青光眼病情进展性损害患者的眼灌注压与球后血流之间的关系

Relationship between ocular perfusion pressure and retrobulbar blood flow in patients with glaucoma with progressive damage.

作者信息

Gherghel D, Orgül S, Gugleta K, Gekkieva M, Flammer J

机构信息

University Eye Clinic, Basel, Switzerland.

出版信息

Am J Ophthalmol. 2000 Nov;130(5):597-605. doi: 10.1016/s0002-9394(00)00766-2.

DOI:10.1016/s0002-9394(00)00766-2

PMID:11078838

Abstract

PURPOSE

To evaluate the relationship between ocular perfusion pressure and color Doppler measurements in patients with glaucoma.

MATERIALS AND METHODS

Twenty patients with primary open-angle glaucoma with visual field deterioration in spite of an intraocular pressure lowered below 21 mm Hg, 20 age-matched patients with glaucoma with stable visual fields, and 20 age-matched healthy controls were recruited. After a 20-minute rest in a supine position, intraocular pressure and color Doppler measurements parameters of the ophthalmic artery and the central retinal artery were obtained. Correlations between mean ocular perfusion pressure and color Doppler measurements parameters were determined.

RESULTS

Patients with glaucoma showed a higher intraocular pressure (P <.0008) and a lower mean ocular perfusion pressure (P <.0045) compared with healthy subjects. Patients with deteriorating glaucoma showed a lower mean blood pressure (P =.033) and a lower end diastolic velocity in the central retinal artery (P =.0093) compared with normals. Mean ocular perfusion pressure correlated positively with end diastolic velocity in the ophthalmic artery (R = 0.66, P =.002) and central retinal artery (R = 0.74, P <.0001) and negatively with resistivity index in the ophthalmic artery (R = -0.70, P =.001) and central retinal artery (R = -0.62, P =.003) in patients with deteriorating glaucoma. Such correlations did not occur in patients with glaucoma with stable visual fields or in normal subjects. The correlations were statistically significantly different between the study groups (parallelism of regression lines in an analysis of covariance model) for end diastolic velocity (P =.001) and resistivity index (P =.0001) in the ophthalmic artery, as well as for end diastolic velocity (P =.0009) and resistivity index (P =. 001) in the central retinal artery.

CONCLUSIONS

The present findings suggest that alterations in ocular blood flow regulation may contribute to the progression in glaucomatous damage.

摘要

目的

评估青光眼患者眼灌注压与彩色多普勒测量值之间的关系。

材料与方法

招募了20例尽管眼压已降至21 mmHg以下但仍有视野恶化的原发性开角型青光眼患者、20例年龄匹配且视野稳定的青光眼患者以及20例年龄匹配的健康对照者。在仰卧位休息20分钟后，测量眼压以及眼动脉和视网膜中央动脉的彩色多普勒测量参数。确定平均眼灌注压与彩色多普勒测量参数之间的相关性。

结果

与健康受试者相比，青光眼患者眼压较高（P <.0008），平均眼灌注压较低（P <.0045）。与正常人相比，青光眼病情恶化的患者平均血压较低（P =.033），视网膜中央动脉舒张末期血流速度较低（P =.0093）。在青光眼病情恶化的患者中，平均眼灌注压与眼动脉舒张末期血流速度（R = 0.66，P =.002）和视网膜中央动脉舒张末期血流速度（R = 0.74，P <.0001）呈正相关，与眼动脉阻力指数（R = -0.70，P =.001）和视网膜中央动脉阻力指数（R = -0.62，P =.003）呈负相关。在视野稳定的青光眼患者或正常受试者中未出现此类相关性。在协方差模型分析中，研究组之间眼动脉舒张末期血流速度（P =.001）和阻力指数（P =.0001）以及视网膜中央动脉舒张末期血流速度（P =.0009）和阻力指数（P =.001）的相关性在统计学上有显著差异（回归线平行）。