Hemodynamic changes in eyes with early primary open‐angle glaucoma measured by transpalpebral rheoophthalmography

Abstract

PurposeTo evaluate the hemodynamic parameters in eyes with primary open‐angle glaucoma (POAG) and early glaucomatous visual field defects (early nasal step) using transpalpebral rheoophthalmography (TR).MethodsTwo groups of subjects were examined. Group 1 consisted of 56 eyes of 39 patients aged 57–79 (ave. age M ± σ = 67.33 ± 6.78) with POAG and early nasal step. Of these, 17 patients had POAG in both eyes. Group 2 consisted of 54 eyes of 27 patients aged 56–73 (ave. age 63.96 ± 5.54) without any eye pathology except initial cataract. Patients with any other optic disc or macular pathology, previous intraocular surgery, ocular trauma, or severe somatic pathology, were excluded from the study. All subjects underwent complete ocular and visual field examination, Goldmann intraocular pressure (IOP) measurement and TR. TR signals were registered using a specially designed tetrapolar lead system. Signal processing of TR with special software allowing automated analysis included three basic parameters: the rheographic index (RI), the period of maximum filling (PMF), and the indicator of the elastic modulus (IEM).ResultsThe measured IOP was 16.9 mmHg (±1.7) in group 1 and 14.6 mmHg (±2.1) in group 2. A statistically significant difference was observed between the average RI (mΩ): for group 1 (M ± σ = 14.76 ± 3.18) vs. group 2 (26.44 ± 3.31), p < 0.05. A slight increase in the values of other parameters in group 1 (PMF = 21 ± 3 cs, IEM = 26 ± 4 cs) as compared to group 2 (PMF = 19 ± 3 cs, IEM = 24 ± 4 cs) was observed. This may be associated with a decrease in elasticity of intraocular blood vessel walls and their sclerotic changes.ConclusionsThe proposed new TR method is easy to use, highly informative and sufficiently accurate, allowing to objectively assess the changes of ocular hemodynamics, and facilitating the diagnosis of glaucoma at an early stage.