Ocular pulse amplitude and Doppler waveform analysis in glaucoma patients

• Published in: Acta ophthalmologica (Oxford, England) Vol. 92; no. 4; pp. e280 - e285
• Main Authors: Abegão Pinto, Luís, Vandewalle, Evelien, Willekens, Koen, Marques‐Neves, Carlos, Stalmans, Ingeborg
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.06.2014
• Subjects: Aged; Blood Flow Velocity; Blood Pressure - physiology; Case-Control Studies; Ciliary Arteries - physiology; colour Doppler imaging; Female; Glaucoma, Open-Angle - physiopathology; Humans; Intraocular Pressure - physiology; Laser-Doppler Flowmetry; Low Tension Glaucoma - physiopathology; Male; normal‐tension glaucoma; ocular pulse amplitude; Ophthalmology; primary open‐angle glaucoma; Prospective Studies; Pulse Wave Analysis; Retinal Artery - physiology; Retinal Vein - physiology; Single-Blind Method; Tonometry, Ocular; vascular dysregulation; normal-tension glaucoma; vascular dysregulation; ocular pulse amplitude; primary open-angle glaucoma; colour Doppler imaging
• ISSN: 1755-375X; 1755-3768; 1755-3768
• DOI: 10.1111/aos.12340

Purpose To determine the correlation between ocular blood flow velocities and ocular pulse amplitude (OPA) in glaucoma patients using colour Doppler imaging (CDI) waveform analysis. Method A prospective, observer‐masked, case‐control study was performed. OPA and blood flow variables from central retinal artery and vein (CRA, CRV), nasal and temporal short posterior ciliary arteries (NPCA, TPCA) and ophthalmic artery (OA) were obtained through dynamic contour tonometry and CDI, respectively. Univariate and multiple regression analyses were performed to explore the correlations between OPA and retrobulbar CDI waveform and systemic cardiovascular parameters (blood pressure, blood pressure amplitude, mean ocular perfusion pressure and peripheral pulse). Results One hundred and ninety‐two patients were included [healthy controls: 55; primary open‐angle glaucoma (POAG): 74; normal‐tension glaucoma (NTG): 63]. OPA was statistically different between groups (Healthy: 3.17 ± 1.2 mmHg; NTG: 2.58 ± 1.2 mmHg; POAG: 2.60 ± 1.1 mmHg; p < 0.01), but not between the glaucoma groups (p = 0.60). Multiple regression models to explain OPA variance were made for each cohort (healthy: p < 0.001, r = 0.605; NTG: p = 0.003, r = 0.372; POAG: p < 0.001, r = 0.412). OPA was independently associated with retrobulbar CDI parameters in the healthy subjects and POAG patients (healthy CRV resistance index: β = 3.37, CI: 0.16–6.59; healthy NPCA mean systolic/diastolic velocity ratio: β = 1.34, CI: 0.52–2.15; POAG TPCA mean systolic velocity: β = 0.14, CI 0.05–0.23). OPA in the NTG group was associated with diastolic blood pressure and pulse rate (β = −0.04, CI: −0.06 to −0.01; β = −0.04, CI: −0.06 to −0.001, respectively). Conclusions Vascular‐related models provide a better explanation to OPA variance in healthy individuals than in glaucoma patients. The variables that influence OPA seem to be different in healthy, POAG and NTG patients.