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Related Experiment Videos

Optic nerve and choroidal circulation in glaucoma

J E Grunwald1, J Piltz, S M Hariprasad

  • 1Department of Ophthalmology, Scheie Eye Institute, School of Medicine, University of Pennsylvania, Philadelphia 19104, USA.

Investigative Ophthalmology & Visual Science
|November 6, 1998
PubMed
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Glaucoma patients exhibit significantly reduced optic nerve head blood flow (ONFlow5), particularly in critical areas like the inferior temporal rim. This decreased flow correlates with disease severity, suggesting a link to glaucoma progression.

Area of Science:

  • Ophthalmology
  • Neuroscience
  • Medical Imaging

Background:

  • Glaucoma is a leading cause of irreversible blindness.
  • Optic nerve head (ONH) and choroidal circulation are crucial for retinal ganglion cell survival.
  • Understanding circulatory changes in glaucoma is vital for diagnosis and treatment.

Purpose of the Study:

  • To investigate optic nerve head and choroidal blood flow in glaucoma patients.
  • To correlate circulatory parameters with glaucoma severity and disease progression.

Main Methods:

  • Laser Doppler flowmetry used to measure optic nerve head relative blood velocity (ONVel), volume (ONVol), and flow (ONFlow).
  • Measurements taken from five sites on the ONH, averaged to ONFlow5.
  • Choroidal blood flow measured from the foveola.

Related Experiment Videos

  • Correlations performed with cup-to-disc ratio and Humphrey visual field indices.

    • Main Results:

    • Glaucoma patients showed a significant 24% reduction in mean ONFlow5 compared to controls (P=0.001).
    • This reduction was driven by decreased ONVol5 (15%, P=0.04) and a trend of decreased ONVel5 (10%, P=0.07).
    • Significant flow reductions observed in the inferior temporal (28%) and superior temporal (24%) neuroretinal rim locations.
    • ONFlow5 inversely correlated with corrected pattern standard deviation (R=-0.53, P=0.02) and cup-to-disc ratio (R=-0.65, P=0.002).
    • No significant differences in foveal choroidal blood flow were found.

    Conclusions:

    • Optic nerve head blood flow (ONFlow5) is significantly reduced in glaucoma patients.
    • Blood flow is notably decreased in the inferior temporal rim, a common site for nerve bundle defects.
    • Lower ONFlow5 is associated with more advanced glaucoma, indicated by visual field and structural measures.
    • The findings suggest a correlation between reduced ONH blood flow and glaucoma progression, though causality remains undetermined.