Reduced Optic Nerve Head Blood Flow Correlates with an Impaired Post-illumination Pupil Response in Glaucoma: The LIGHT Study.
Yoshikawa Tadanobu, Jimura Hironobu, Miyata Kimie, Obayashi Kenji, Saeki Keigo, Ogata Nahoko, Kase Satoru
AI Summary
In glaucoma, reduced optic nerve head blood flow correlated with impaired intrinsically photosensitive retinal ganglion cell function, suggesting vascular compromise impacts these cells, potentially aiding early detection or monitoring.
Abstract
Precis: In glaucomatous eyes, reduced optic nerve head blood flow was significantly associated with impaired intrinsically photosensitive retinal ganglion cell function, as assessed by the post-illumination pupil response, independent of age and other confounding factors.
Purpose
To investigate whether ocular nerve head (ONH) blood flow is associated with impaired intrinsically photosensitive retinal ganglion cell (ipRGC) function, assessed by the post-illumination pupil response (PIPR), in eyes with glaucoma.
Patients and methods: This cross-sectional study included 114 eyes from 114 patients with glaucoma (mean age, 69.5 y). PIPR was evaluated by measuring pupil diameters after red and blue light exposure. The main PIPR outcomes were the amplitudes of red and blue 6-s PIPR, which are pupil diameters 6 s after red and blue light exposure. ONH blood flow was assessed by the tissue-area mean blur rate (MBR) using laser speckle flowgraphy.
Results
A significantly higher blue 6-s PIPR amplitude was observed in the low tissue-area MBR group than in the high tissue-area MBR group (93.5% vs. 91.1%, P=0.043). After adjusting for age, sex, body mass index, hypertension, diabetes, intraocular pressure, and axial length, a multivariable linear regression analysis showed that tissue-area MBR inversely correlated with the blue 6-s PIPR amplitude (regression coefficient=-0.40; 95% CI, -0.73 to -0.06; P=0.021), but not the red 6-s PIPR amplitude (regression coefficient=-0.01; 95% CI, -0.36 to -0.15; P=0.42).
Conclusions
Lower ONH blood flow in eyes with glaucoma correlated with impairments in ipRGCs independent of potential confounders, including age.
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Key Concepts5
In glaucomatous eyes, reduced optic nerve head blood flow was significantly associated with impaired intrinsically photosensitive retinal ganglion cell function, as assessed by the post-illumination pupil response, independent of age and other confounding factors.
A significantly higher blue 6-s PIPR amplitude was observed in the low tissue-area MBR group (93.5%) than in the high tissue-area MBR group (91.1%, P=0.043) in 114 eyes from 114 patients with glaucoma.
After adjusting for age, sex, body mass index, hypertension, diabetes, intraocular pressure, and axial length, a multivariable linear regression analysis showed that tissue-area MBR inversely correlated with the blue 6-s PIPR amplitude (regression coefficient=-0.40; 95% CI, -0.73 to -0.06; P=0.021) in 114 eyes from 114 patients with glaucoma.
Lower optic nerve head blood flow in eyes with glaucoma correlated with impairments in intrinsically photosensitive retinal ganglion cells independent of potential confounders, including age.
After adjusting for age, sex, body mass index, hypertension, diabetes, intraocular pressure, and axial length, a multivariable linear regression analysis showed that tissue-area MBR did not correlate with the red 6-s PIPR amplitude (regression coefficient=-0.01; 95% CI, -0.36 to -0.15; P=0.42) in 114 eyes from 114 patients with glaucoma.
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