Elsevier

Ophthalmology

Volume 108, Issue 6, June 2001, Pages 1043-1049
Ophthalmology

Ocular hemodynamics in pseudoexfoliation syndrome and pseudoexfoliation glaucoma

https://doi.org/10.1016/S0161-6420(01)00572-3Get rights and content

Abstract

Objective

To evaluate orbital blood flow velocities by using color Doppler imaging in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma.

Design

Prospective, comparative case series.

Participants

Twenty-eight patients with pseudoexfoliation syndrome (n = 14) or pseudoexfoliation glaucoma (n = 14) and 14 healthy control participants were included.

Intervention

Color Doppler imaging was used with a 7.5-MHz probe. Evaluation of the ophthalmic, central retinal, short posterior nasal, and temporal ciliary arteries was performed, and peak systolic and end diastolic flow velocities were measured. Resistive indices were calculated.

Results

When compared with the control participants, patients with pseudoexfoliation syndrome showed statistically significant decreases in the mean peak systolic velocity of the central retinal artery (11.21 ± 2.19 cm/second; P < 0.05), and end diastolic velocities of the central retinal artery (3.00 ± 1.03 cm/second; P < 0.005), and short posterior temporal ciliary arteries (3.50 ± 1.74 cm/second; P < 0.005), whereas mean resistive indices of the ophthalmic artery (0.75 ± 0.06 cm/second; P < 0.005) and central retinal artery were found to have increased (0.70 ± 0.05 cm/second; P < 0.01). Patients with pseudoexfoliation glaucoma, when compared with the control participants, showed statistically significant decreases in the mean peak systolic and end diastolic velocities and increased mean resistive indices in all vessels measured (P < 0.05). Compared with the patients with pseudoexfoliation syndrome, patients with pseudoexfoliation glaucoma showed statistically significant decreases in the mean peak systolic velocities of the ophthalmic artery (30.07 ± 4.00 cm/second; P < 0.05) and short posterior nasal ciliary arteries (2.35 ± 0.09 cm/second; P < 0.05), and in the mean end diastolic velocities of the ophthalmic artery (6.28 ± 2.12 cm/second; P < 0.05), and short posterior nasal ciliary arteries (2.35 ± 0.09 cm/second; P < 0.05). The differences in the mean resistive indices were not statistically significant between the patients with pseudoexfoliation syndrome and the ones with pseudoexfoliation glaucoma.

Conclusions

The findings suggest that hemodynamic parameters in the retrobulbar vessels were altered in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma; however, these alterations were more prominent in the latter group.

Section snippets

Materials and methods

Forty-two patients taken into the study were monitored and treated in the Ophthalmology Department and Glaucoma Unit of the Medical Faculty of Kocaeli University. Of those, 14 patients had pseudoexfoliation glaucoma, 14 had pseudoexfoliation syndrome; 14 had no ocular pathologic features other than refractive errors and had intraocular pressure less than 21 mmHg were included as controls. Written informed consent was obtained from each participant before study initiation.

Evaluation of visual

Results

Demographic features of all patients evaluated in the study are shown in Table 1. No significant differences were found with respect to mean age between the three groups. In addition, the presence of either diabetes mellitus or systemic hypertension was not significantly different among the groups. However, the mean intraocular pressure was found to be significantly different among the groups (P < 0.05). Of 14 patients with pseudoexfoliation glaucoma, 11 patients had a current history of drug

Discussion

This study showed that at least some hemodynamic parameters in the retrobulbar vessels were altered in patients with pseudoexfoliation syndrome, more prominently in patients with pseudoexfoliation glaucoma.

A definitive explanation was lacking concerning the alterations in the retrobulbar blood flow parameters in pseudoexfoliation syndrome. Such alterations were found in various types of glaucoma. Costa et al,20 in a study of color Doppler imaging in patients with open- or closed-angle glaucoma

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