Wolf S, Arend O, Haase A, Schulte K, Remky A, Reim M
Augenklinik der RWTH Aachen, Germany.
Ger J Ophthalmol. 1995 Sep;4(5):279-82.
Recently it has been demonstrated that retinal hemodynamics are disturbed in patients with chronic open-angle glaucoma. As the underlying cause a reduction in perfusion pressure due to increased intraocular pressure (IOP) and deficiencies of retinal autoregulation has been discussed. The present study was undertaken to clarify the influence of filtering surgery on retinal hemodynamics in patients with chronic open-angle glaucoma. A total of 17 patients with chronic open-angle glaucoma aged between 37 and 86 years were included in this prospective study. All patients underwent digital fluorescein angiography before and 10 days after fistulating procedures. From the angiograms the arteriovenous passage time (AVP) and arterial mean dye-bolus velocity (MDV) were quantified by means of digital picture analysis. At baseline the AVP was significantly prolonged in the patients as compared with reference values (AVP, 2.5 +/- 0.8 versus 1.6 +/- 0.4 s; P < 0.01). After the fistulating procedure (IOP: before, 29 +/- 5 mmHg; after, 16 +/- 4 mmHg) the AVP was significantly reduced as compared with baseline values (AVP, 2.5 +/- 0.8 versus 2.0 +/- 0.4 s; P < 0.05), whereas the MDV showed only a slight increase (MDV, 5.70 +/- 0.89 versus 5.99 +/- 0.92 mm/s; P > 0.05). This study confirms a disturbance of retinal hemodynamics in patients with chronic open-angle glaucoma. The significant reduction in AVP observed after lowering of the IOP by fistulating procedures demonstrates the positive influence of IOP reduction on the retinal circulation. The improvement in retinal circulation may prevent the occurrence of further glaucomatous damage after fistulating procedures.
最近有研究表明，慢性开角型青光眼患者的视网膜血流动力学受到干扰。关于其潜在原因，有人讨论是由于眼内压（IOP）升高导致灌注压降低以及视网膜自身调节功能缺陷。本研究旨在阐明滤过手术对慢性开角型青光眼患者视网膜血流动力学的影响。这项前瞻性研究共纳入了17例年龄在37至86岁之间的慢性开角型青光眼患者。所有患者在造瘘手术前和术后10天均接受了数字荧光血管造影。通过数字图像分析从血管造影照片中量化动静脉通过时间（AVP）和动脉平均染料团块速度（MDV）。基线时，与参考值相比，患者的AVP显著延长（AVP，2.5±0.8秒对1.6±0.4秒；P<0.01）。造瘘手术后（IOP：术前29±5mmHg；术后16±4mmHg），与基线值相比，AVP显著降低（AVP，2.5±0.8秒对2.0±0.4秒；P<0.05），而MDV仅略有增加（MDV，5.70±0.89毫米/秒对5.99±0.92毫米/秒；P>0.05）。本研究证实了慢性开角型青光眼患者存在视网膜血流动力学紊乱。通过造瘘手术降低IOP后观察到的AVP显著降低表明降低IOP对视网膜循环有积极影响。视网膜循环的改善可能会预防造瘘手术后进一步青光眼性损伤的发生。
