Study of Pulsatile Ocular Blood Flow in Primary Chronic Angle Closure Glaucoma

HC Agarwal, V Gupta, R Sihota
Department of Ophthalmology, Dr Rajendra
Prasad Centre for Ophthalmic Sciences, All India
Institute of Medical Sciences, New Delhi, India

Aims: To estimate pulsatile ocular blood flow in patients with primary chronic angle closure glaucoma and to correlate pulsatile ocular blood flow with the extent of the glaucomatous defect.

Patients and Methods: Pulsatile ocular blood flow recordings were taken in both eyes of 42 patients with primary chronic angle closure glaucoma in at least one eye and compared with 42 age- and sex-matched healthy controls. Axial length and intraocular pressure, both factors known to influence pulsatile ocular blood flow, were also recorded. Pulsatile ocular blood flow findings were correlated with measures of disease progression such as cup disc ratio and Humphrey visual field indices.

Results: Eyes with primary chronic angle closure glaucoma with advanced visual field defects had significantly lower pulsatile ocular blood flow compared with fellow eyes with no glaucoma (p < 0.05). Pulsatile ocular blood flow in the fellow eyes of patients with glaucoma did not differ significantly from that in healthy controls. Mean deviation had a negative correlation with pulsatile ocular blood flow. However, corrected pattern standard deviation, as well as the degree of cupping among eyes with chronic angle closure glaucoma, did not correlate with the pulsatile ocular blood flow.

Conclusions: Pulsatile ocular blood flow is significantly lower in eyes with primary chronic angle closure glaucoma with advanced glaucomatous defects than in fellow eyes and eyes of healthy controls, although this relationship is not evident in patients with early or moderate glaucomatous defects.