Vascular concepts in glaucoma.

A relationship has been found among vascular risk factors, normal-tension glaucoma (NTG), and visual field progression. All these factors have been measured qualitatively. These factors are disc hemorrhages, peripapillary atrophy, myopic disc, choroidal sclerosis, slow filling of the choroid and veins, and vasospasms. Now we are in a transition period where more and more quantitative methods are becoming available: pulsatile ocular blood flow measurement (POBF), scanning laser angiography of the peripapillary choroid (SLAPPC), scanning laser angiography of the retinal circulation (SLARC), scanning laser Doppler flowmetry (SLDF), and color Doppler imaging. With POBF, SLAPPC, SLARC, and SLDF a deficient blood flow was found in at least 50% of patients with NTG. With these results a vascular pathogenesis of NTG becomes more and more evident.