VARIOUS GLAUCOMATOUS OPTIC-NERVE APPEARANCES - A COLOR DOPPLER IMAGING STUDY OF RETROBULBAR CIRCULATION

Purpose: The purpose of this study was to observe the blood flow veloc ity in the retrobulbar vessels of patients with glaucoma with differen t appearances of optic discs. Methods: Patients with four different di sc appearances (focal ischemic discs, myopic glaucomatous discs, senil e sclerotic discs, and discs with a generalized enlargement of the cup ) were selected from a pool of optic disc photographs. No clinical inf ormation from the patients was available during the selection. Color D oppler imaging (CDI) was performed in those patients whose discs clear ly belonged to one of the disc patterns. The peak systolic and end dia stolic velocity were measured and the resistance index calculated from the central retinal artery, short posterior ciliary arteries and opht halmic artery. Results: Color Doppler imaging was performed in 24 pati ents with focal ischemic discs, 26 patients with myopic glaucomatous d iscs, 16 patients with senile sclerotic discs, and 16 patients with ge neralized enlargements of the cup. The patients with senile sclerotic discs had statistically significantly lower diastolic velocity and a h igher resistance index in their ophthalmic, central retinal and the me an of the short posterior ciliary arteries sampled. These statistical differences persisted for the ophthalmic artery even after correcting the values for the age differences between the groups. Conclusions: Pa tients with senile sclerotic discs seem to have greater circulatory ab normalities in their retrobulbar vessels studied with color Doppler im aging that are compatible with a higher downstream resistance in these vessels. These circulatory abnormalities could be related to the path ogenesis of the glaucoma in these patients.