Ocular hemodynamics and glaucoma prognosis - A color Doppler imaging study

Objective: To evaluate the effect of optic nerve circulation, using color Doppler imaging (CDI), on the progression of visual field damage in primary open-angle glaucoma. Methods: The relationship between the results of retrobulbar CDI, performed shortly after the diagnosis of primary open-angle glaucoma, and the progression of visual field loss for 7 years was evaluated in 44 glaucoma patients. Color Doppler imaging variables in patients with a stable and deteriorating clinical course were compared, and the pattern of increasing risk for different CDI values was analyzed using an additive logistic model. Based on this nonparametric analysis, we arrived at a discriminant CDI value identifying glaucoma patients with a poor prognosis. On the basis of the discriminant value, patients were divided into 2 groups, and the odds ratio of visual field loss for each group was then estimated. Results: Patients with a stable visual field had a higher diastolic velocity and a lower resistivity index in the ophthalmic artery (P<.001 for both) compared with those with a deteriorating visual field during the study. The odds of visual field deterioration in patients with an ophthalmic artery resistivity index of 0.78 or higher was about 6 times that of patients with an ophthalmic artery resistivity index lower than 0.78. Conclusion: Color Doppler imaging variables of the ophthalmic artery correlate with the risk of visual field deterioration in patients with primary open-angle glaucoma.