Color Doppler Imaging Analysis of Retrobulbar Blood Flow Velocities in Primary Open-Angle Glaucomatous Eyes: A Meta-Analysis

Nana Meng,Ping Zhang,Yi Qu,Hao Li,Yue Zhang,Huadong Huang,Jinlan Ma,Keisuke Mori

doi:10.1371/journal.pone.0062723

Nana Meng, Ping Zhang + Show 6 more

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https://doi.org/10.1371/journal.pone.0062723

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Abstract

BackgroundTo analyze the diagnostic value of color Doppler imaging (CDI) of blood flow in the retrobulbar vessels of eyes with primary open-angle glaucoma (POAG).MethodsPertinent publications were retrieved from the Cochrane Central Register of Controlled Trials, PubMed and the ISI Web of Knowledge up to October 2012. Changes in peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) of the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary artery (SPCA) of POAG eyes and normal controls were evaluated by CDI. Subgroup analyses were conducted according to whether patients received IOP-lowering drugs treatment and were defined as treated and untreated.ResultsPSV and EDV were statistically significantly reduced in the OA of POAG eyes (P = 0.0002; P<0.00001; respectively), with significant heterogeneity (Pheterogeneity<0.00001, I2 = 94%; Pheterogeneity<0.00001, I2 = 85%; respectively). Similar results were demonstrated for the CRA (P<0.00001; respectively) and SPCA (P = 0.005; P<0.00001; respectively), with significant heterogeneities for both the CRA (Pheterogeneity<0.00001, I2 = 81%; Pheterogeneity<0.00001, I2 = 98%; respectively) and the SPCA (Pheterogeneity<0.00001, I2 = 96%; Pheterogeneity<0.00001, I2 = 93%; respectively). Significant increases in RI were found in all retrobulbar vessels (P<0.00001; respectively), with significant heterogeneities (Pheterogeneity<0.00001, I2 = 95%; Pheterogeneity<0.00001, I2 = 94%; Pheterogeneity<0.00001, I2 = 97%; respectively).ConclusionsThis meta-analysis suggests that CDI is a potential diagnostic tool for POAG.

Highlights

Primary open-angle glaucoma (POAG) is multifactorial in origin and characterized by optic nerve head excavation, visual field defects and psychophysical changes [1]
Values on the left side of the vertical line at 0 represent greater changes in peak systolic velocity (PSV) in normal controls; values on the right side of the vertical line represent greater changes in eyes with primary open-angle glaucoma (POAG). 95% confidence intervals (95%CIs) that do not intersect with the vertical line at 0 indicate the results that were statistically significant at the 0.05 level
Significant reductions in PSV in the ophthalmic artery (OA) and central retinal artery (CRA) of POAG eyes were found in 20 studies, with a total summary mean difference (MD) of – 2.87 cm/s (95%CI: –4.36 to –1.38, P = 0.0002; Figure 2) and – 1.60 cm/s (95%CI: –1.88 to –1.32, P,0.00001; Figure 3) and significant heterogeneities (Pheterogeneity,0.00001, I2 = 94%; Pheterogeneity,0.00001, I2 = 81%; respectively)

Summary

Introduction

Primary open-angle glaucoma (POAG) is multifactorial in origin and characterized by optic nerve head excavation, visual field defects and psychophysical changes [1]. Inability of the perfusion system to adapt to tissue blood flow requirements or changes in perfusion pressure may lead to chronically low or unstable ocular perfusion [6], which in turn may cause ischemia, oxidative stress or both, possibly leading to glaucomatous damage to the optic nerve head. It seems that vascular factors are important in the development and progression of POAG. To analyze the diagnostic value of color Doppler imaging (CDI) of blood flow in the retrobulbar vessels of eyes with primary open-angle glaucoma (POAG)

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Results

Conclusion