Blood flow and metabolism measurements: are they ready for the clinic?

Abstract

Abstract Purpose A growing number of epidemiological studies clearly identified reduced ocular diastolic perfusion pressure as a significant risk factor for open angle glaucoma (POAG), suggesting that optic nerve ischemia and hypoxia may play a role in the etiology and pathogenesis of POAG. Methods Advances in ultrasound, laser computerized image analysis and Doppler technologies, within the last two decades have made it possible to objectively measure ocular hemodynamics. Each technique, however, examines different facets of the vascular system focusing on varying anatomical location of blood vessels and providing differing hemodynamic outcomes. Results My talk will cover the pros and cons of the existing technologies for measuring ocular blood flow. Focusing on color Doppler imaging, scanning laser ophthalmoscopy with fluorescein, scanning laser ophthalmoscopy with indo‐cyanine green, Heidelberg retinal flowmetry, laser Doppler flowmetry, retinal vessel analyzer (RVA) as well as the new generation of technologies aimed at measuring oxygen saturation in the optic nerve head and retina. Conclusion At present no single technique can accurately assess all relevant vascular beds. More development and emphasis is necessary. This presentation will also focus on possible clinical utilization of ocular blood flow and metabolism measurements.