Abstract
Background
Previous studies have reported impaired blood flow in the ophthalmic artery (OA) and central retinal artery (CRA) in exfoliation syndrome and exfloliation glaucoma. This study evaluates blood flow at the long and short posterior ciliary arteries (LPCA and SPCA, respectively) in these conditions.
Methods
Consecutively examined candidates for cataract surgery were included. Only one eye (OD) was included in the analyses for consistency. Patients were classified into non-glaucoma and non-exfoliation (controls), primary open angle glaucoma (POAG), exfoliation syndrome and exfoliation glaucoma groups, based on the findings of the OD. Sixty-eight patients (41 males, 60.3%) were included. Color Doppler imaging (CDI) of the nasal and temporal branches of LPCA and SPCA was performed using a 7.5 Mhz probe. The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistivity index (RI) were recorded for the examined vessels.
Results
EDV at the LPCA was significantly lower in exfoliation syndrome and glaucoma, compared with controls and POAG respectively. EDV was significantly lower and RI was significantly higher at the SPCA in exfoliation glaucoma, compared with exfoliation, whereas respective differences were statistically not significant between controls and POAG.
Conclusions
The hemodynamic impairment at the LPCA in exfoliation syndrome and glaucoma supports an association between exfoliation and ischemic stress at the anterior ocular segment.
Similar content being viewed by others
References
Campo RV, Sipperley JO (1988) Anterior hyaloidal fibrovascular proliferation after diabetic vitrectomy. Am J Ophthalmol 105:432–434
Chung HS, Harris A, Evans DW, Kagemann L, Garzozi HJ, Martin B (1999) Vascular aspects in the pathophysiology of glaucomatous optic neuropathy. Surv Ophthalmol 43 Suppl 1:S43–S50
Costa VP, Harris A, Stefansson E, Flammer J, Krieglstein GK, Orzalesi N, Heijl A, Renard JP, Serra LM (2003) The effects of antiglaucoma and systemic medications on ocular blood flow. Prog Retin Eye Res 22:769–805
Gherghel D, Orgul S, Gugleta K, Gekkieva M, Flammer J (2000) Relationship between ocular perfusion pressure and retrobulbar blood flow in patients with glaucoma with progressive damage. Am J Ophthalmol 130:597–605
Gillespie BW, Musch DC, Guire KE, Mills RP, Lichter PR, Janz NK, Wren PA; CIGTS (Collaborative Initial Glaucoma Treatment Study) Study Group (2003) The collaborative initial glaucoma treatment study: baseline visual field and test-retest variability. Invest Ophthalmol Vis Sci 44:2613–2620
Hammer T, Schlotzer-Schrehardt U, Naumann GO (2001) Unilateral or asymmetric exfoliation syndrome? An ultrastructural study. Arch Ophthalmol 119:1023–1031
Harris A, Spaeth GL, Sergott RC, Katz LJ, Cantor LB, Martin BJ (1995) Retrobulbar arterial hemodynamic effects of betaxolol and timolol in normal-tension glaucoma. Am J Ophthalmol 120:168–175
Matthiessen ET, Zeitz O, Richard G, Klemm M (2004) Reproducibility of blood flow velocity measurements using colour decoded Doppler imaging. Eye 18:400–405
Mitchell P, Wang JJ, Smith W (1997) Association of exfoliation syndrome with increased vascular risk. Am J Ophthalmol 124:685–687
Morrison JC, Van Buskirk EM (1983) Anterior collateral circulation in the primate eye. Ophthalmology 90:707–715
Kaiser HJ, Schoetzau A, Stumpfig D, Flammer J (1997) Blood-flow velocities of the extraocular vessels in patients with high-tension and normal-tension primary open-angle glaucoma. Am J Ophthalmol 123:320–327
Konstas AG, Jay JL, Marshall GE, Lee WR (1993) Prevalence, diagnostic features, and response to trabeculectomy in exfoliation glaucoma. Ophthalmology 100:619–627
Kozobolis VP, Detorakis ET, Tsilimbaris MK, Siganos DS, Vlachonikolis IG, Pallikaris IG (2000) Crete Greece Glaucoma Study. J Glaucoma 9:143–149
Liu CJ, Chiou HJ, Chiang SC, Chou JC, Chou YH, Liu JH (1999) Variations in ocular hemodynamics in patients with early and late glaucoma. Acta Ophthalmol Scand 77:658–662
Quaranta L, Harris A, Donato F, Cassamali M, Semeraro F, Nascimbeni G, Gandolfo E, Quaranta CA (1997) Color Doppler imaging of ophthalmic artery blood flow velocity: a study of repeatability and agreement. Ophthalmology 104:653–658
Repo LP, Suhonen MT, Terasvirta ME, Koivisto KJ (1995) Color Doppler imaging of the ophthalmic artery blood flow spectra of patients who have had a transient ischemic attack. Correlations with generalized iris transluminance and exfoliation syndrome. Ophthalmology 102:1199–1205
Reus NJ, Lemij HG (2004) Diagnostic accuracy of the GDx VCC for glaucoma. Ophthalmology 111:1860–1865
Ritch R, Schlotzer-Schrehardt U (2001) Exfoliation syndrome. Surv Ophthalmol 45:265–315
Ritch R, Schlotzer-Schrehardt U (2001) Exfoliation (exfoliation) syndrome: toward a new understanding. Proceedings of the First International Think Tank. Acta Ophthalmol Scand 79:213–217
Schlotzer-Scherardt UM, Koca MR, Naumann GOH, Volkholz H (1992) Exfoliation syndrome. Ocular manifestation of a systemic disorder? Arch Ophthalmol 110:1752–1756
Schlotzer-Schrehardt U, Kuchle M, Naumann GO (1991) Electron-microscopic identification of exfoliation material in extrabulbar tissue. Arch Ophthalmol 109:565.70
Takahashi K, Muraoka K, Kishi S, Shimizu K (1996) Watershed zone in the human peripheral choroid. Ophthalmology 103:336–342
Tawara A, Kubota T, Hata Y, Sakamoto T, Honda M, Yoshikawa H, Inomata H, Ohnishi Y (2002) Neovascularization in the anterior segment of the rabbit eye by experimental anterior ischemia. Graefes Arch Clin Exp Ophthalmol 240:144–153
Trible JR, Anderson DR (1998). Factors associated with retrobulbar hemodynamic measurements at variable intraocular pressure. J Glaucoma 7:33–38
Vesti E, Kivela T (2000) Exfoliation syndrome and exfoliation glaucoma. Prog Retin Eye Res 19:345–368
Williamson TH, Haris A (1996) Color Doppler ultrasound imaging of the eye and orbit. Surv Ophthalmol 40:225–267
Yuksel N, Karabas VL, Arslan A, Demirci A, Caglar Y (2001) Ocular hemodynamics in exfoliation syndrome and exfoliation glaucoma. Ophthalmology 108:1043–1049
Yuksel N, Karabas VL, Demirci A, Arslan A, Altintas O, Caglar Y (2001) Comparison of blood flow velocities of the extraocular vessels in patients with exfoliation or primary open-angle glaucoma. Ophthalmologica 215:424–429
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Detorakis, E.T., Achtaropoulos, A.K., Drakonaki, E.E. et al. Hemodynamic evaluation of the posterior ciliary circulation in exfoliation syndrome and exfoliation glaucoma. Graefe's Arch Clin Exp Ophthalmol 245, 516–521 (2007). https://doi.org/10.1007/s00417-006-0439-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-006-0439-7