Assessment of Time Lag Between Blood Flow, Retinal Nerve Fiber Layer Thickness and Visual Field Sensitivity Changes in Glaucoma.
Higgins Bethany E, Cull Grant, Gardiner Stuart K
AI Summary
This glaucoma study found visual field changes (MD) precede optic nerve blood flow changes, which may then precede retinal nerve fiber thinning (RNFLT), suggesting a potential disease progression sequence.
Abstract
Purpose
This study investigates the temporal relationship between blood flow changes and alterations in retinal nerve fiber layer thickness (RNFLT) and mean deviation (MD) in individuals with glaucoma.
Methods
Blood flow, measured by mean blur rate in optic nerve head vessels (MBRv) and tissues (MBRt) using laser speckle flowgraphy (LSFG)-NAVI, was analyzed using structural equation models (SEMs). SEMs assessed whether the previous rate of one parameter predicted the current rate of the other parameter, adjusted for its own rate in the previous time interval. Data from 345 eyes of 174 participants were gathered from visits every six months.
Results
Rates of change of both MBRv and MBRt were significantly predicted by their own rate in the previous time interval and by the rate of change of MD in the previous time interval (P < 0.001 and P = 0.043, respectively), but not by the rate of MD in the concurrent interval (P = 0.947 and P = 0.549), implying that changes in MD precede changes in blood flow. Rates of change of RNFLT were predicted by their own previous rate and the rate of change of MBRv and MBRt in either the previous interval (P = 0.002 and P = 0.008) or the concurrent interval (P = 0.001 and P = 0.018), suggesting that MBR may change before RNFLT.
Conclusions
The evidence supports a temporal sequence where MD changes precede blood flow changes, which, in turn, may precede alterations in RNFLT.
MeSH Terms
Shields Classification
Key Concepts5
In individuals with glaucoma, rates of change of mean blur rate in optic nerve head vessels (MBRv) and tissues (MBRt), measured by laser speckle flowgraphy (LSFG)-NAVI, were significantly predicted by their own rate in the previous time interval and by the rate of change of mean deviation (MD) in the previous time interval (P < 0.001 and P = 0.043, respectively).
In individuals with glaucoma, changes in mean deviation (MD) precede changes in blood flow, as rates of change of both MBRv and MBRt were not predicted by the rate of MD in the concurrent interval (P = 0.947 and P = 0.549).
In individuals with glaucoma, rates of change of retinal nerve fiber layer thickness (RNFLT) were predicted by their own previous rate and the rate of change of mean blur rate in optic nerve head vessels (MBRv) and tissues (MBRt) in either the previous interval (P = 0.002 and P = 0.008) or the concurrent interval (P = 0.001 and P = 0.018).
In individuals with glaucoma, mean blur rate (MBR) may change before retinal nerve fiber layer thickness (RNFLT).
The temporal sequence in individuals with glaucoma supports that mean deviation (MD) changes precede blood flow changes, which, in turn, may precede alterations in retinal nerve fiber layer thickness (RNFLT).
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