Rate of progression of glaucoma correlates with retrobulbar circulation and intraocular pressure

Abstract

Purpose: To evaluate the correlation between progression rate of glaucomatous damage and retrobulbar blood flow in an institutional setting.

Design: Retrospective, observational case series.

Methods: Twenty open-angle glaucoma patients with at least five visual field examinations and progressive damage in at least one eye were included in the study. Mean +/- standard deviation follow-up time was 4.3 +/- 1.6 years. As an indicator of progression rate of visual field damage, the angle to a horizontal line of the slope of the regression line of the visual field index mean defect over time was calculated for one randomly selected eye per patient. The association between this angle and intraocular pressure, as well as retrobulbar color Doppler imaging measurements obtained at the beginning of the observation period, was analyzed by a multiple linear regression analysis in a stepwise forward approach.

Results: With a faster rate in progression of glaucomatous damage, a lower baseline end diastolic blood flow velocity in the central retinal artery (partial r = -.63; P <.0037) and a higher baseline intraocular pressure (partial r =.59; P <.0078) were noted (multiple r =.69; P <.0043). Rate of progression was not related to the extent of preexisting visual field damage.

Conclusions: Independent of the extent of glaucomatous damage and intraocular pressure, the progression rate of glaucomatous visual field damage statistically correlates with retrobulbar hemodynamic variables.