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Vascular concepts in glaucoma.

H C Geijssen1, E L Greve

  • 1Academic Medical Center, University of Amsterdam, Glaucoma Center, The Netherlands.

Current Opinion in Ophthalmology
|March 9, 1995
PubMed
Summary

Vascular risk factors are linked to normal-tension glaucoma (NTG) progression. Quantitative blood flow measurements reveal deficient ocular circulation in over 50% of NTG patients, supporting a vascular cause.

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Area of Science:

  • Ophthalmology
  • Vascular Biology
  • Medical Diagnostics

Background:

  • Normal-tension glaucoma (NTG) is associated with vascular risk factors.
  • Traditionally, these factors were assessed qualitatively.
  • A shift towards quantitative methods is occurring for better assessment.

Purpose of the Study:

  • To investigate the relationship between vascular risk factors and NTG visual field progression.
  • To explore the utility of emerging quantitative methods in understanding NTG pathogenesis.
  • To determine the prevalence of deficient ocular blood flow in NTG patients.

Main Methods:

  • Qualitative assessment of factors like disc hemorrhages and vasospasms.
  • Introduction of quantitative techniques: pulsatile ocular blood flow (POBF), scanning laser angiography of the peripapillary choroid (SLAPPC), scanning laser angiography of the retinal circulation (SLARC), and scanning laser Doppler flowmetry (SLDF).
  • Application of POBF, SLAPPC, SLARC, and SLDF to NTG patients.

Main Results:

  • Deficient ocular blood flow was identified in at least 50% of NTG patients using quantitative methods.
  • These findings correlate vascular factors with NTG.
  • Emerging quantitative techniques provide objective measures of ocular hemodynamics.

Conclusions:

  • Quantitative methods strongly support a vascular pathogenesis for normal-tension glaucoma.
  • Deficient ocular blood flow is a significant finding in a majority of NTG patients.
  • This research highlights the importance of vascular assessment in NTG management.

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