PULSATILE OCULAR BLOOD-FLOW INVESTIGATION IN ASYMMETRIC NORMAL-TENSION GLAUCOMA AND NORMAL SUBJECTS

Aims-This study was designed to investigate pulsatile ocular blood flo w (POBF) in normal tension glaucoma (NTG) patients and in normal contr ols. NTG patients with unilateral field loss were evaluated to compare POBF values between eyes with and without field loss. Methods-POBF me asurements from more than 1500 subjects were collected during a period of 6 months from six optometric centres. Subjects with systemic vascu lar diseases (such as systemic hypertension and diabetes), ophthalmic diseases, a positive family history of glaucoma, and those individuals receiving treatment with systemic beta blockers were excluded on the basis of a questionnaire. For comparison, 95 NTG patients with unilate ral field lass, selected from 403 consecutive patients with NTG, under went POBF testing. For each individual age, sex, intraocular pressure, refraction, and pulse rate were entered into a database. Results-Data from 777 subjects were included in the analysis. POBF measurements of patients and subjects were compared allowing for differences in age, sex, intraocular pressure, refraction, and pulse rate. POBF was signif icantly lower in eyes of NTG patients with and without field loss (p < 0.001 and p = 0.01 respectively). Eyes of NTG patients with field loss showed significantly lower POBF than the contralateral eyes with norm al field (p < 0.001). Conclusions-POBF was significantly lower in eyes of NTG patients with and without field loss than in normal subjects, suggesting that differences in ocular blood perfusion are relevant to the development of NTG and are detectable from the early stage of the disease. Furthermore, the finding of lower POBF in NTG eyes with field loss than in the contralateral eyes with normal field suggests that h aemodynamic differences between fellow eyes contribute to determine th e side of onset of the disease.