COLOR DOPPLER IMAGING IN PATIENTS WITH ASYMMETRIC GLAUCOMA AND UNILATERAL VISUAL-FIELD LOSS

PURPOSE: To determine whether lower blood velocities and high resistiv e index in the retrobulbar arteries are primary or secondary to glauco matous damage in patients with open-angle glaucoma. METHODS: Color Dop pler imaging was performed in 32 glaucomatous patients with unilateral visual field loss and in 31 control subjects, Peak systolic velocity and end diastolic velocity were measured, and resistive index was calc ulated in the central retinal artery and short posterior ciliary arter ies. RESULTS: In patients with glaucoma, both the more affected and th e contralateral eyes with normal visual fields had significantly lower peak systolic velocity and end diastolic velocity in their central re tinal artery and short posterior ciliary arteries than did the control subjects of similar age (P less than or equal to .03), The resistive index of the central retinal artery of both eyes of patients with glau coma was also significantly higher than in the control subjects (P = . 001), When considering the 16 patients who had the greatest visual fie ld asymmetry, the more affected eyes had lower peak systolic velocity and end diastolic velocity in the central retinal artery than the cont ralateral eyes did (P = .02). CONCLUSIONS: Even eyes with normal visua l fields in patients with asymmetric disease had decreased blood veloc ities in their retrobulbar vessels, suggesting that these circulatory changes probably precede detectable damage, Furthermore, the finding o f lower central retinal artery blood velocities in the more affected e ye of asymmetric patients suggests that low blood velocities may be on e of the lateralizing factors in those patients and that they have a p ossible role in the pathogenesis of the disease.