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Optic Disc Morphometry Correlated with Neuro-retinal Rim Perfusion Measurements in Normal-pressure Glaucoma

1Papastathopoulos K., 2Michelson G., 3Harazny J., 1Budde W. M., 2Mardin C. Y., 1Jonas J. B.,
1Ruprecht-Karls-Universität Heidelberg, Fakultät für klinische Medizin Mannheim, Augenklinik (Mannheim)
2Friedrich-Alexander-Universität, Augenklinik (Erlangen)
3Friedrich-Alexander-Universität, Augenklinik, Labor für okuläre Perfusion (Erlangen)

Purpose: For glaucomatous optic nerve damage, a reduction of the blood perfusion of the optic nerve head has been discussed to be pathogenically important or to occur as an epiphenomenon. It was the purpose of the present study to correlate, in patients with normal-pressure glaucoma, morphometric measurements of the optic disc with ocular blood perfusion measurements to look for a statistical relationship between both parameters.
Methods: The study included 133 eyes of patients with normal-pressure glaucoma who were prospectively examined as part of the Erlanger Glaucoma Registry. Mean age was 55.50 ± 9.99 years, mean refractive error was -0.57 ± 2.61 diopters. The glaucoma group was compared with an age adapted normal control group consisting of 159 eyes of normal persons with a mean age of 54.75 ± 7.58 years and a mean refractive error of -0.13 ± 1.28 diopters. For all patients and subjects, 15 degree color stereo optic disc photographs were taken and morphometrically examined. Additionally, the mean capillary blood flow within the neuroretinal rim was measured by confocal laser scanning flowmetry (Heidelberg Retinal Flow Meter).
Results: Mean capillary blood flow in the neuroretinal rim was significantly (p=0.003) lower in the normal pressure glaucoma group (259.1 ± 129.5 units) than in the control group (297.0 ± 121.3 units). Correspondingly, mean capillary blood flow within the neuroretinal rim decreased marginally significantly (p=0.13) with decreasing neuroretinal rim area, and decreased significantly (p=0.019) with increasing mean visual field defect.
Conclusions: In eyes with normal-pressure glaucoma, capillary blood flow within the neuroretinal rim, as measured by confocal laser scanning flowmetry, decreases with increasing glaucomatous optic nerve damage, and it is lower than in an age-adapted normal control group.

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