EVALUATION OF THE PERIPAPILLARY CIRCULATION IN HEALTHY AND GLAUCOMA EYES WITH SCANNING LASER-DOPPLER FLOWMETRY

In order to study peripapillary perfusion, one randomly selected eye o f 34 healthy volunteers and 40 glaucoma patients (27 suffering from pr imary open-angle glaucoma (POAG) 10 from normal pressure glaucoma (NPG ) and three from other types of glaucoma) was studied with a Heidelber g Retina flowmeter. Temporal flow adjacent to the disc edge was signif icantly higher than the nasal flow (p < 0.01). It was reduced signific antly in myopia both in controls (p < 0.05) and in glaucoma patients ( p < 0.001). However, there was no difference between either controls a nd glaucoma patients or between POAG and NPG patients. It was independ ent of treatment type in glaucoma. Within the temporal peripapillary a rea extremely high flow values (values higher than the mean + 2 SD of the corresponding individual retinal flow) seemed to represent deep pe ripapillary vascular rings. They were significantly more frequent in g laucoma (72%) than in healthy volunteers (44%, p < 0.05). Their freque ncy was 83% in myopic and 23% in non-myopic eyes in the control group (p < 0.001). However, in glaucoma patients they were common both in my opic eyes (71%) and in non-myopic ones (75%). The results suggest that capillary perfusion adjacent to the temporal edge of the disc is sign ificantly reduced in myopia. Deep peripapillary vascular structures ca n be measured on images focused on the surface of the retina, especial ly if the retina is thinner than normal (healthy myopic eyes and glauc omatous eyes independently of the refraction). This may mask a deficie nt function of the retinal capillary bed.