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Estimation of Choroid-perfusion by Color Decoded Doppler Imaging Versus other Methods in Glaucoma Patients
Zeitz O., Matthiessen E. T., Reuss J., Richard G., Klemm M.,
Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Augenheilkunde (Hamburg)
Purpose: Alterations of ocular hemodynamics are under discussion to cause or to contribute to several ocular diseases. This leads to the need of reliable methods for determination of ocular perfusion. Several studies postulate advantages of color decoded Doppler imaging compared to other methods, although no systematic comparative study has performed up to now.
Method: n=56 eyes from n=28 patients with primary open angle glaucoma were subjected to Laser Doppler Flowmetrie (LDF) and/ or Langham-ocular-blood-flowmetry (LOBF) and CDI. Statistic evaluation of the results was done by calculation of the Spearman correlations coefficient (R).
Results: Flow determined by LDF correlated with maximum (TAMx) and mean (TAMn) of average velocity assessed by CDI in the long, but not in the short posterior ciliary artery (TAMx: R=0.466,p=0.038,n=20; TAMn: R=0.462,p=0.040,n=20). LOBF correlated with pulsatility index (PI) and resistive index (RI) from CDI in the short (PI: R=0.514,p=0.002,n=35; RI: R=0.438,p=0.008,n=35) and long posterior ciliary artery (PI: R=0.436,p=0.009,n=35; RI: R=0.506,p=0.002,n=35). After Differentiation of the patients in one subgroup marked by progression and one marked by steadiness of glaucoma, patients with progression showed a significant lowered enddiastolic velocity in the short posterior ciliary artery (p=0.003). All other parameters were indifferent in both subgroups.
Conclusions: Methods strengthen each other by partial correlations. CDI assesses compared to the other methods additional and more detailed parameters of ocular perfusion. The results from the subgroup analysis may indicate that lowered enddiastolic velocities in the short posterior ciliary artery accelerate progression of glaucoma.