positions. IOP was measured with Goldmann tonometry. Twenty-six patients were started on topical treatment to reduce IOP, and the measurements were repeated at a review visit. RESULTS: Untreated POAG patients and high-risk OHT had reduced POBF (p < 0.001) and pulse volume (p < 0.001) compared with both normals and low-risk OHT. Females had higher POBF than males (p = 0.009, two-way analysis of variance). Subjects with pharmacologically lowered IOP had a significant increase in mean POBF (+80.9 μl/min, p = 0.02) and a significant reduction in mean arterial blood pressure (-11.0 mmHg, p = 0.003). Postural reduction in POBF (from sitting to supine) increased and became statistically significant in POAG and OHT subjects on treatment (p < 0.0001). CONCLUSIONS: High-risk ocular hypertensives have reduced POBF when compared with low-risk ocular hypertensives and normals and do not differ significantly from POAG patients. These findings support the clinical impression that ocular hypertensive subjects with IOP of over 25 mmHg should be monitored closely and may benefit from prophylactic treatment to lower IOP.
Dr. J. Kerr, Princess Alexandra Eye Pavilion, Edinburgh, Scotland, UK
Classification:
6.11 Bloodflow measurements (Part of: 6 Clinical examination methods)
