Color Doppler imaging of the ophthalmic artery in glaucoma patients

Abstract

OBJECTIVES: To evaluate retrobulbar hemodynamics in ophthalmic artery in primary open angle glaucoma and primary angle closure glaucoma compared with age and male matched controls. MATERIALS AND METHODS: Of the 1357 persons 35-64 years of age, who were examined in the MONICA in the Eye clinic of Kaunas Medical University Hospital from April 2001 till May 2002, glaucoma was 15 (30 eyes). All of them were performed CDI, visual field examination, gonioskopy. In this study we separate all glaucoma patients in Primary Open Angle Glaucoma (POAG) patients (N=11) group and Primary Angle Closure Glaucoma (PACG) patients (N=4) group. Only no operated eyes enrolled in POAG patient group (17 eyes) and all eyes enrolled in PACG patient group(8 eyes). In PACG patients group all patients were after various types of surgery and laser treatment. To asses the results of patients with POAG and PACG a control groups of healthy persons was formed. Dopplerography of ophthalmic artery was performed by means of the ultrasonic blood flow detector UDD – 03, developed on the bases of IBM PC 386 (Kaunas University of Technology), working in CDI mode for investigation of peripheral vessels. This instrument measures automatically Vmax during systole, blood flow velocity at the end of diastole V diast, PI (pulsatily index), RI (resistive index). The maximum measuring of depth – 35 mm, the frequency ultrasonic waves 8 MHz, intensivity of ultrasound < 15 mW/cm2 . Standard method was used for this investigation. Patients investigated through the upper lid in a sitting position looking down to the nose. Statisticl analysis was performed using "Microsoft Excel 2000", "statistica 5.0". Both control groups of healthy persons were adjusting for age and male with POAG and PCAG patient groups. REZULTS: There were no significant differences between the POAG patients and healthy persons groups according to the age and sex. Systolic blood pressure of POAG patients was statistical significant (p<0,05) lower, than of healthy persons, but diastolic blood pressure was the same. Intraocular pressure (IOP) was statistically significant (p<0,05) higher in POAG group compared to normal controls. There were no significant differences between the PACG patients and healthy persons groups according to the age and sex. Systolic and diastolic blood pressure of PACG patients was the same as healthy persons. Intraocular pressure (IOP) was statistically significant (p<0,05) higher in PACG group compared to normal controls. The average of systolic blood flow velocity in ophthalmic artery of glaucoma patients (POAG and PACG) was statistical significant (p<0,05) lower than in ophthalmic artery of healthy persons. Peripheral resistive index RI in ophthalmic artery of glaucoma patients (POAG and PACG) was lower than in ophthalmic artery of healthy persons, but statistical not significant (p>0,05). Pulsatily index PI in ophthalmic artery of glaucoma patients (POAG and PACG) was lower than in ophthalmic artery of healthy persons, but statistical not significant (p>0,05) too. We did not find differences in blood flow velocity at the end of diastole of the ophthalmic artery in glaucoma patients (POAG and PACG) and in control groups (p>0,05). CONCLUSIONS: 1. The peak systolic blood flow velocity in ophthalmic artery of POAG patients was statistical significant (p<0,05) lower than in ophthalmic artery of healthy persons. 2. The peak systolic blood flow velocity in ophthalmic artery was significantly lower in PACG patients compared to normal subjects. 3. Interpretation of CDI results must be careful