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Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 3/2014

01.03.2014 | Glaucoma

Higher optic nerve sheath diameters are associated with lower ocular blood flow velocities in glaucoma patients

verfasst von: Koen Willekens, Luís Abegão Pinto, Evelien Vandewalle, Carlos Marques-Neves, Ingeborg Stalmans

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 3/2014

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Abstract

Purpose

To investigate the relationship between optic nerve sheath diameter (ONSD) and retrobulbar blood flow velocities, as measured by color Doppler imaging (CDI) in glaucoma patients.

Methods

We performed a prospective, randomized, observer-masked study involving a total of 197 subjects. Once enrolled, they were divided by three groups: healthy controls (n = 51), normal-tension glaucoma patients (NTG, n = 58), and primary, open-angle glaucoma patients (POAG, n = 88). All subjects underwent a general ophthalmological examination, an ultrasound-based assessment of the ONSD, and a hemodynamic study of the retrobulbar vascularization using CDI. Non-parametric tests, chi-square contingency tables, and the Deming correlations were used to explore differences and correlations between variables in the diagnostic groups.

Results

ONSD was not different between experimental groups (p = 0.28). ONSD correlated positively with the pulsatility index of the ophthalmic artery in healthy individuals (p = 0.007), but not in glaucoma patients (NTG: p = 0.41; POAG: p = 0.22). In NTG patients, higher ONSD values were associated with lower end-diastolic and mean flow velocities in the short ciliary arteries (p = 0.005 in both correlations). No such correlation was found in healthy nor POAG groups (p range between 0.15 to 0.96). ONSD was not associated with any CDI-related variable of the central retinal artery in any cohort. Venous outflow velocities were not associated with ONSD in any of the three groups.

Conclusions

ONSD is negatively correlated with retrobulbar blood flow velocities in glaucoma patients, but not in healthy controls.
Literatur
1.
5.
Zurück zum Zitat Abegão Pinto L, Vandewalle E, Pronk A, Stalmans I (2012) Intraocular pressure correlates with optic nerve sheath diameter in patients with normal tension glaucoma. Graefes Arch Clin Exp Ophthalmol 250:1075–1080. doi:10.1007/s00417-011-1878-3 PubMedCrossRef Abegão Pinto L, Vandewalle E, Pronk A, Stalmans I (2012) Intraocular pressure correlates with optic nerve sheath diameter in patients with normal tension glaucoma. Graefes Arch Clin Exp Ophthalmol 250:1075–1080. doi:10.​1007/​s00417-011-1878-3 PubMedCrossRef
8.
Zurück zum Zitat Dubourg J, Javouhey E, Geeraerts T, Messerer M, Kassai B (2011) Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med 37:1059–1068. doi:10.1007/s00134-011-2224-2 PubMedCrossRef Dubourg J, Javouhey E, Geeraerts T, Messerer M, Kassai B (2011) Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med 37:1059–1068. doi:10.​1007/​s00134-011-2224-2 PubMedCrossRef
9.
Zurück zum Zitat Wang N, Xie X, Yang D, Xian J, Li Y, Ren R, Peng X, Jonas JB, Weinreb RN (2012) Orbital cerebrospinal fluid space in glaucoma: the Beijing intracranial and intraocular pressure (iCOP) study. Ophthalmology 119: 2065–2073.e2061. doi:10.1016/j.ophtha.2012.03.054 Wang N, Xie X, Yang D, Xian J, Li Y, Ren R, Peng X, Jonas JB, Weinreb RN (2012) Orbital cerebrospinal fluid space in glaucoma: the Beijing intracranial and intraocular pressure (iCOP) study. Ophthalmology 119: 2065–2073.e2061. doi:10.​1016/​j.​ophtha.​2012.​03.​054
10.
Zurück zum Zitat Ter Minassian A, Dubé L, Guilleux AM, Wehrmann N, Ursino M, Beydon L (2002) Changes in intracranial pressure and cerebral autoregulation in patients with severe traumatic brain injury. Crit Care Med 30:1616–1622PubMedCrossRef Ter Minassian A, Dubé L, Guilleux AM, Wehrmann N, Ursino M, Beydon L (2002) Changes in intracranial pressure and cerebral autoregulation in patients with severe traumatic brain injury. Crit Care Med 30:1616–1622PubMedCrossRef
12.
Zurück zum Zitat Garhöfer G, Fuchsjäger-Mayrl G, Vass C, Pemp B, Hommer A, Schmetterer L (2010) Retrobulbar blood flow velocities in open angle glaucoma and their association with mean arterial blood pressure. Invest Ophthalmol Vis Sci 51:6652–6657. doi:10.1167/iovs.10-5490 PubMedCrossRef Garhöfer G, Fuchsjäger-Mayrl G, Vass C, Pemp B, Hommer A, Schmetterer L (2010) Retrobulbar blood flow velocities in open angle glaucoma and their association with mean arterial blood pressure. Invest Ophthalmol Vis Sci 51:6652–6657. doi:10.​1167/​iovs.​10-5490 PubMedCrossRef
14.
Zurück zum Zitat Stalmans I, Vandewalle E, Anderson DR, Costa VP, Frenkel RE, Garhofer G, Grunwald J, Gugleta K, Harris A, Hudson C, Januleviciene I, Kagemann L, Kergoat H, Lovasik JV, Lanzl I, Martinez A, Nguyen QD, Plange N, Reitsamer HA, Sehi M, Siesky B, Zeitz O, Orgül S, Schmetterer L (2011) Use of colour Doppler imaging in ocular blood flow research. Acta Ophthalmol 89:e609–e630. doi:10.1111/j.1755-3768.2011.02178.x PubMedCrossRef Stalmans I, Vandewalle E, Anderson DR, Costa VP, Frenkel RE, Garhofer G, Grunwald J, Gugleta K, Harris A, Hudson C, Januleviciene I, Kagemann L, Kergoat H, Lovasik JV, Lanzl I, Martinez A, Nguyen QD, Plange N, Reitsamer HA, Sehi M, Siesky B, Zeitz O, Orgül S, Schmetterer L (2011) Use of colour Doppler imaging in ocular blood flow research. Acta Ophthalmol 89:e609–e630. doi:10.​1111/​j.​1755-3768.​2011.​02178.​x PubMedCrossRef
16.
Zurück zum Zitat Steinmeier R, Laumer R, Bondár I, Priem R, Fahlbusch R (1993) Cerebral hemodynamics in subarachnoid hemorrhage evaluated by transcranial Doppler sonography. Part 2. Pulsatility indices: normal reference values and characteristics in subarachnoid hemorrhage. Neurosurgery 33:10–18, discussion 18–19PubMedCrossRef Steinmeier R, Laumer R, Bondár I, Priem R, Fahlbusch R (1993) Cerebral hemodynamics in subarachnoid hemorrhage evaluated by transcranial Doppler sonography. Part 2. Pulsatility indices: normal reference values and characteristics in subarachnoid hemorrhage. Neurosurgery 33:10–18, discussion 18–19PubMedCrossRef
17.
Zurück zum Zitat Harris A, Zarfati D, Zalish M, Biller J, Sheets CW, Rechtman E, Migliardi R, Garzozi HJ (2003) Reduced cerebrovascular blood flow velocities and vasoreactivity in open-angle glaucoma. Am J Ophthalmol 135:144–147PubMedCrossRef Harris A, Zarfati D, Zalish M, Biller J, Sheets CW, Rechtman E, Migliardi R, Garzozi HJ (2003) Reduced cerebrovascular blood flow velocities and vasoreactivity in open-angle glaucoma. Am J Ophthalmol 135:144–147PubMedCrossRef
19.
Zurück zum Zitat Gugleta K, Waldmann N, Polunina A, Kochkorov A, Katamay R, Flammer J, Orgul S (2013) Retinal neurovascular coupling in patients with glaucoma and ocular hypertension and its association with the level of glaucomatous damage. Graefes Arch Clin Exp Ophthalmol 251:1577–1585. doi:10.1007/s00417-013-2276-9 PubMedCrossRef Gugleta K, Waldmann N, Polunina A, Kochkorov A, Katamay R, Flammer J, Orgul S (2013) Retinal neurovascular coupling in patients with glaucoma and ocular hypertension and its association with the level of glaucomatous damage. Graefes Arch Clin Exp Ophthalmol 251:1577–1585. doi:10.​1007/​s00417-013-2276-9 PubMedCrossRef
20.
Zurück zum Zitat Gugleta K, Kochkorov A, Waldmann N, Polunina A, Katamay R, Flammer J, Orgul S (2012) Dynamics of retinal vessel response to flicker light in glaucoma patients and ocular hypertensives. Graefes Arch Clin Exp Ophthalmol 250:589–594. doi:10.1007/s00417-011-1842-2 PubMedCrossRef Gugleta K, Kochkorov A, Waldmann N, Polunina A, Katamay R, Flammer J, Orgul S (2012) Dynamics of retinal vessel response to flicker light in glaucoma patients and ocular hypertensives. Graefes Arch Clin Exp Ophthalmol 250:589–594. doi:10.​1007/​s00417-011-1842-2 PubMedCrossRef
24.
Zurück zum Zitat Kang MH, Balaratnasingam C, Yu PK, Morgan WH, McAllister IL, Cringle SJ, Yu DY (2011) Morphometric characteristics of central retinal artery and vein endothelium in the normal human optic nerve head. Invest Ophthalmol Vis Sci 52:1359–1367. doi:10.1167/iovs.10-6366 PubMedCrossRef Kang MH, Balaratnasingam C, Yu PK, Morgan WH, McAllister IL, Cringle SJ, Yu DY (2011) Morphometric characteristics of central retinal artery and vein endothelium in the normal human optic nerve head. Invest Ophthalmol Vis Sci 52:1359–1367. doi:10.​1167/​iovs.​10-6366 PubMedCrossRef
25.
Zurück zum Zitat Wang N, Jonas JB (2013) Low cerebrospinal fluid pressure in the pathogenesis of primary open-angle glaucoma: epiphenomenon or causal relationship? The Beijing Intracranial and Intraocular Pressure (iCOP) study. J Glaucoma 22(Suppl 5):S11–S12. doi:10.1097/IJG.0b013e31829349a2 PubMedCrossRef Wang N, Jonas JB (2013) Low cerebrospinal fluid pressure in the pathogenesis of primary open-angle glaucoma: epiphenomenon or causal relationship? The Beijing Intracranial and Intraocular Pressure (iCOP) study. J Glaucoma 22(Suppl 5):S11–S12. doi:10.​1097/​IJG.​0b013e31829349a2​ PubMedCrossRef
28.
Metadaten
Titel
Higher optic nerve sheath diameters are associated with lower ocular blood flow velocities in glaucoma patients
verfasst von
Koen Willekens
Luís Abegão Pinto
Evelien Vandewalle
Carlos Marques-Neves
Ingeborg Stalmans
Publikationsdatum
01.03.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 3/2014
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-013-2533-y

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