Hafez Ali S, Bizzarro Regina L G, Rivard Michele, Lesk Mark R
Department of Ophthalmology and Guy-Bernier Research Center, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada.
Ophthalmology. 2003 Jan;110(1):201-10. doi: 10.1016/s0161-6420(02)01716-5.
To detect and quantify changes in optic nerve head (ONH) and peripapillary retinal blood flow by scanning laser Doppler flowmetry (SLDF) in open-angle glaucoma (OAG) and ocular hypertension (OHT) after therapeutic intraocular pressure (IOP) reduction.
Prospective, nonrandomized, self-controlled trial.
Twenty patients with OAG and 20 patients with OHT with clinical indications for therapeutic IOP reduction were prospectively enrolled.
IOP reduction was achieved by medical, laser, or surgical therapy. All patients had IOP reductions more than 20% and a minimum of 4 weeks follow-up.
Blood flow measurements were performed by SLDF analysis software (version 3.3) using Heidelberg Retina Flowmeter images. Statistical evaluations were performed on both groups using a two-tailed distribution paired t test.
Twenty patients with OAG had a mean IOP reduction of 37% after treatment. In these patients, mean (+/- standard deviation) rim blood flow increased by 67% (from 158 +/- 79 arbitrary units to 264 +/- 127 arbitrary units, P = 0.001), whereas mean temporal peripapillary retinal flow decreased by 7.4% (P = 0.24), and mean nasal peripapillary retinal flow increased by 0.3% (P = 0.96). Twenty OHT patients had a mean IOP reduction of 33% after treatment. In contrast to the OAG group, neither the mean rim blood flow (7.5% increase from 277 +/- 158 arbitrary units to 298 +/- 140 arbitrary units, P = 0.41) nor the mean temporal (P = 0.35) or nasal (P = 0.88) peripapillary retinal flow changed significantly.
For a similar percentage of IOP reduction, OAG patients had a statistically significant improvement of blood flow in the neuroretinal rim of the ONH, whereas OHT patients did not demonstrate such a change. Peripapillary retinal blood flow, expected to be affected less in glaucoma, remained stable in both groups. In addition to indicating a response to therapy in OAG patients, the reported changes in rim perfusion suggest that ONH autoregulation may be defective in OAG while intact in OHT.
通过扫描激光多普勒血流仪（SLDF）检测并量化开角型青光眼（OAG）和高眼压症（OHT）患者在治疗性降低眼压（IOP）后视神经乳头（ONH）和视乳头周围视网膜血流的变化。
前瞻性、非随机、自身对照试验。
前瞻性纳入20例有治疗性降低眼压临床指征的OAG患者和20例OHT患者。
通过药物、激光或手术治疗降低眼压。所有患者眼压降低超过20%，且至少随访4周。
使用海德堡视网膜血流仪图像，通过SLDF分析软件（3.3版）进行血流测量。两组均采用双尾分布配对t检验进行统计学评估。
20例OAG患者治疗后眼压平均降低37%。在这些患者中，平均（±标准差）视盘边缘血流增加67%（从158±79任意单位增至264±127任意单位，P = 0.001），而平均颞侧视乳头周围视网膜血流减少7.4%（P = 0.24），平均鼻侧视乳头周围视网膜血流增加0.3%（P = 0.96）。20例OHT患者治疗后眼压平均降低33%。与OAG组不同，平均视盘边缘血流（从277±158任意单位增加7.5%至298±140任意单位，P = 0.41）以及平均颞侧（P = 0.35）或鼻侧（P = 0.88）视乳头周围视网膜血流均无显著变化。
对于相似的眼压降低百分比，OAG患者视盘神经视网膜边缘的血流有统计学显著改善，而OHT患者未显示出此类变化。预计在青光眼中受影响较小的视乳头周围视网膜血流在两组中均保持稳定。除了表明OAG患者对治疗有反应外，所报告的视盘边缘灌注变化提示OAG患者的ONH自身调节可能存在缺陷，而OHT患者的自身调节功能完好。
