Vécsei P V, Hommer A, Reitner A, Kircher K, Egger S, Schneider B, Bettelheim H C
Universitätsklinik für Augenheilkunde Wien.
Klin Monbl Augenheilkd. 1998 Jun;212(6):444-8.
Various authors report that the glaucomatous loss of function is due to a chronic anterior ischemic optic neuropathy, being caused by a disturbed relationship between intraocular pressure and perfusion pressure in the posterior short ciliary arteries, which possibly leads to increased resistance in the ciliary vascular system. The authors attempt to test this hypothesis by measuring the vascular resistance (Resistance Index) in the ciliary vessel system by means of color Doppler sonography.
35 eyes of 35 patients, suffering from open angle glaucoma (OAG), with a mean age of 65.3 years, were examined as well as 35 eyes of 35 patients with normal tension glaucoma (NTG), whose mean age was 65.8 years. Both glaucoma groups were compared to an age- and sex-matched control group of healthy volunteers. The color-Doppler measurements were performed with an Acuson 128 XP/10, which allows imaging of all retrobulbar arteries, the ophthalmic artery, the central retinal artery and the short posterior ciliary arteries, and also guarantees the precise calculation of blood flow velocity and resistive index (RI). The RI was statistically evaluated.
The resistance index of all retrobulbar arteries showed a statistically significant increase (p < 0.05) according to Wilcoxon's test in the OAG group as well as the NTG group.
Increased vascular resistance was found in all retrobulbar arteries in OAG and in NTG. These findings point out the pathognomonic importance of perfusion disturbance in glaucoma.
多位作者报告称，青光眼的功能丧失是由于慢性前部缺血性视神经病变所致，其起因是眼内压与睫状后短动脉灌注压之间的关系紊乱，这可能导致睫状血管系统阻力增加。作者试图通过彩色多普勒超声测量睫状血管系统的血管阻力（阻力指数）来验证这一假设。
对35例开角型青光眼（OAG）患者的35只眼睛进行了检查，患者平均年龄为65.3岁，同时对35例正常眼压性青光眼（NTG）患者的35只眼睛进行了检查，其平均年龄为65.8岁。将这两个青光眼组与年龄和性别匹配的健康志愿者对照组进行比较。使用Acuson 128 XP/10进行彩色多普勒测量，该设备能够对所有球后动脉、眼动脉、视网膜中央动脉和睫状后短动脉进行成像，还能保证精确计算血流速度和阻力指数（RI）。对RI进行了统计学评估。
根据威尔科克森检验，OAG组和NTG组所有球后动脉的阻力指数均有统计学显著增加（p < 0.05）。
在OAG和NTG患者的所有球后动脉中均发现血管阻力增加。这些发现指出了灌注紊乱在青光眼中的特征性重要意义。
