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Conjunctival Venular Hemodynamic Biomarkers in Glaucoma.
Albert Yang1, Jennifer Cano2, Benjamin Xu2
1Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Translational Vision Science & Technology
|September 15, 2025
Summary
Primary open-angle glaucoma (POAG) is linked to reduced blood flow in conjunctival venules. This study suggests conjunctival wall shear stress may be a new biomarker for glaucoma-related vascular damage.
Area of Science:
- Ophthalmology
- Vascular Biology
- Medical Imaging
Background:
- Vascular dysfunction is a suspected contributor to glaucomatous damage.
- Noninvasive imaging of the bulbar conjunctiva allows direct assessment of systemic microcirculation.
Purpose of the Study:
- To investigate the association between hemodynamic biomarkers in conjunctival venules and the presence of primary open-angle glaucoma (POAG).
Main Methods:
- A cross-sectional study compared 26 normal controls (NC) with 29 POAG subjects.
- Conjunctival microcirculation was assessed non-invasively using video microscopy and automated software.
- Key hemodynamic biomarkers measured included vessel diameter (D), blood velocity (V), blood flow (Q), wall shear rate (WSR), and wall shear stress (WSS).
Main Results:
- Conjunctival venular blood velocity (V), wall shear rate (WSR), and wall shear stress (WSS) were significantly lower in POAG patients compared to NC.
- No significant differences were found in vessel diameter (D) or blood flow (Q) between the groups after adjustments.
- Age was a significant differentiating factor between the NC and POAG groups.
Conclusions:
- Reduced conjunctival venular wall shear stress in POAG supports the vascular theory of glaucoma and suggests endothelial dysfunction.
- Conjunctival wall shear stress shows potential as a novel biomarker for detecting vascular damage in glaucoma.
- Assessing microvasculature wall shear stress could enhance understanding, diagnosis, and monitoring of glaucoma and other optic neuropathies.
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