97th DOG Annual Meeting 1999
OCULAR HEMODYNAMICS IN NORMAL PRESSURE GLAUCOMA PATIENTS WITH DISC HEMORRHAGES
L. E. Pillunat, A. G. Böhm, K. G. Schmidt*
Purpose: Optic disc hemorrhages in normal pressure glaucoma (NPG) patients are usually regarded as a sign of vascular dysfunction and as an indicator for glaucoma damage progression. In an attempt to elucidate hemodynamical changes in these patients, 18 patients suffering from NPG with acute optic disc hemorrhages were examined.
Methods: Ocular pulse amplitudes and the parameter pulsatile ocular blood flow were measured with a pneumotonometric system (OBF-system, U.K.) and optic nerve head blood flow was measured by scanning laserdoppler flowmetry (HRF) at different locations of the optic disc. In addition the parameters IOP, mean deviation of the visual field (Humphrey 30-2) were monitored. 18 consecutive NPG-patients with newly diagnosed optic disc hemorrhages were examined (mean age 69,9 years, 14 female, 4 male). Two groups served as a control: 18 patients with NPG which were matched for age, sex and stage of the disease (mean age 70,0 years, 14 female, 4 male) and in addition the contralateral eye without any hemorrhages. For statistical analysis the Mann-Whitney-U-test and the Wilcoxon-test were applied.
Results: Optic nerve head blood flow as a mean of several locations was significantly (p = 0,0057) lower (x = 513 AU) in eyes with optic disc hemorrhages (ODH) compared to the control group (x = 632 AU) but did not significantly differ from the contralateral eye (x = 617 AU). Pulsatile ocular blood flow and OPA were found to be significantly lower (p<0,05) in eyes with ODH (x=652 µl/min; x = 1,66 mmHg) compared to the contralateral eyes (x = 755 µl/min; x = 1,91 mmHg) and compared to the control group (x = 958 µl/min; x = 2,48 mmHg). Furthermore there was found a significant difference between the contralateral eye and the control group (p<0,05).
Conclusion: The results indicate that optic nerve blood flow is diminished in NPG eyes with optic disc hemorrhages. Furthermore the contralateral eye of eyes with disc hemorrhages show reduced OPA and POBF compared to a NPG control group. Therefore a diminished OPA and POBF might be interpreted as an early sign of progression.
University Eye Hospital Hamburg, Martinistr. 52, 20246 Hamburg
*University Eye Hospital Gießen, Friedrichstr. 18, 35385 Gießen