Follow up of focal narrowing of retinal arterioles in glaucoma

Aim-To evaluate whether focal narrowing of retinal arterioles increases wit h progressive glaucomatous optic neuropathy. Methods-Focal narrowing of retinal arterioles and area of neuroretinal rim were morphometrically evaluated on colour stereo optic disc photographs of 59 patients with primary open angle glaucoma, 22 patients with normal press ure glaucoma, 11 patients with secondary open angle glaucoma, and 31 patien ts with ocular hypertension. Minimum follow up was 8 months. Focal arteriol ar narrowing was quantified by calculating the ratio of the vessel width in the broadest to the narrowest vessel part. Results-In the subgroup of patients with progressive glaucomatous optic ner ve damage (n=37), focal narrowing of retinal arterioles increased significa ntly (p<0.005) with decreasing neuroretinal rim area. In the subgroup of pa tients with stable appearance of the optic disc (n=86), focal narrowing of retinal arterioles did not change significantly (p=0.79). The positive corr elation between increasing focal thinning of retinal arterioles and progres sion of glaucomatous optic neuropathy was present, although not statistical ly significant, in all the glaucoma subtypes examined. The location of foca l thinning of retinal arterioles did not change in the follow up. Conclusions-Focal narrowing of retinal arterioles increases significantly w ith progressive glaucomatous optic neuropathy, independent of the type of g laucoma. It is stable in patients with non-progressive glaucoma. The findin gs agree with previous reports on a higher degree of focal arteriole narrow ing in eyes with pronounced optic nerve damage in comparison with those wit h moderate optic nerve atrophy or normal eyes. In the clinical management o f patients with glaucoma, in some eyes, increasing focal arteriole narrowin g may suggest progression of disease.