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Other Testing in Glaucoma: Optic Nerve Blood Flow I

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Abstract

The body of evidence to date does not yet support the suggestion that blood flow in the optic nerve should be routinely measured in glaucoma and glaucoma suspect patients. This is primarily due to the fact that no single blood flow device at present can simultaneously evaluate all the vascular beds relevant to glaucoma [1]. Also, the currently available methods provide limited information on quantitative blood flow. They typically measure some surrogate parameters that are assumed to reflect volumetric perfusion, such as vessel diameter, pulsatility and velocity of flow, or they extrapolate on change in blood flow as a result of a provocative test (including flicker stimulation, O2 and CO2 inhalation and cold pressor tests). Therefore, the ideal test to measure comprehensive ocular blood flow (OBF) in the routine patient is yet to be developed [1–3].

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References

  1. Schmetterer L, Garhofer G. How can blood flow be measured? Surv Ophthalmol 2007;52(suppl 2):S134–8.

    Article  Google Scholar 

  2. Cioffi GA. Three assumptions: ocular blood flow and glaucoma. J Glaucoma 1998;7(5):299–300.

    PubMed  CAS  Google Scholar 

  3. Rechtman E, Harris A, Kumar R, et al. An update on retinal circulation assessment technologies. Curr Eye Res 2003;27(6):329–43.

    Article  PubMed  Google Scholar 

  4. Grieshaber MC, Flammer J. Blood flow in glaucoma. Curr Opin Ophthalmol 2005;16(2):79–83.

    Article  PubMed  Google Scholar 

  5. Harris A, Rechtman E, Siesky B, et al The role of optic nerve blood flow in the pathogenesis of glaucoma. Ophthalmol Clin North Am 2005;18(3):345–53, v.

    Article  PubMed  Google Scholar 

  6. Flammer J, Orgul S, Costa VP, et al. The impact of ocular blood flow in glaucoma. Prog Retin Eye Res 2002;21(4):359–93.

    Article  PubMed  Google Scholar 

  7. Pache M, Flammer J. A sick eye in a sick body? Systemic findings in patients with primary open-angle glaucoma. Surv Ophthalmol 2006;51(3):179–212.

    Article  PubMed  Google Scholar 

  8. Grieshaber MC, Mozaffarieh M, Flammer J. What is the link between vascular dysregulation and glaucoma? Surv Oph­thal­mol 2007;52(suppl 2):S144–54.

    Article  Google Scholar 

  9. Duijm HF, van den Berg TJ, Greve EL. Choroidal haemodynamics in glaucoma. Br J Ophthalmol 1997;81(9):735–42.

    Article  PubMed  CAS  Google Scholar 

  10. Galassi F, Sodi A, Ucci F, et al. Ocular hemodynamics and glaucoma prognosis: a color Doppler imaging study. Arch Ophthalmol 2003;121(12):1711–5.

    Article  PubMed  Google Scholar 

  11. Emre M, Orgul S, Gugleta K, Flammer J. Ocular blood flow alteration in glaucoma is related to systemic vascular dysregulation. Br J Ophthalmol 2004;88(5):662–6.

    Article  PubMed  CAS  Google Scholar 

  12. Martinez A, Sanchez M. Predictive value of colour Doppler imaging in a prospective study of visual field progression in primary open-angle glaucoma. Acta Ophthalmol Scand 2005;83(6):716–22.

    Article  PubMed  Google Scholar 

  13. Satilmis M, Orgul S, Doubler B, Flammer J. Rate of progression of glaucoma correlates with retrobulbar circulation and intraocular pressure. Am J Ophthalmol 2003;135(5):664–9.

    Article  PubMed  Google Scholar 

  14. Leske MC, Wu SY, Hennis A, et al. Risk factors for incident open-angle glaucoma: the Barbados Eye Studies. Ophthal­mology 2008;115(1):85–93.

    Article  Google Scholar 

  15. Leske MC, Heijl A, Hyman L, et al. Predictors of long-term progression in the early manifest glaucoma trial. Ophthal­mology 2007;114(11):1965–72.

    Article  Google Scholar 

  16. Nicolela MT, Drance SM, Rankin SJ, et al. Color Doppler imaging in patients with asymmetric glaucoma and unilateral visual field loss. Am J Ophthalmol 1996;121(5):502–10.

    PubMed  CAS  Google Scholar 

  17. Kaiser HJ, Schoetzau A, Stumpfig D, Flammer J. Blood-flow velocities of the extraocular vessels in patients with high-tension and normal-tension primary open-angle glaucoma. Am J Ophthalmol 1997;123(3):320–7.

    PubMed  CAS  Google Scholar 

  18. Gasser P, Flammer J. Blood-cell velocity in the nailfold ­capillaries of patients with normal-tension and high-tension glaucoma. Am J Ophthalmol 1991;111(5):585–8.

    PubMed  CAS  Google Scholar 

  19. Dielemans I, Vingerling JR, Algra D, et al Primary open-angle glaucoma, intraocular pressure, and systemic blood pressure in the general elderly population. The Rotterdam Study. Ophthalmology 1995;102(1):54–60.

    PubMed  CAS  Google Scholar 

  20. Mitchell P, Lee AJ, Rochtchina E, Wang JJ. Open-angle glaucoma and systemic hypertension: the blue mountains eye study. J Glaucoma 2004;13(4):319–26.

    Article  PubMed  Google Scholar 

  21. Bonomi L, Marchini G, Marraffa M, et al. Vascular risk factors for primary open angle glaucoma: the Egna-Neumarkt Study. Ophthalmology 2000;107(7):1287–93.

    Article  PubMed  CAS  Google Scholar 

  22. Tielsch JM, Katz J, Sommer A, et al Hypertension, perfusion pressure, and primary open-angle glaucoma. A population-based assessment. Arch Ophthalmol 1995;113(2):216–21.

    Article  PubMed  CAS  Google Scholar 

  23. Leske MC, Wu SY, Nemesure B, Hennis A. Incident open-angle glaucoma and blood pressure. Arch Ophthalmol 2002;120(7):954–9.

    PubMed  Google Scholar 

  24. Le A, Mukesh BN, McCarty CA, Taylor HR. Risk factors associated with the incidence of open-angle glaucoma: the visual impairment project. Invest Ophthalmol Vis Sci 2003;44(9):3783–9.

    Article  PubMed  Google Scholar 

  25. Yu DY, Su EN, Cringle SJ, et al. Systemic and ocular ­vascular roles of the antiglaucoma agents beta-adrenergic antagonists and Ca2+ entry blockers. Surv Ophthalmol 1999;43(suppl 1):S214–22.

    Article  Google Scholar 

  26. Flammer J, Pache M, Resink T. Vasospasm, its role in the pathogenesis of diseases with particular reference to the eye. Prog Retin Eye Res 2001;20(3):319–49.

    Article  PubMed  CAS  Google Scholar 

  27. Netland PA, Chaturvedi N, Dreyer EB. Calcium channel blockers in the management of low-tension and open-angle glaucoma. Am J Ophthalmol 1993;115(5):608–13.

    PubMed  CAS  Google Scholar 

  28. Langman MJ, Lancashire RJ, Cheng KK, Stewart PM. Systemic hypertension and glaucoma: mechanisms in common and co-occurrence. Br J Ophthalmol 2005;89(8):960–3.

    Article  PubMed  CAS  Google Scholar 

  29. Muskens RP, de Voogd S, Wolfs RC, et al. Systemic antihypertensive medication and incident open-angle glaucoma. Ophthalmology 2007;114(12):2221–6.

    Article  PubMed  Google Scholar 

  30. Kitazawa Y, Shirai H, Go FJ. The effect of Ca2(+) -­antagonist on visual field in low-tension glaucoma. Graefes Arch Clin Exp Ophthalmol 1989;227(5):408–12.

    Article  PubMed  CAS  Google Scholar 

  31. Topouzis F, Coleman AL, Harris A, et al. Association of blood pressure status with the optic disk structure in ­non-glaucoma subjects: the Thessaloniki eye study. Am J Ophthalmol 2006;142(1):60–7.

    Article  PubMed  Google Scholar 

  32. Jonas JB. Association of blood pressure status with the optic disk structure. Am J Ophthalmol 2006;142(1):144–5.

    Article  PubMed  Google Scholar 

  33. Gherghel D, Orgul S, Gugleta K, et al. Relationship between ocular perfusion pressure and retrobulbar blood flow in patients with glaucoma with progressive damage. Am J Oph­thalmol 2000;130(5):597–605.

    Article  CAS  Google Scholar 

  34. Broadway DC, Drance SM. Glaucoma and vasospasm. Br J Ophthalmol 1998;82(8):862–70.

    Article  PubMed  CAS  Google Scholar 

  35. Delaney Y, Walshe TE, O’Brien C. Vasospasm in ­glaucoma: clinical and laboratory aspects. Optom Vis Sci 2006;83(7):406–14.

    Article  PubMed  Google Scholar 

  36. Leske MC, Heijl A, Hussein M, et al. Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol 2003;121(1):48–56.

    Article  PubMed  Google Scholar 

  37. Gherghel D, Hosking SL, Cunliffe IA. Abnormal systemic and ocular vascular response to temperature provocation in primary open-angle glaucoma patients: a case for autonomic failure? Invest Ophthalmol Vis Sci 2004;45(10):3546–54.

    Article  PubMed  Google Scholar 

  38. Mojon DS, Hess CW, Goldblum D, et al. High prevalence of glaucoma in patients with sleep apnea syndrome. Ophthal­mology 1999;106(5):1009–12.

    Article  CAS  Google Scholar 

  39. Karakucuk S, Goktas S, Aksu M, et al. Ocular blood flow in patients with obstructive sleep apnea syndrome (OSAS). Graefes Arch Clin Exp Ophthalmol 2008;246(1):129–34.

    Article  PubMed  Google Scholar 

  40. Teuchner B, Orgul S, Ulmer H, et al. Reduced thirst in patients with a vasospastic syndrome. Acta Ophthalmol Scand 2004;82(6):738–40.

    Article  PubMed  Google Scholar 

  41. Buckley C, Hadoke PW, Henry E, O’Brien C. Systemic vascular endothelial cell dysfunction in normal pressure glaucoma. Br J Ophthalmol 2002;86(2):227–32.

    Article  PubMed  Google Scholar 

  42. Hayreh SS, Zimmerman MB, Podhajsky P, Alward WL. Nocturnal arterial hypotension and its role in optic nerve head and ocular ischemic disorders. Am J Ophthalmol 1994;117(5):603–24.

    PubMed  CAS  Google Scholar 

  43. Graham SL, Drance SM, Wijsman K, et al Ambulatory blood pressure monitoring in glaucoma. The nocturnal dip. Ophthalmology 1995;102(1):61–9.

    PubMed  CAS  Google Scholar 

  44. Kaiser HJ, Flammer J, Graf T, Stumpfig D. Systemic blood pressure in glaucoma patients. Graefes Arch Clin Exp Oph­thalmol 1993;231(12):677–80.

    Article  CAS  Google Scholar 

  45. Hayreh SS. Factors influencing blood flow in the optic nerve head. J Glaucoma 1997;6(6):412–25.

    Article  PubMed  CAS  Google Scholar 

  46. de Voogd S, Ikram MK, Wolfs RC, et al. Is diabetes mellitus a risk factor for open-angle glaucoma? The Rotterdam Study. Ophthalmology 2006;113(10):1827–31.

    Article  PubMed  Google Scholar 

  47. Pasquale LR, Kang JH, Manson JE, et al. Prospective study of type 2 diabetes mellitus and risk of primary open-angle glaucoma in women. Ophthalmology 2006;113(7):1081–6.

    Article  PubMed  Google Scholar 

  48. Bonovas S, Peponis V, Filioussi K. Diabetes mellitus as a risk factor for primary open-angle glaucoma: a meta-analysis. Diabet Med 2004;21(6):609–14.

    Article  PubMed  CAS  Google Scholar 

  49. Sehi M, Flanagan JG, Zeng L, et al. Anterior optic nerve capillary blood flow response to diurnal variation of mean ocular perfusion pressure in early untreated primary open-angle glaucoma. Invest Ophthalmol Vis Sci 2005;46(12):4581–7.

    Article  PubMed  Google Scholar 

  50. Shiose Y, Kitazawa Y, Tsukahara S, et al. Epidemiology of glaucoma in Japan – a nationwide glaucoma survey. Jpn J Ophthalmol 1991;35(2):133–55.

    PubMed  CAS  Google Scholar 

  51. Kitazawa Y, Shirato S, Yamamoto T. Optic disc hemorrhage in low-tension glaucoma. Ophthalmology 1986;93(6):853–7.

    PubMed  CAS  Google Scholar 

  52. Drance SM, Fairclough M, Butler DM, Kottler MS. The importance of disc hemorrhage in the prognosis of chronic open angle glaucoma. Arch Ophthalmol 1977;95(2):226–8.

    Article  PubMed  CAS  Google Scholar 

  53. Siegner SW, Netland PA. Optic disc hemorrhages and progression of glaucoma. Ophthalmology 1996;103(7):1014–24.

    PubMed  CAS  Google Scholar 

  54. Rasker MT, van den Enden A, Bakker D, Hoyng PF. Deterioration of visual fields in patients with glaucoma with and without optic disc hemorrhages. Arch Ophthalmol 1997;115(10):1257–62.

    Article  PubMed  CAS  Google Scholar 

  55. Budenz DL, Anderson DR, Feuer WJ, et al. Detection and prognostic significance of optic disc hemorrhages during the Ocular Hypertension Treatment Study. Ophthalmology 2006;113(12):2137–43.

    Article  PubMed  Google Scholar 

  56. Phelps CD, Corbett JJ. Migraine and low-tension glaucoma. A case-control study. Invest Ophthalmol Vis Sci 1985;26(8):1105–8.

    PubMed  CAS  Google Scholar 

  57. Drance S, Anderson DR, Schulzer M. Risk factors for progression of visual field abnormalities in normal-tension glaucoma. Am J Ophthalmol 2001;131(6):699–708.

    Article  PubMed  CAS  Google Scholar 

  58. Legarth J, Nolsoe C. Doppler blood velocity waveforms and the relation to peripheral resistance in the brachial artery. J Ultrasound Med 1990;9(8):449–53.

    PubMed  CAS  Google Scholar 

  59. Polska E, Kircher K, Ehrlich P, et al. RI in central retinal artery as assessed by CDI does not correspond to retinal vascular resistance. Am J Physiol Heart Circ Physiol 2001;280(4):H1442–7.

    Google Scholar 

  60. Valdueza JM, Balzer JO, Villringer A, et al. Changes in blood flow velocity and diameter of the middle cerebral artery during hyperventilation: assessment with MR and transcranial Doppler sonography. AJNR Am J Neuroradiol 1997;18(10):1929–34.

    PubMed  CAS  Google Scholar 

  61. Polska E, Polak K, Luksch A, et al. Twelve hour reproducibility of choroidal blood flow parameters in healthy subjects. Br J Ophthalmol 2004;88(4):533–7.

    Article  PubMed  CAS  Google Scholar 

  62. Bonner RF, Nossal R. Principles of laser-Doppler flowmetry. In: Shepard AP and Oberg PA (eds). Laser-Doppler Blood Flowmetry. Boston, MD: Kluwer, 1990.

    Google Scholar 

  63. Petrig BL, Riva CE, Hayreh SS. Laser Doppler flowmetry and optic nerve head blood flow. Am J Ophthalmol 1999;127(4):413–25.

    Article  PubMed  CAS  Google Scholar 

  64. Michelson G, Langhans MJ, Groh MJ. Perfusion of the juxtapapillary retina and the neuroretinal rim area in primary open angle glaucoma. J Glaucoma 1996;5(2):91–8.

    PubMed  CAS  Google Scholar 

  65. Kerr J, Nelson P, O’Brien C. Pulsatile ocular blood flow in primary open-angle glaucoma and ocular hypertension. Am J Ophthalmol 2003;136(6):1106–13.

    Article  PubMed  Google Scholar 

  66. Silver DM, Farrell RA, Langham ME, et al. Estimation of pulsatile ocular blood flow from intraocular pressure. Acta Ophthalmol Suppl 1989;191:25–9.

    PubMed  CAS  Google Scholar 

  67. Silver DM, Farrell RA. Validity of pulsatile ocular blood flow measurements. Surv Ophthalmol 1994;38(suppl):S72–80.

    Article  Google Scholar 

  68. Silver DM, Geyer O. Pressure-volume relation for the living human eye. Curr Eye Res 2000;20(2):115–20.

    Article  PubMed  CAS  Google Scholar 

  69. Zion IB, Harris A, Siesky B, et al. Pulsatile ocular blood flow: relationship with flow velocities in vessels supplying the retina and choroid. Br J Ophthalmol 2007;91(7):882–4.

    Article  PubMed  Google Scholar 

  70. Fontana L, Poinoosawmy D, Bunce CV, et al. Pulsatile ocular blood flow investigation in asymmetric normal tension glaucoma and normal subjects. Br J Ophthalmol 1998;82(7):731–6.

    Article  PubMed  CAS  Google Scholar 

  71. Aydin A, Wollstein G, Price LL, Schuman JS. Evaluating pulsatile ocular blood flow analysis in normal and treated glaucomatous eyes. Am J Ophthalmol 2003;136(3):448–53.

    Article  PubMed  Google Scholar 

  72. Geyer O, Neudorfer M, Snir T, et al. Pulsatile ocular blood flow in diabetic retinopathy. Acta Ophthalmol Scand 1999;77(5):522–5.

    Article  PubMed  CAS  Google Scholar 

  73. Savage HI, Hendrix JW, Peterson DC, et al. Differences in pulsatile ocular blood flow among three classifications of diabetic retinopathy. Invest Ophthalmol Vis Sci 2004;45(12):4504–9.

    Article  PubMed  Google Scholar 

  74. MacKinnon JR, O’Brien C, Swa K, et al. Pulsatile ocular blood flow in untreated diabetic retinopathy. Acta Ophthalmol Scand 1997;75(6):661–4.

    Article  PubMed  CAS  Google Scholar 

  75. Flower RW. Extraction of choriocapillaris hemodynamic data from ICG fluorescence angiograms. Invest Ophthalmol Vis Sci 1993;34(9):2720–9.

    PubMed  CAS  Google Scholar 

  76. Tanaka T, Muraoka K, Shimizu K. Fluorescein fundus angiography with scanning laser ophthalmoscope. Visibility of leukocytes and platelets in perifoveal capillaries. Oph­thalmology 1991;98(12):1824–9.

    CAS  Google Scholar 

  77. Wolf S, Arend O, Toonen H, et al Retinal capillary blood flow measurement with a scanning laser ophthalmoscope. Preliminary results. Ophthalmology 1991;98(6): 996–1000.

    PubMed  CAS  Google Scholar 

  78. Guan K, Hudson C, Flanagan JG. Variability and repeatability of retinal blood flow measurements using the Canon Laser Blood Flowmeter. Microvasc Res 2003;65(3) :145–51.

    Article  PubMed  Google Scholar 

  79. Venkataraman ST, Hudson C, Fisher JA, Rachmiel R, Ahmed T, Buys Y, Trope G, Flanagan JG. Retinal Arteriolar and Capillary Response to Isoxic Hypercapnia in Primary Open Angle Glaucoma Pre- & Post-Treatment. World Glaucoma Congress. Singapore, 2007.

    Google Scholar 

  80. Gilmore ED, Hudson C, Nrusimhadevara RK, et al. Retinal arteriolar hemodynamic response to an acute hyperglycemic provocation in early and sight-threatening diabetic retinopathy. Microvasc Res 2007;73(3):191–7.

    Article  PubMed  CAS  Google Scholar 

  81. Gilmore ED, Hudson C, Nrusimhadevara RK, et al. Retinal arteriolar hemodynamic response to a combined isocapnic hyperoxia and glucose provocation in early sight-­threatening diabetic retinopathy. Invest Ophthalmol Vis Sci 2008;49(2):699–705.

    Article  PubMed  Google Scholar 

  82. Guan K, Hudson C, Wong T, et al. Retinal hemodynamics in early diabetic macular edema. Diabetes 2006;55(3):813–8.

    Article  PubMed  CAS  Google Scholar 

  83. Gilmore ED, Hudson C, Nrusimhadevara RK, et al. Retinal arteriolar diameter, blood velocity, and blood flow response to an isocapnic hyperoxic provocation in early sight-threatening diabetic retinopathy. Invest Ophthalmol Vis Sci 2007;48(4):1744–50.

    Article  PubMed  Google Scholar 

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Rachmiel, R., Buys, Y.M., Hudson, C., Trope, G.E. (2010). Other Testing in Glaucoma: Optic Nerve Blood Flow I. In: Giaconi, J., Law, S., Coleman, A., Caprioli, J. (eds) Pearls of Glaucoma Management. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68240-0_19

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