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Updated: Jan 22, 2026

Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
Increased Optic Nerve Head Capillary Blood Flow in Early Primary Open-Angle Glaucoma
Stuart K Gardiner1, Grant Cull1, Brad Fortune1
1Devers Eye Institute, Legacy Health, Portland, Oregon, United States.
Optic nerve head blood flow is elevated in early glaucoma suspects but decreases with functional loss. Pulsatile flow changes were also observed in glaucoma patients.
Area of Science:
- Ophthalmology
- Cardiovascular Research
- Medical Imaging
Background:
- Glaucoma is a leading cause of irreversible blindness.
- Reduced blood flow in the optic nerve head (ONH) is associated with advanced glaucoma.
- Previous studies in non-human primates suggest an initial increase in ONH blood flow during early glaucoma stages.
Purpose of the Study:
- To investigate optic nerve head (ONH) blood flow and pulsatile hemodynamics in human glaucoma.
- To test the hypothesis that ONH blood flow initially increases in early human glaucoma.
- To assess blood flow changes across a spectrum of glaucoma severity.
Main Methods:
- Laser speckle flowgraphy was employed to measure ONH capillary blood flow (MBRave) and pulsatile waveforms.
- The study included 93 eyes with functional loss, 74 glaucoma suspect/fellow eyes, and 92 healthy control eyes.
- Age-corrected data were analyzed using generalized estimating equation models.
Main Results:
- Glaucoma suspect eyes showed significantly higher mean MBRave (16.4 units) than healthy controls (12.5 units).
- Eyes with functional loss had lower MBRave (13.8 units) than glaucoma suspects but remained higher than controls.
- Delayed deceleration in pulsatile waveform flow was observed in glaucoma eyes.
Conclusions:
- Optic nerve head capillary blood flow is elevated in glaucoma suspects compared to healthy individuals.
- Blood flow is less elevated in eyes with established functional loss.
- Further research is needed to elucidate the mechanisms behind these hemodynamic changes and their relationship to pulsatile hemodynamics in glaucoma.
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