Role of eye hemoperfusion in the progress of primary open-angle glaucoma

PURPOSE: To compare the diagnostic value of regional blood flow indicators and choroidal thickness with other morphological and functional parameters in early glaucoma detection. METHODS: 30 normal eyes and 32 eyes with preperimetric glaucoma were analyzed in the present study. The thickness of the ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) and choroidal thickness (ChT) were measured using RTVue SD-OCT images. Perimetry - using Humphrey test (Carl Zeiss Meditec, Dublin, CA). Ocular blood flow velocity was measured by the color Doppler mapping (VOLUSON 730 ProSystem). Intraocular pressure (lOPcc) and corneal hysteresis (CH) were determined using Ocular Response Analyzer (ORA). As a measure of the parameter significance in early glaucoma detections, a value of the adjusted standardized statistic of the Wilcoxon-Mann-Whitney (z-value) and the area under the receiver operating characteristic (ROC) curve (AUC) were applied. RESULTS: The following parameters presented with the largest AUC score and highest z-values: the mean BFV in the vortex vein (AUC 1.0; z-value 5.35) and central retinal vein (0.85; 3.74), end diastolic BFV in the central retinal artery (0.73; 2.74) and temporal posterior ciliary arteries (0.71; 2.53), intraocular pressure (IOP) (0.74; -2.9), perimetric index Mean Deviation (MD) (0.72; 2.65), corneal hysteresis (CH) (0.69; 2.24), peripapillar ChT (0.69; -2.28), average GCC thickness (0.67; 2.05) and FLV (0.66; -1.86). CONCLUSIONS: The most informative clinical parameters in pre-perimetric glaucoma are blood flow indicators in vorticose veins, central retinal vein, central retinal artery and short posterior ciliary arteries, and the thickness of the peripapillary choroid, which indicates the role of hemoperfusion disorder in the progress of glaucoma and emphasizes the importance of ocular hemodynamic studies for early glaucoma detection.

ервичная открытоугольная глаукома, GCC, оптическая когерентная томография, MD, толщина хориоидеи, глазной кровоток, primary open-angle glaucoma, GCC, optical coherence tomography, MD, choroidal thickness, ocular blood flow

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