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Capillary Perfusion Measurements of the Retina and Optic Disc in Primary Open-angle Glaucoma
1Harazny J., 2Michelson G., 3Budde W. M., 2Mardin C. Y., 3Jonas J. B.,
1Friedrich-Alexander-Universität, Augenklinik, Labor für okuläre Perfusion (Erlangen)
2Friedrich-Alexander-Universität, Augenklinik (Erlangen)
3Ruprecht-Karls-Universität Heidelberg, Fakultät für klinische Medizin Mannheim, Augenklinik (Mannheim)
Purpose: One of the features of optic nerve damage is a reduction in the caliber of the retinal arterioles with increasing stage of the disease. Since the arteriole diameter is only one out of several measures to quantify the blood perfusion, it was the purpose of the present study to measure confocal laser scanning measurements of the capillary blood flow in the optic disc and parapapillary retina and to correlate the data with morphometric measurements of the optic disc.
Method: The study included 290 eyes of patients with primary open-angle glaucoma who were prospectively examined as part of the Erlanger Glaucoma Registry. Mean age was 51.1 ± 12.3 years, mean refractive error was -1.34 ± 2.42 diopters. The glaucoma group was compared with an age adapted normal control group which consisted of 229 eyes of normal persons with a mean age of 50.9 ± 10.5 years and a mean refractive error of -0.35 ± 1.45 diopters. For all patients and subjects, 15 degree color stereo optic disc photographs were taken and morphometrically examined. Additionally, the mean capillary blood flow in the neuroretinal rim and in the retina at the temporal and nasal optic disc border was measured by confocal laser scanning flowmetry (Heidelberg Retinal Flow Meter).
Results: In the glaucoma group compared with the normal control group, measurements of the mean capillary blood flow in the neuroretinal rim (235.0 ± 131.0 units versus 290.2 ± 123 units; p<0.001), and in the retina at the temporal disc border (222.9 ± 109.8 units versus 240.1 ± 119.7units; p=0.05) and nasal optic disc border (202.6 ± 107.5 units versus 228.7 ± 89.0 units; p<0.001) were significantly smaller. Correspondingly, the capillary perfusion measurements in the neuroretinal rim and at the temporal disc border were significantly (p=0.001 and p=0.05) correlated with the area of the neuroretinal rim and mean visual field defect (p=0.02 und p=0.006).
Conclusions: In eyes with primary open-angle glaucoma, confocal laser scanning measurements of the capillary blood flow in the optic disc and in the parapapillary retina are signifcantly correlated with presence and degree of glaucomatous optic nerve damage.