Rigidity of Retinal Vessel in Untreated Eyes of Normal Tension Primary Open-angle Glaucoma Patients

BackgroundTo analyze pulse wave propagation in the ocular circulation and vessel stiffness in untreated eyes of normal tension primary open-angle glaucoma (NTG) patients. MethodsInferotemporal retinal vessels of 22 NTG eyes and 25 controls were examined with a Retinal Vessel Analyzer. Inferotemporal peripapillary retinal nerve fiber layer thickness was measured by ocular coherence tomography. Phase delay between venous trough and arterial peak was assessed at 3 sites centrifugal from the disc and a choroid-to-retina pulse delay was calculated as an estimation of vessel rigidity. ResultsThere was choroid-to-retina pulse delay of 0.26±0.08, 0.30±0.11, and 0.33±0.11 seconds, respectively, in NTG eyes at proximal, middle, and distal sites; in control eyes, the corresponding values were 0.28±0.10, 0.35±0.12, and 0.40±0.17 seconds. Average choroid-to-retina pulse delay was shorter in NTG eyes (P=0.028). Retinal nerve fiber layer (inferotemporal) showed an opposite correlation with choroid-to-retina pulse delay in controls (r=−0.48, P=0.019) and in NTG eyes (r=0.47, P=0.032 ). ConclusionsUntreated NTG eyes show stiffer retinal vessels. Vessel rigidity correlates with level of glaucomatous damage.

[1]  J. Singh,et al.  Hypertensive retinopathy. , 1983, Indian journal of ophthalmology.

[2]  Josef Flammer,et al.  Rate of progression of glaucoma correlates with retrobulbar circulation and intraocular pressure. , 2003, American journal of ophthalmology.

[3]  Thomas Weber,et al.  Arterial Stiffness, Wave Reflections, and the Risk of Coronary Artery Disease , 2004, Circulation.

[4]  T. Sugiyama,et al.  Association of endothelin-1 with normal tension glaucoma: clinical and fundamental studies. , 1995, Survey of ophthalmology.

[5]  J Flammer,et al.  Ocular blood flow alteration in glaucoma is related to systemic vascular dysregulation , 2004, British Journal of Ophthalmology.

[6]  Leopold Schmetterer,et al.  Endothelial dysfunction in glaucoma , 2009, Acta ophthalmologica.

[7]  E. Stefánsson,et al.  The impact of ocular blood flow in glaucoma , 2002, Progress in Retinal and Eye Research.

[8]  M. Cellini,et al.  Color Doppler imaging and plasma levels of endothelin-1 in low-tension glaucoma. , 2009, Acta ophthalmologica Scandinavica. Supplement.

[9]  A P Avolio,et al.  Effects of age on ventricular-vascular coupling. , 1985, The American journal of cardiology.

[10]  Josef Flammer,et al.  On pulse-wave propagation in the ocular circulation. , 2006, Investigative ophthalmology & visual science.

[11]  S. Laurent,et al.  Aortic Stiffness Is an Independent Predictor of Fatal Stroke in Essential Hypertension , 2003, Stroke.

[12]  C. Denton,et al.  Differentiation of primary and secondary Raynaud's disease by carotid arterial stiffness. , 2003, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[13]  Evaluation of Arterial Stiffness in Patients with Branch Retinal Vein Occlusion , 2005, Ophthalmologica.

[14]  P. Ducimetiere,et al.  Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patients , 2001, Hypertension.

[15]  H. Struijker‐Boudier,et al.  Cranial and Peripheral Interictal Vascular Changes in Migraine Patients , 2003, Cephalalgia : an international journal of headache.

[16]  J. Kesselring,et al.  Increased Endothelin-1 Plasma Levels in Patients With Multiple Sclerosis , 2001, Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society.

[17]  L. Kappos,et al.  Rigidity of Retinal Vessels in Patients with Multiple Sclerosis , 2009, Klinische Monatsblatter fur Augenheilkunde.

[18]  W. Nichols,et al.  Ventricular/vascular interaction in health and heart failure. , 1992, Comprehensive therapy.

[19]  T. Lüscher,et al.  Endothelin-1 plasma levels in normal-tension glaucoma: abnormal response to postural changes , 1995, Graefe's Archive for Clinical and Experimental Ophthalmology.

[20]  L. Kappos,et al.  Extraocular Blood Flow and Endothelin-1 Plasma Levels in Patients with Multiple Sclerosis , 2003, European Neurology.

[21]  M. Hofbeck,et al.  Impaired Compliance of the Intracranial Vessels in Complicated Childhood Migraine. Demonstration by Transcranial Doppler-Sonography - A Vascular Model Approach , 2001, Ultraschall in der Medizin.

[22]  Leopold Schmetterer,et al.  Use of the retinal vessel analyzer in ocular blood flow research , 2010, Acta ophthalmologica.

[23]  W Vilser,et al.  RETINAL VESSEL ANALYSIS - NEW POSSIBILITIES , 2002, Biomedizinische Technik. Biomedical engineering.

[24]  D. Webb,et al.  Peripheral endothelial dysfunction in normal pressure glaucoma. , 1999, Investigative ophthalmology & visual science.

[25]  S. Sasayama,et al.  Stiffness of systemic arteries in patients with myocardial infarction. A noninvasive method to predict severity of coronary atherosclerosis. , 1989, Circulation.

[26]  L. Schmetterer,et al.  Nitric oxide regulates retinal vascular tone in humans. , 2003, American journal of physiology. Heart and circulatory physiology.

[27]  H. Ulmer,et al.  Reduced thirst in patients with a vasospastic syndrome. , 2004, Acta ophthalmologica Scandinavica.

[28]  B.-U. Seifert,et al.  RETINAL VESSEL ANALYZER (RVA) - DESIGN AND FUNCTION , 2002, Biomedizinische Technik. Biomedical engineering.