Assessment of blood flow in posterior ciliary arteries and its correlation with intraocular and arterial blood pressures in patients with open angle glaucoma
Agnieszka Waliszek-Iwanicka, Marek Waliszek, Maciej Banach, Jacek Rysz, Roman Gos
Med Sci Monit 2010; 16(10): CR501-509
Available online: 2010-10-01
Background: At present, the vascular theory of glaucomatous neuropathy is still the subject of intensive scientific studies aiming at settling the relationship between the development of glaucomatous neuropathy and vascular factors. Therefore the purpose of this study was to assess the blood flow parameters in the posterior ciliary artery and middle cerebral artery in patients with glaucoma and the correlation of glaucomatous changes with flow in vessels supplying the retina, choroid and anterior segment of the optic nerve in patients with glaucoma with and without coexisting arterial hypertension.
Material/Methods: The study comprised 50 patients who were divided into two groups: group I – 25 patients (50 eyes) with primary open angle glaucoma (POAG) without coexisting arterial hypertension; and group II – 25 patients (50 eyes) with POAG with diagnosed and treated arterial hypertension.
Results: The median of the mean maximal velocity in posterior ciliary arteries was 10.4 cm/s in patients from group I. In patients with POAG and arterial hypertension the median of the mean maximal velocity in posterior ciliary arteries was 8.95 cm/s (p<0.002). In group I the median of the Gosling pulsatility index (PI) in posterior ciliary arteries was 1.0, whereas in group II the median was 1.16 (p<0.002). The median of the pulsatility transmission index (PTI) for cerebral and ocular vessels was 1.3 in group I, whereas in group II the median was 1.38 (p<0.02).
Conclusions: The coexistence of arterial hypertension in glaucoma patients significantly worsens microcirculation in the area of posterior ciliary arteries and may be the cause of accelerated progression of glaucomatous neuropathy.
Keywords: Intraocular Pressure, Glaucoma, Open-Angle - ultrasonography, Eye - blood supply, Choroid - ultrasonography, Cerebral Arteries - physiopathology, Blood Pressure, Blood Flow Velocity, Ocular Hypertension - ultrasonography, Optic Nerve - blood supply, Retina - ultrasonography