Sectoral Differences in the Association of Optic Nerve Head Blood Flow and Glaucomatous Visual Field Defect Severity and Progression.
Kiyota Naoki, Shiga Yukihiro, Yasuda Masayuki, Aizawa Naoko, Omodaka Kazuko, Tsuda Satoru, Kunikata Hiroshi, Nakazawa Toru
AI Summary
This study found sectoral optic nerve blood flow correlates with visual field defects and predicts progression, suggesting LSFG and systemic factors could help clinicians predict glaucoma severity and progression.
Abstract
Purpose
To investigate sectoral differences in the relationship between optic nerve head tissue blood flow, anatomically corresponding visual field defect severity, and future progression.
Methods
This retrospective longitudinal medical chart review comprised 508 eyes of 319 open-angle glaucoma patients (mean deviation: -9.2 ± 7.0 dB), followed for an average of 4.7 ± 1.1 years; an average 11.7 ± 3.7 visual field tests were performed. Average total deviation (TD) was calculated in the superior, central, and inferior sectors of the Humphrey 24-2 program. The optic nerve head was divided to obtain inferior, temporal, and superior tissue-area mean blur rate (MT), derived from laser speckle flowgraphy. At baseline, the correlation between MT and TD was compared in anatomically corresponding sectors. We performed a multivariate analysis to determine the contribution of baseline MT to corresponding TD slope and to determine background factors influencing superior to temporal MT. We used a linear-mixed effect model for the statistical analysis.
Results
At baseline, the highest β coefficients were found between MT-superior and TD-inferior, MT-temporal and TD-central, and between MT-inferior and TD-superior, in that order (β = 0.38, β = 0.27, β = 0.26, respectively). MT-superior and MT-temporal independently contributed to corresponding TD slope (P < 0.05). Male sex, high body mass index, and the prevalence of sleep apnea syndrome were contributing factors to lower superior to temporal MT (P < 0.05).
Conclusions
Review of medical history, measurements of systemic variables, and laser speckle flowgraphy parameters might help clinicians to predict visual field defect severity and progression.
MeSH Terms
Shields Classification
Key Concepts5
In a retrospective longitudinal medical chart review of 508 eyes of 319 open-angle glaucoma patients (mean deviation: -9.2 ± 7.0 dB) with an average follow-up of 4.7 ± 1.1 years, the highest β coefficients at baseline were found between optic nerve head tissue blood flow in the superior sector (MT-superior) and visual field total deviation in the inferior sector (TD-inferior) (β = 0.38).
In a retrospective longitudinal medical chart review of 508 eyes of 319 open-angle glaucoma patients (mean deviation: -9.2 ± 7.0 dB) with an average follow-up of 4.7 ± 1.1 years, the highest β coefficients at baseline were found between optic nerve head tissue blood flow in the temporal sector (MT-temporal) and visual field total deviation in the central sector (TD-central) (β = 0.27).
In a retrospective longitudinal medical chart review of 508 eyes of 319 open-angle glaucoma patients (mean deviation: -9.2 ± 7.0 dB) with an average follow-up of 4.7 ± 1.1 years, the highest β coefficients at baseline were found between optic nerve head tissue blood flow in the inferior sector (MT-inferior) and visual field total deviation in the superior sector (TD-superior) (β = 0.26).
In a retrospective longitudinal medical chart review of 508 eyes of 319 open-angle glaucoma patients, optic nerve head tissue blood flow in the superior sector (MT-superior) and temporal sector (MT-temporal) independently contributed to the corresponding visual field total deviation slope (P < 0.05).
In a retrospective longitudinal medical chart review of 508 eyes of 319 open-angle glaucoma patients, male sex, high body mass index, and the prevalence of sleep apnea syndrome were identified as contributing factors to lower superior to temporal optic nerve head tissue blood flow (P < 0.05).
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