Carotid Doppler imaging in glaucoma and glaucoma suspects.

Area of Science:

• Ophthalmology
• Vascular Neurology
• Medical Imaging

Background:

• Glaucoma is a leading cause of irreversible blindness worldwide.
• Carotid occlusive disease (COD) is a significant risk factor for cerebrovascular events.
• The relationship between glaucoma and COD requires further investigation.

Purpose of the Study:

• To determine the association between carotid occlusive disease (COD) and glaucoma.
• To assess the prevalence of COD in glaucoma suspects, primary open-angle glaucoma (POAG), and normal tension glaucoma (NTG).

Main Methods:

• Retrospective review of medical records and carotid Doppler reports for 279 patients (485 eyes) between January 2012 and June 2022.
• Inclusion criteria: glaucoma suspects, POAG, or NTG with suspected vascular pathology or unexplained Humphrey visual field (HVF) progression.
• Carotid artery involvement defined by significant stenosis on Doppler imaging.

Main Results:

• Carotid artery stenosis was observed in 7.4% of POAG, 11.4% of NTG, and 12% of patients with unexplained HVF progression.
• Only 3% of glaucoma suspects showed stenosis exceeding 10% (P > 0.05).
• A weak negative correlation (r = -0.22) was found between worsening visual field index (VFI) and increasing stenosis.

Conclusions:

• Carotid occlusive disease (COD) is rare in glaucoma suspects.
• COD is more prevalent in NTG and POAG patients experiencing unexplained visual field progression.
• COD may hold clinical significance primarily within these specific glaucoma subgroups.