Duijm H F, van den Berg T J, Greve E L
Department of Ophthalmology, University of Amsterdam, The Netherlaneds.
Am J Ophthalmol. 1997 May;123(5):644-56. doi: 10.1016/s0002-9394(14)71077-3.
To quantify, compare, and assess differences between retinal and choroidal hemodynamics in normal control subjects and patients with ocular hypertension, primary open-angle glaucoma, and normal-pressure glaucoma.
Video fluorescein angiograms were made in 20 normal subjects, 11 patients with ocular hypertension, 45 patients with primary open-angle glaucoma, and 43 patients with normal-pressure glaucoma. Choroidal dye build-up curves were analyzed using an exponential model. The model time constant tau reflected the local blood refreshment time, the time needed to replace the blood volume in a tissue volume. Retinal arteriovenous passage time was estimated from the time lapse between retinal arterial and venous dye curves.
The retinal arteriovenous passage time was longer in patients with primary open-angle glaucoma compared with normal subjects and patients with normal-pressure glaucoma; the average arteriovenous passage times (+/-SEM) in normal subjects and in patients with ocular hypertension, primary open-angle glaucoma, and normal-pressure glaucoma were, respectively, 2.44 +/- 0.19, 2.90 +/- 0.37, 3.02 +/- 0.17, and 2.55 +/- 0.15 seconds. Choroidal tau was longest in the normal-pressure glaucoma group but not as long in the primary open-angle glaucoma group; tau values in normal subjects and patients with ocular hypertension, primary open-angle glaucoma, and normal-pressure glaucoma were, respectively, 4.6 +/- 0.29, 5.6 +/- 0.69, 6.2 +/- 0.39, and 7.1 +/- 0.33 seconds.
Whereas choroidal circulation is especially slower in patients with normal-pressure glaucoma, retinal circulation is delayed in patients with primary open-angle glaucoma. The choroidal and retinal vascular systems behave differently in primary open-angle and normal-pressure glaucoma, which may be important in the management of glaucoma.
量化、比较并评估正常对照受试者与高眼压症、原发性开角型青光眼及正常眼压性青光眼患者视网膜和脉络膜血流动力学之间的差异。
对20名正常受试者、11名高眼压症患者、45名原发性开角型青光眼患者和43名正常眼压性青光眼患者进行了视频荧光血管造影。使用指数模型分析脉络膜染料积聚曲线。模型时间常数tau反映局部血液更新时间，即替换组织体积中血容量所需的时间。视网膜动静脉通过时间根据视网膜动脉和静脉染料曲线之间的时间间隔估算。
与正常受试者和正常眼压性青光眼患者相比，原发性开角型青光眼患者的视网膜动静脉通过时间更长；正常受试者、高眼压症患者、原发性开角型青光眼患者和正常眼压性青光眼患者的平均动静脉通过时间（±标准误）分别为2.44±0.19、2.90±0.37、3.02±0.17和2.55±0.15秒。脉络膜tau在正常眼压性青光眼组中最长，但在原发性开角型青光眼组中没有那么长；正常受试者、高眼压症患者、原发性开角型青光眼患者和正常眼压性青光眼患者的tau值分别为4.6±0.29、5.6±0.69、6.2±0.39和7.1±0.33秒。
正常眼压性青光眼患者的脉络膜循环尤其缓慢，而原发性开角型青光眼患者的视网膜循环延迟。在原发性开角型青光眼和正常眼压性青光眼中，脉络膜和视网膜血管系统表现不同，这在青光眼的治疗中可能很重要。
