Temporal Short Posterior Ciliary Arteries Research Articles

Correlation of retrobulbar perfusion deficits with glaucomatous visual field defects.

This study is to evaluate the correlation between retrobulbar perfusion deficits and glaucomatous visual field defects. Eighty-four patients with glaucoma and 17 normal subjects serving as controls were selected. Color Doppler imaging (CDI) was used to measure the changes in blood flow parameters in the retrobulbar ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (SPCAs). Visual field testing was performed using a Humphrey perimeter, categorizing the visual field deficits into four stages according to the Advanced Glaucoma Intervention Study (AGIS) scoring method. Subsequently, the correlation of retrobulbar hemodynamic parameter alterations among glaucomatous patients with varying visual field defects was examined. The higher the visual field stage, the lower the peak systolic velocity (PSV) of the OA, CRA, and SPCAs in glaucomatous patients. The CRA had the highest sensitivity to changes in its PSV. The PSV of the temporal SPCA (TSPCA-PSV) was lower in advanced glaucoma than in early-stage glaucoma. The PSVs of the OA, CRA, and TSPCA, as well as the resistance index of the CRA (CRA-RI), were positively correlated with the visual field index and the mean deviation. Except for that of OA, the PSV of the retrobulbar vessels was negatively correlated with the pattern standard deviation (PSD). The OA-PSV and end-diastolic velocity (EDV) of the CRA and TSPCA were lower in patients with superior visual field defects than in those with inferior visual field defects. Greater severity of visual field defects corresponded to poorer retrobulbar blood flow in glaucomatous patients. Patients suffered significant perfusion impairments in the CRA at the early stage, accompanied by SPCA perfusion disorder at the advanced stage. The presence of a bow-shaped defect in the superior or inferior region of the visual field in moderate-stage glaucoma was closely correlated with retrobulbar vascular EDV. ChiCTR2200059048 (2022-04-23).

Retrobulbar Short Posterior Ciliary Artery Hemodynamics in Patients with Pseudoexfoliation Glaucoma and Primary Open-Angle Glaucoma.

Purpose:To investigate retrobulbar blood flow changes in the short posterior ciliary arteries (SPCAs) in patients with pseudoexfoliation glaucoma (PEG) and primary open-angle glaucoma (POAG).Methods:In this prospective study, there were 22 eyes in the PEG group, 28 eyes in the POAG group, and 28 eyes with senile cataract in the control group. Peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (Vm), and resistivity index (RI) parameters of the temporal and nasal SPCAs were compared between the study groups.Results:Mean temporal PSV, EDV, and Vm value were significantly lower in both the POAG group and the PEG group (P = 0.049, P = 0.004, P = 0.020), respectively. Temporal SPCA RI values were not significantly different between the groups (P = 0.115).Conclusion:There are retrobulbar blood flow changes in glaucomatous compared to nonglaucomatous eyes. However, SPCAs blood flow characteristics are similar between PEG and POAG subtypes.

Hemodynamics of the temporal and nasal short posterior ciliary arteries in pseudoexfoliation syndrome.

The aim of this study was to investigate blood flow changes in the temporal and nasal short posterior ciliary arteries (SPCAs) in pseudoexfoliation syndrome using color Doppler ultrasonography. This prospective clinical study included 67 eyes of 53 patients scheduled for cataract surgery. Pseudophakic eyes, eyes with traumatic cataract, were excluded. The demographic characteristic of the patients were recorded. Ocular blood flow was measured using 6-10MHz Doppler ultrasound. Peak systolic velocity (PSV), end-diastolic velocity (EDV), mean flow velocity (Vm), and resistive index (RI) in the temporal and nasal SPCAs were determined for 39 eyes of 30 patients with pseudoexfoliation syndrome and cataract and a control group comprising 28 eyes of 23 patients with senile cataract. Compared to the control group, patients with pseudoexfoliation syndrome had significantly lower PSV (8.85 ± 2.88cm/s), EDV (3.21 ± 1.12cm/s), and Vm (5.27 ± 1.98cm/s) in the temporal SPCA (PSV P = .001; EDV P = .002; Vm P = .001). There was no difference in velocities in the nasal SPCA. RI of both the temporal and nasal SPCA did not differ statistically between the groups (temporal SPCA P = .517, nasal SPCA P = .752) CONCLUSION: There were significant decreases in temporal SPCA hemodynamic parameters in patients with pseudoexfoliation syndrome. These findings suggest that temporal SPCA ocular blood flow measurements have greater diagnostic value than those of the nasal SPCA.

Racial differences in the correlations between structural parameters and ocular blood flow in healthy eyes

Purpose: This study aimed to assess differences in the relationship between structural parameters and ocular blood flow between persons of African (AD) and European descent (ED) with healthy eyes.Methods: The relationship between structural and ocular blood flow parameters was assessed in 46 participants (20 AD, 26 ED) with healthy eyes. Disc area (DA), rim area (RA), and retinal nerve fiber layer (RNFL) thickness were measured. Retrobulbar blood flow was assessed in the ophthalmic (OA), central retinal (CRA), nasal (NPCA) and temporal short posterior ciliary arteries (TPCA). Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) were assessed. Retinal capillary blood flow was also evaluated. Differences between the correlations were determined using the Fisher r-to-z transformation.Results: Significant differences in correlations were observed between the AD and ED groups in the CRA, where PSV and DA were positively correlated in AD (r=0.43) and negatively correlated in ED (r=-0.36) (Δr=0.79; P=0.01). A similar finding was observed for PSV and RA (AD: r=0.39; ED: r=-0.23; Δr=0.62; P=0.04). In the inferior hemifield for ED group only, percentage of avascular space and RNFL thickness were positively correlated (r=0.51, P=0.01) and mean retinal flow and RNFL thickness were negatively correlated (r=-0.50, P=0.01).Conclusion: The relationship between structural parameters and the blood supply to the superficial layer of the retina was significantly different in the healthy eyes of AD compared to ED. More research is required to show how these differences may affect glaucomatous risk.

Inter-device reproducibility of retrobulbar blood flow velocity measurements in healthy subjects using color Doppler imaging.

To evaluate the inter-device reproducibility of retrobulbar blood flow measurements obtained by two commercially available CDI (color Doppler imaging) devices. The right eyes of 10 healthy volunteers were investigated. Four examiners, namely two ophthalmologists and two radiologists, performed CDI examination of the ophthalmic artery, central retinal artery and temporal short posterior ciliary arteries using both CDI devices: ESAOTE MYLAB™ and SIEMENS ANTARES STELLAR PLUS™. The peak systolic velocity (PSV), the end-diastolic velocity (EDV) and the resulting resistivity index (RI) were averaged for 3 cardiac cycles. To evaluate the reproducibility between both device measurements, the Lin's concordance correlation coefficient (CCC) was used. CCC can be expressed as the product of Pearson's r (the measure of precision) and C_b (the measure of accuracy). Results show that the inter-device reproducibility for CDI measurements is not acceptable since a poor degree of overall concordance (0.15<CCC<0.37) was obtained: accuracy was high (C_b>0.71) but overall precision low (0.18< Pearson's r <0.47). Ophthalmologists and radiologists obtained similar results. To evaluate the causal role of blood flow abnormalities in glaucoma, CDI analysis using different devices seems unreliable. CDI inter-device reproducibility seems unrelated to medical speciality of the examiners. However, to improve present results, the use of similar probes and standardized CDI instrument settings as well as a CDI images analysis by a single grader, might possibly improve the inter-device reproducibility when testing the retrobulbar blood flow velocity.

Effects of dorzolamide/timolol fixed combination on retrobulbar hemodynamics in pseudoexfoliative glaucoma

In our study we aimed to evaluate the short-term effects of dorzolamide/timolol on ocular perfusion pressure and retrobulbar blood flow in patients with pseudoexfoliative glaucoma (PXG). This prospective observational cross-sectional study enrolled 22 eyes of 22 newly-diagnosed patients with PXG in a single center. All of the patients received a fixed combination of dorzolamide/timolol. Besides routine ophthalmologic examination, the retrobulbar hemodynamic parameters in the ophthalmic artery, central retinal artery, and short posterior ciliary arteries were measured in all participants at baseline and the 3rd month using color Doppler imaging. The mean intraocular pressure (IOP) was 22.3 ± 2.1 mmHg at baseline and reduced to 17.4 ± 2.3 mmHg at the 3rd month (p < 0.05). None of the retrobulbar parameters, except peak systolic velocity and resistive index in temporal short posterior ciliary arteries, changed significantly on therapy with dorzolamide/timolol fixed combination when the results were analyzed at Month 3. The drug significantly decreased the peak systolic velocity (p = 0.044) and reduced the resistive index in 0.04 units, 95% confidence interval 0.03–0.05, (p < 0.001) in the temporal short posterior ciliary arteries. This study reports that the retrobulbar hemodynamics might be affected less than expected by dorzolamide/timolol fixed combination in patients with PXG although the reduction of IOP was statistically significant.

Differences in Ocular Blood Flow in Glaucoma Between Patients of African and European Descent

To investigate differences in ocular blood flow in individuals of African descent (AD) and European descent (ED) with open angle glaucoma (OAG). A retrospective data analysis was performed on OAG patients of AD and ED who were previously examined for ocular blood flow within the Department of Ophthalmology at Indiana University School of Medicine. Data analysis included blood pressure, heart rate, visual fields, intraocular pressure, ocular perfusion pressure, and color Doppler imaging of retrobulbar vessels. Color Doppler imaging measurements were performed on ophthalmic, central retinal, and nasal and temporal short posterior ciliary arteries, with peak systolic (PSV) and end diastolic velocities (EDV) as well as the Pourcelot vascular resistive index calculated for each vessel. Two-sample t tests of unequal variance were performed with P values <0.05 considered statistically significant. OAG patients of AD had statistically significant lower retrobulbar blood flow values than patients of ED including lower ophthalmic artery PSV (P=0.0001), ophthalmic artery EDV (P=0.0008), central retinal artery PSV (P=0.01), temporal short posterior ciliary artery PSV (P=0.0037), and nasal short posterior ciliary artery PSV (P<0.0001). No significant differences were found in terms of intraocular pressure or visual field parameters. Significantly lower blood flow values were identified in all retrobulbar blood vessels in AD compared with ED OAG patients. These findings suggest that the contribution of ocular blood flow to the disease process may be different in AD compared with ED OAG patients.

Ocular pulse amplitude and Doppler waveform analysis in glaucoma patients

To determine the correlation between ocular blood flow velocities and ocular pulse amplitude (OPA) in glaucoma patients using colour Doppler imaging (CDI) waveform analysis. A prospective, observer-masked, case-control study was performed. OPA and blood flow variables from central retinal artery and vein (CRA, CRV), nasal and temporal short posterior ciliary arteries (NPCA, TPCA) and ophthalmic artery (OA) were obtained through dynamic contour tonometry and CDI, respectively. Univariate and multiple regression analyses were performed to explore the correlations between OPA and retrobulbar CDI waveform and systemic cardiovascular parameters (blood pressure, blood pressure amplitude, mean ocular perfusion pressure and peripheral pulse). One hundred and ninety-two patients were included [healthy controls: 55; primary open-angle glaucoma (POAG): 74; normal-tension glaucoma (NTG): 63]. OPA was statistically different between groups (Healthy: 3.17±1.2mmHg; NTG: 2.58±1.2mmHg; POAG: 2.60±1.1mmHg; p<0.01), but not between the glaucoma groups (p=0.60). Multiple regression models to explain OPA variance were made for each cohort (healthy: p<0.001, r=0.605; NTG: p=0.003, r=0.372; POAG: p<0.001, r=0.412). OPA was independently associated with retrobulbar CDI parameters in the healthy subjects and POAG patients (healthy CRV resistance index: β=3.37, CI: 0.16-6.59; healthy NPCA mean systolic/diastolic velocity ratio: β=1.34, CI: 0.52-2.15; POAG TPCA mean systolic velocity: β=0.14, CI 0.05-0.23). OPA in the NTG group was associated with diastolic blood pressure and pulse rate (β=-0.04, CI: -0.06 to -0.01; β=-0.04, CI: -0.06 to -0.001, respectively). Vascular-related models provide a better explanation to OPA variance in healthy individuals than in glaucoma patients. The variables that influence OPA seem to be different in healthy, POAG and NTG patients.

Prolonged postocclusive hyperemia response in patients with normal-tension glaucoma.

BackgroundIt is believed that endothelial dysfunction may be a link between systemic and ocular dysregulation in glaucoma. The aim of this study was to evaluate peripheral vascular reactive hyperemia in response to occlusion test and to correlate peripheral vascular findings with retrobulbar hemodynamics parameters in patients with normal-tension glaucoma.Material/MethodsForty-eight patients with normal-tension glaucoma (mean age 58.1 years, 38 women) and 40 control subjects (mean age 54.1 years, 36 women) were subjected to a brachial arterial occlusion test and color Doppler imaging (LOGIQ 9, GE Medical Systems) of the retrobulbar arteries. Finger hyperemia was assessed by using a 2-channel laser Doppler flowmeter (MBF-3D, Moor Instruments, Ltd.). Time parameters (time to peak flow, half-time of hyperemia, time of recovery) and amplitude parameters (maximum hyperemia response, biological zero) of the post-occlusive reactive hyperemia signal pattern as well as velocities and resistance index of the ophthalmic, central retinal, and short posterior ciliary arteries were evaluated and compared between study groups.ResultsIn glaucoma patients, time to peak flow and half-time of hyperemia were significantly longer (21.4 vs. 12.0 s, p=0.02 and 74.1 vs. 44.2 s, p=0.03, respectively) and biological zero was significantly lower (2.4 vs. 3.2, p=0.01) comparing with healthy subjects. In glaucoma patients, peak-systolic and end-diastolic velocities of central retinal artery were significantly lower (12.8 vs.14.1, p=0.03 and 3.9 vs. 4.7, p=0.01, respectively) and resistance index of this artery was significantly higher (0.69 vs. 0.67, p=0.03) compared to controls. In the glaucoma group, maximum hyperemic response was negatively correlated with the resistance index of temporal short posterior ciliary arteries (r=−0.4, p=0.01), whereas in the control group half-time of hyperemia was negatively correlated with end-diastolic velocity of the central retinal artery (r=−0.3, p=0.03).ConclusionsArterial occlusion test elicited a prolonged systemic hyperemia response in patients with glaucoma as compared with healthy subjects. Retrobulbar blood flow alterations in glaucoma patients may be related to systemic vascular dysregulation.

Should Men and Women be Managed Differently in Glaucoma?

IntroductionTo assess differences in associations of ocular perfusion pressure (OPP) as well as retinal and retrobulbar blood flow between men and women with primary open angle glaucoma (OAG).MethodsA total of 116 patients with OAG (age 66.9 ± 10.9 years, 70 females) participating in the Indianapolis Glaucoma Progression Study were assessed for OPP, retinal microcirculation, and retrobulbar blood flow. Confocal scanning laser Doppler flowmetry measured peripapillary retinal capillary blood flow. Color Doppler imaging measured peak systolic (PSV) and diastolic blood flow velocities and vascular resistance in the ophthalmic (OA), central retinal (CRA), and nasal and temporal short posterior ciliary arteries (N/T PCA). Bivariate Spearman correlation and multivariate linear regression analyses were performed.ResultsIn female patients with OAG, inferior retinal capillary flow was associated with OPP (r = 0.246, P = 0.044). In men, superior and inferior sector retinal blood flow was associated with OPP (r = −0.402, P = 0.006 and r = −0.357, P = 0.016, respectively). There was no statistically significant association between OPP and retrobulbar blood vessel flow velocities in male patients with OAG but there was an association between OA and TPCA PSV and OPP in female patients with OAG (r = 0.290, P = 0.015 and r = 0.357, P = 0.002, respectively). In female patients with OAG, multivariate regression showed no statistically significant effect of any variable on the superior retinal capillary blood flow, with CRA PSV as a sole predictor to the inferior retinal sector (partial rho = 0.302, P = 0.015) and in male patients with OAG, superior sector retinal capillary blood flow was independently associated with intraocular pressure (partial rho = −0.371, P = 0.016) and OPP (partial rho = −0.456, P = 0.002) with a trend of association with OPP in the inferior retina (partial rho = −0.301, P = 0.053).ConclusionsThere was a positive linear association between retinal microcirculation and OPP in females and a negative association in males. Male and female patients with OAG may differ in their vascular autoregulation in response to changes in OPP.

Repeatability of Retrobulbar Blood Flow Velocity Measured Using Color Doppler Imaging in the Indianapolis Glaucoma Progression Study

Determine the repeatability of color Doppler imaging (CDI) measurements in patients with open-angle glaucoma (OAG). We performed a cross-sectional, observational study of OAG patients participating in the Indianapolis Glaucoma Progression Study. Retrobulbar blood flow velocities and Pourcelot's vascular resistance index (RI) measured with CDI were examined. Two baseline measurements were obtained 1 to 2 weeks apart at the same time of day for all participants. Peak systolic and end diastolic blood flow velocities (PSV/EDV) were measured in the ophthalmic (OA), central retinal (CRA), and nasal and temporal short posterior ciliary arteries (N/TPCA) and RI was calculated. Intraclass correlation coefficient (ICC) between the 2 baselines was calculated. One hundred and sixteen patients with OAG [mean age 65.9 y (SD 10.9 y), 60% female] were examined in both baseline visits. In the OA, the intraobserver ICC for the PSV, EDV, and RI were all above 0.82. In the CRA, the intraobserver ICC for the PSV and RI were both above 0.8, whereas the EDV was 0.64. The intraobserver ICC in the N/TPCA for the PSV, EDV, and RI ranged from 0.71 to 0.88. The interobserver ICC was similar to the intraobserver ICC for the OA and the CRA but was lower than 0.7 in the EDV and RI of the T/NPCA. Blood flow velocities and calculated vascular resistance of the OA, CRA, and PCAs conducted within 2 weeks in patients with OAG are repeatable. Intraobserver CDI measurements were found more reproducible than interobserver CDI analysis.

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Munier, Francis L MD*; Beck-Popovic, Maja MD†; Balmer, Aubin MD*; Gaillard, Marie-Claire MD*; Bovey, Etienne MD*; Binaghi, Stefano MD‡ Author Information

Central retinal artery originating from the temporal short posterior ciliary artery associated with intraorbital external-to-internal carotid arterial anastomoses

Although variations in the peripapillary division pattern of the central retinal artery (CRA) are common, variations in the origin of this artery are seldom reported in the literature. Herein, the authors report a variant of the CRA that originated from the temporal short posterior ciliary artery. Two intraorbital anastomoses were also noted between the internal and external carotid arterial systems: one through the lacrimal artery-middle meningeal artery to the ophthalmic artery and the other through supraorbital artery-recurrent meningeal artery to the ophthalmic artery. A brief review of CRA variations and potential clinical significances of the observed variant are discussed.

Retrobulbar Hemodynamic Effects of Nipradilol in Normal and Normal-Tension Glaucoma Eyes

Purpose. To investigate the effects of nipradilol on retrobulbar hemodynamics. Methods. We investigated normal and normal-tension glaucoma (NTG) eyes. Topical nipradilol (one eye) and placebo eye drops (fellow eye) were instilled for 1 week in volunteers. Nipradilol was also instilled in NTG patients. Ultrasound color Doppler imaging for the posterior vessels was performed before, 2 hr, 1 week (for normal), and at 4 weeks (for NTG). Results. In normal eyes, there were significant decreases in the resistance index (RI) for the temporal short posterior ciliary arteries (PCA) at 2 hr and for the ophthalmic arteries at 1 week. There were no significant changes in the placebo-treated eyes. In the NTG eyes, there was a significant decrease in the RI for the central retinal artery, nasal, and temporal PCA at 2 hr and 4 weeks. Conclusion. Short-term observations found that nipradilol increased the ocular blood flow in normal and NTG eyes.

Potential diagnostic value of fluorescein angiography and color Doppler imaging in primary open angle glaucoma

To evaluate absolute filling defects of the optic disc and color Doppler imaging (CDI) measurements in primary open angle glaucoma (POAG) to assess their diagnostic potentialities. Twenty patients with POAG and 20 age- and sex-matched controls were included in this study. Fluorescein angiograms were performed and percentage of absolute fluorescein filling defects was calculated. Peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive indices (RI) of the ophthalmic artery (OA), central retinal artery (CRA), and temporal and nasal short posterior ciliary arteries (TPCA, NPCA) were measured using CDI. Absolute filling defects of the optic nerve head and RI of CRA were significantly larger in patients with POAG (p<0.001). EDV of CRA, TPCA, and NPCA were significantly reduced in POAG (p<0.05). RI of OA, TPCA, and NPCA were significantly increased in patients with POAG (p<0.05). Absolute fluorescein filling defects percentages correlated with the RI of CRA and NPCA. They correlated negatively with EDV of CRA, NPCA, and TPCA. The diagnostic accuracy of the RI of CRA in glaucoma was 96% while that of absolute fluorescein filling defects percentages was 92%. The combination of different techniques allows further interpretation of ocular circulatory changes in glaucoma and help in diagnosis of glaucoma. Further studies are needed for better understanding of the relationship between circulatory and neural loss.

Correlation Among Choroidal, Parapapillary, and Retrobulbar Vascular Parameters in Glaucoma

To study and compare the correlation among choroidal, parapapillary, and retrobulbar vascular parameters in healthy subjects, glaucoma suspects, and open-angle glaucoma (OAG) patients. Prospective observational clinical study. The study included one randomly selected eye from 21 normal subjects, 30 glaucoma suspects based on optic disc appearance, and 22 OAG patients. The pulsatile ocular blood flow (POBF), a measure of choroidal blood flow, was assessed using ocular blood flow analyzer whereas parapapillary blood flow and blood velocity of retrobulbar blood vessels were measured using scanning laser Doppler flowmetry and color Doppler imaging, respectively. All vascular parameters along with blood pressure and intraocular pressure measurements were obtained within a 2-hour period. Univariate regression analyses were used to evaluate the correlation of POBF values with parapapillary blood flow values, retrobulbar blood flow velocities, and resistive index, which represents vascular resistance, in each group. Two multiple linear regression models were created based on results of univariate analyses and included POBF, mean parapapillary blood flow, age, and mean ocular perfusion pressure; and POBF, temporal short posterior ciliary artery resistive index, age, and mean ocular perfusion pressure. POBF was significantly associated with parapapillary blood flow (r2 = 0.54; P < .001, positive correlation) and temporal short posterior ciliary artery resistive index (r2 = 0.39; P < .001, negative correlation) in normal subjects. Results were consistent when corrected for age, intraocular pressure, and blood pressure parameters. POBF values did not correlate with parapapillary blood flow values or temporal short posterior ciliary artery resistive index in glaucoma suspects or OAG patients. The relationships of POBF with parapapillary blood flow and calculated retrobulbar vascular resistance differs among normal subjects, glaucoma suspects, and OAG patients. This provides further evidence of vascular dysregulation in OAG.

Retrobulbar hemodynamic parameters in pseudoexfoliation syndrome and pseudoexfoliative glaucoma

To compare the hemodynamic parameters in the retrobulbar vessels in pseudoexfoliative syndrome (PXS), pseudoexfoliative glaucoma (PXG), and age-matched healthy subjects by using color Doppler imaging (CDI). 72 eyes from 72 patients with PXS, 70 eyes from 70 patients with PXG, and 66 eyes from 66 age-matched healthy subjects who met the inclusion/exclusion criteria were included in this prospective cross-sectional study. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and Pourcelot resistance index (RI) were assessed in the ophthalmic artery (OA), central retinal artery (CRA), and temporal short-posterior ciliary arteries (SPCA). Visual function was assessed using the 24-2 Swedish Interactive Threshold Algorithm (SITA). The main outcomes of the study were PSV, EDV and RI in the OA, SPCA, and CRA. The EDV in the OA, SPCA and the CRA was decreased significantly (p < 0.001, <0.001, and 0.003 respectively) in the eyes of PXG patients compared with controls and PSX respectively. The RI in the OA, SPCA, and the CRA was significantly higher (p = 0.022, 0.005, and 0.007 respectively) in the eyes of PXG patients compared with healthy controls and PSX patients respectively. The mean difference in mean EDV in the OA between the control group and the PXS was 0.18 cm/s, 95% confidence interval (CI) -0.60 to 0.95, p = 0.661. The mean difference in mean EDV in the SPCA between the control healthy subjects and the pseudoexfoliative subjects was -0.18 cm/s, 95% CI -0.45 to 0.08, p = 0.176. Multivariate regression analysis showed that in the PXG patients the PSV and EDV in the CRA were significantly positively correlated with the mean defect (p = 0.006 and 0.002 respectively). The RI in the CRA was significantly negatively correlated with the mean defect in PXG patients, p = 0.009. The results of this study showed that the retrobulbar hemodynamics might be disturbed in patients with PXG, especially in the central retinal artery. Our results have found no significant differences in the retrobulbar hemodynamic parameters between pseudoexfoliative syndrome patients and age-matched healthy subjects.

Effect of Travoprost and Brinzolamide on ocular hemodynamics

Abstract Purpose: To investigate the effect of topical travoprost and brinzolamide on retrobulbar flow velocities and ocular pulse amplitude in glaucoma patients. Methods: Twenty patients with glaucoma underwent color doppler imaging of the central retinal, temporal and nasal short posterior ciliary and ophthalmic artery, as well as Pascal dynamic contour tonometry and ocular pulse amplitude (OPA) measurement at baseline without treatment (timepoint 1, T1), after 1 month of travoprost (T2) and subsequently after 3 months of travoprost and brinzolamide (T3). A multivariate model was used to evaluate the changes in retrobulbar flow velocities and OPA. Results: In the temporal posterior ciliary artery, the flow velocities remained unchanged after administration of travoprost (7.9 at T1 versus 7.7 cm/s at T2, p=0.55 and 2.6 versus 2.7 cm/s, p=0.36 for peak systolic and end diastolic velocity respectively). Peak systolic velocity significantly increased after addition of brinzolamide compared to travoprost alone (8.7 cm/s at T3, p=0.003), which was a borderline increase as compared to baseline (p=0.05), whereas end diastolic velocity significantly increased as compared to baseline (2.9 cm/s, p=0.001). Ocular pulse amplitude did not change after administration of travoprost (p=0.19), but decreased markedly after addition of brinzolamide (p=0.005) despite a more important intra‐ocular pressure reduction with travoprost than after addition of brinzolamide. Conclusions: Flow velocities improved only in the temporal posterior ciliary artery after topical treatment with travoprost and brinzolamide in glaucoma patients. Ocular pulse amplitude decreased significantly with brinzolamide added to travoprost, but not with travoprost alone.

Comparison of the effects of travoprost, latanoprost and bimatoprost on ocular circulation: a 6‐month clinical trial

To study the effect of three prostaglandin F(2)-alpha (PG) analogues on retrobulbar blood flow velocity in previously untreated patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT), using colour Doppler ultrasound. Sixty newly diagnosed patients with POAG or OHT were randomly assigned to travoprost 0.004% (n = 12 with POAG, n = 8 with OHT), latanoprost 0.005% (n = 11 with POAG, n = 9 with OHT) and bimatoprost 0.03% (n = 13 with POAG, n = 7 with OHT) treatment groups in a double-masked fashion. At baseline examination, blood pressure, heart rate and intraocular pressure (IOP) were recorded. Peak-systolic and end-diastolic velocities were measured in the ophthalmic (OA), central retinal (CRA) and temporal short posterior ciliary arteries (PCA). The resistive index (RI) and ocular perfusion pressure (OPP) were determined for each treatment group. After a treatment period of 6-months, all procedures were repeated. There were no significant differences in age (53 +/- 14 years in the travoprost group, 51 +/- 14 years in the latanoprost group, 53 +/- 11 years in the bimatoprost group), gender (11 men, nine women; 11 men, nine women; 13 men, seven women, by group, respectively), or clinical diagnosis (POAG or OHT) among treatment groups (p > 0.05). A significant decrease in IOP (baseline: 26.4 +/- 3.3 mmHg, 26.8 +/- 1.3 mmHg, 25.8 +/- 1.8 mmHg, respectively; month 6: 20.9 +/- 1.9 mmHg, 20.8 +/- 2.4 mmHg, 18.3 +/- 1.2 mmHg, respectively; p < 0.0001) and an increase in OPP (baseline: 33.7 +/- 3.8 mmHg, 33.5 +/- 3.2 mmHg, 33.9 +/- 2.6 mmHg, respectively; month 6: 40.2 +/- 3.5 mmHg, 39.9 +/- 3.1 mmHg, 41.7 +/- 2.6 mmHg, respectively; p < 0.0001) were verified in all three groups during the study period. Mean baseline RI values for the CRA in the travoprost group and the OA in the latanoprost group were both 0.7 +/- 0.1 mmHg and both values were statistically significantly lower at 6 months (0.6 +/- 0.1 mmHg in both groups; p = 0.002, p < 0.0001, respectively). In the bimatoprost group there was no statistically significant difference in haemodynamic parameters over the study period (p > 0.05). Our results suggest that the three PG analogues significantly reduce IOP and increase OPP in patients with POAG or OHT. Topical travoprost and latanoprost significantly reduce the RI of the CRA and OA, respectively. We were unable to determine any effect of topical bimatoprost on ocular haemodynamics.

Ocular Blood Flow Evaluation in Injured and Healthy Fellow Eyes

To assess if injured eyes develop ocular blood flow disturbances that may contribute to development of traumatic glaucoma. Twenty-five eyes of 25 patients hospitalized from January 1997 to July 1999 for blunt (15) or penetrating (10) eye injury and elevated intraocular pressure (IOP) (>23 mm Hg) were controlled at least 24 months after the trauma and underwent visual field examination, pulsatile ocular blood flow (pOBF), and color Doppler imaging (CDI) analysis of ophthalmic artery, central retinal artery, nasal and temporal short posterior ciliary arteries. Uninjured healthy eye was used as control. IOP was significantly higher in injured eyes (15.1+/-3.3 vs 13.0+/-2.7 mmHg; p<0.01), but only 2 eyes (8%) were under medical treatment. pOBF values were significantly lower in injured eyes: 11.25+/-6.56 microL/sec in the trauma eyes and 15.40+/-7.29 in fellow eyes (p=0.002). Resistivity index of all investigated retrobulbar vessels was very significantly higher in injured eyes than in fellow eyes (p<0.0001). There is no significant correlation between IOP and ocular blood flow disturbance. Long-term follow-up (mean 39+/-12 months) of injured eyes shows, besides a slight but significant increase of IOP, a very significant impairment of ocular blood supply to injured eyes compared to healthy fellow eyes with reduction of pulsatile ocular blood flow and marked increase of resistance to flow in all retrobulbar vessels. These anomalies may be considered an independent risk factor to develop traumatic glaucoma.