Change in retinal blood flow and retinal arterial diameter after intraocular pressure reduction in glaucomatous eyes
Change in retinal blood flow and retinal arterial diameter after intraocular pressure reduction in glaucomatous eyes
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DOI：
10.1111/aos.12268
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发表时间：
2014-09-01
影响因子：
3.4
通讯作者：
Harju, Mika
中科院分区：
文献类型：
--
作者：
Kurvinen, Leena;Kyto, Janne P.;Harju, Mika
目的：研究高压和低压青光眼（即剥脱性青光眼（ExG）和正常眼压性青光眼（NTG））眼内压（IOP）降低后的视网膜血流量和血管直径。 方法：该研究包括 17 只患有 ExG 的眼睛和 20 只患有 NTG 的眼睛。深层巩膜切除术至少可降低 25% 的眼压。使用扫描激光多普勒血流计（海德堡视网膜流量计，HRF）测量颞侧视乳头周围视网膜的血流量，并使用视网膜血管分析仪（RVA）评估视网膜血管直径。术前和术后 3 个月进行检查。结果：ExG 术前眼压显着高于 NTG（中位 26 mmHg，范围 20-33 mmHg 对比 15 mmHg，12-20；p < 0.001）。手术使 ExG 眼的 IOP 显着降低（术后 IOP）13 mmHg，5-17； p < 0.001) 和 NTG 眼睛 (9 mmHg, 3-13; p < 0.001)。手术后，ExG 眼的收缩期视网膜血流显着减少，而 NTG 眼的 IIRF 参数保持不变。术前，ExG 眼的视网膜中央动脉当量 (CRAE) 和动静脉比 (AYR) 高于 NTG 眼。眼压降低后，ExG眼的CRAE和AVR均减少，但NTG眼保持不变。结论：研究表明，眼压降低前，ExG眼的动脉直径大于NTG眼。眼压降低导致 ExG 中血管收缩和血流减少，而 NTG 中血管直径和视网膜血流保持不变。
Purpose: To study retinal blood flow and vessel diameter after intra-ocular pressure (IOP) reduction in high- and low-pressure glaucomas, that is, exfoliation glaucoma (ExG) and normal-tension glaucoma (NTG).Methods: The study included 17 eyes with ExG and 20 with NTG. A minimum of 25% IOP reduction was achieved by deep sclerectomy. Blood flow in the temporal peripapillary retina was measured with scanning laser Doppler flowmetry (Heidelberg Retina Flowmeter, HRF), and retinal vessel diameters were evaluated with the retinal vessel analyser (RVA). Examinations were carried out before and 3 months after the operation.Results: Pre-operative IOP was significantly higher in ExG than in NTG (median 26 mmHg, range 20-33 mmHg versus 15 mmHg, 12-20; p < 0.001). Surgery reduced IOP significantly both in ExG eyes (postoperative IOP) 13 mmHg, 5-17; p < 0.001) and NTG eyes (9 mmHg, 3-13; p < 0.001). After the operation, systolic retinal flow was significantly reduced in ExG eyes, whereas in NTG, IIRF parameters remained unchanged. Pre-operatively, the central retinal artery equivalent (CRAE) and arteriovenous ratio (AYR) were higher in ExG than in NTG eyes. After IOP reduction, both CRAE and AVR were reduced in ExG eyes, but remained unchanged in NTG.Conclusion: The study showed that before IOP reduction, arterial diameter was larger in ExG eyes than in NTG eyes. IOP reduction resulted in vasoconstriction and reduction of flow in ExG, whereas in NTG, both vessel diameter and retinal flow remained unchanged.