Mitra Sehi1, Iman Goharian2, Ranjith Konduru3, Ou Tan4, Sowmya Srinivas3, Srinivas R Sadda3, Brian A Francis3, David Huang4, David S Greenfield2. 1. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida. Electronic address: msehi@med.miami.edu. 2. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida. 3. Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California. 4. Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.
Abstract
PURPOSE: To examine the hypotheses that in glaucomatous eyes with single-hemifield damage, retinal blood flow (RBF) is significantly reduced in the retinal hemisphere corresponding with the abnormal visual hemifield and that there are significant associations among reduced retinal sensitivity (RS) in the abnormal hemifield, RBF, and structural measurements in the corresponding hemisphere. DESIGN: Prospective, nonrandomized, case-control study. PARTICIPANTS: Thirty eyes of 30 patients with glaucoma with visual field loss confined to a single hemifield and 27 eyes of 27 controls. METHODS: Normal and glaucomatous eyes underwent spectral-domain optical coherence tomography (SD-OCT) and standard automated perimetry. Doppler SD-OCT with a double-circle scanning pattern was used to measure RBF. The RBF was derived from the recorded Doppler frequency shift and the measured angle between the beam and the vessel. Total and hemispheric RBF, retinal nerve fiber layer (RNFL), and ganglion cell complex (GCC) values were calculated. The RS values were converted to 1/Lambert. Analysis of variance and regression analyses were performed. MAIN OUTCOME MEASURES: Total and hemispheric RS, RBF, RNFL, and GCC values. RESULTS: The total RBF (34.6±12.2 μl/minute) and venous cross-sectional area (0.039 ± 0.009 mm(2)) were reduced (P<0.001) in those with glaucoma compared with controls (46.5 ± 10.6 μl/minute; 0.052 ± 0.012 mm(2)). Mean RBF was reduced in the abnormal hemisphere compared with the opposite hemisphere (15.3 ± 5.4 vs. 19.3 ± 8.4 μl/minute; P = 0.004). The RNFL and GCC were thinner in the corresponding abnormal hemisphere compared with the opposite hemisphere (87.0 ± 20.2 vs. 103.7 ± 20.6 μm, P = 0.002; 77.6 ± 12.1 vs. 83.6 ± 10.1 μm, P = 0.04). The RBF was correlated with RNFL (r = 0.41; P = 0.02) and GCC (r = 0.43; P = 0.02) but not the RS (r = 0.31; P = 0.09) in the abnormal hemisphere. The RBF (19.3 ± 8.4 μl/minute), RNFL (103.7 ± 20.6 μm), and GCC (83.6 ± 10.1 μm) were reduced (P<0.05) in the hemisphere with apparently normal visual field in glaucomatous eyes compared with the mean hemispheric values of the normal eyes (23.2 ± 5.3 μl/minute, 124.8 ± 9.6 μm, and 96.1 ± 5.7 μm, respectively). CONCLUSIONS: In glaucomatous eyes with single-hemifield damage, the RBF is significantly reduced in the hemisphere associated with the abnormal hemifield. Reduced RBF is associated with thinner RNFL and GCC in the corresponding abnormal hemisphere. Reduced RBF and RNFL and GCC loss also are observed in the perimetrically normal hemisphere of glaucomatous eyes.
PURPOSE: To examine the hypotheses that in glaucomatous eyes with single-hemifield damage, retinal blood flow (RBF) is significantly reduced in the retinal hemisphere corresponding with the abnormal visual hemifield and that there are significant associations among reduced retinal sensitivity (RS) in the abnormal hemifield, RBF, and structural measurements in the corresponding hemisphere. DESIGN: Prospective, nonrandomized, case-control study. PARTICIPANTS: Thirty eyes of 30 patients with glaucoma with visual field loss confined to a single hemifield and 27 eyes of 27 controls. METHODS: Normal and glaucomatous eyes underwent spectral-domain optical coherence tomography (SD-OCT) and standard automated perimetry. Doppler SD-OCT with a double-circle scanning pattern was used to measure RBF. The RBF was derived from the recorded Doppler frequency shift and the measured angle between the beam and the vessel. Total and hemispheric RBF, retinal nerve fiber layer (RNFL), and ganglion cell complex (GCC) values were calculated. The RS values were converted to 1/Lambert. Analysis of variance and regression analyses were performed. MAIN OUTCOME MEASURES: Total and hemispheric RS, RBF, RNFL, and GCC values. RESULTS: The total RBF (34.6±12.2 μl/minute) and venous cross-sectional area (0.039 ± 0.009 mm(2)) were reduced (P<0.001) in those with glaucoma compared with controls (46.5 ± 10.6 μl/minute; 0.052 ± 0.012 mm(2)). Mean RBF was reduced in the abnormal hemisphere compared with the opposite hemisphere (15.3 ± 5.4 vs. 19.3 ± 8.4 μl/minute; P = 0.004). The RNFL and GCC were thinner in the corresponding abnormal hemisphere compared with the opposite hemisphere (87.0 ± 20.2 vs. 103.7 ± 20.6 μm, P = 0.002; 77.6 ± 12.1 vs. 83.6 ± 10.1 μm, P = 0.04). The RBF was correlated with RNFL (r = 0.41; P = 0.02) and GCC (r = 0.43; P = 0.02) but not the RS (r = 0.31; P = 0.09) in the abnormal hemisphere. The RBF (19.3 ± 8.4 μl/minute), RNFL (103.7 ± 20.6 μm), and GCC (83.6 ± 10.1 μm) were reduced (P<0.05) in the hemisphere with apparently normal visual field in glaucomatous eyes compared with the mean hemispheric values of the normal eyes (23.2 ± 5.3 μl/minute, 124.8 ± 9.6 μm, and 96.1 ± 5.7 μm, respectively). CONCLUSIONS: In glaucomatous eyes with single-hemifield damage, the RBF is significantly reduced in the hemisphere associated with the abnormal hemifield. Reduced RBF is associated with thinner RNFL and GCC in the corresponding abnormal hemisphere. Reduced RBF and RNFL and GCC loss also are observed in the perimetrically normal hemisphere of glaucomatous eyes.
Authors: Mitra Sehi; John G Flanagan; Leilei Zeng; Richard J Cook; Graham E Trope Journal: Invest Ophthalmol Vis Sci Date: 2005-12 Impact factor: 4.799
Authors: John C Hwang; Ranjith Konduru; Xinbo Zhang; Ou Tan; Brian A Francis; Rohit Varma; Mitra Sehi; David S Greenfield; Srinivas R Sadda; David Huang Journal: Invest Ophthalmol Vis Sci Date: 2012-05-17 Impact factor: 4.799
Authors: Donald C Hood; Brad Fortune; Stella N Arthur; Danli Xing; Jennifer A Salant; Robert Ritch; Jeffrey M Liebmann Journal: J Glaucoma Date: 2008 Oct-Nov Impact factor: 2.503
Authors: Adeleh Yarmohammadi; Linda M Zangwill; Alberto Diniz-Filho; Luke J Saunders; Min Hee Suh; Zhichao Wu; Patricia Isabel C Manalastas; Tadamichi Akagi; Felipe A Medeiros; Robert N Weinreb Journal: Ophthalmology Date: 2017-02-10 Impact factor: 12.079
Authors: Chieh-Li Chen; Karine D Bojikian; Joanne C Wen; Qinqin Zhang; Chen Xin; Raghu C Mudumbai; Murray A Johnstone; Philip P Chen; Ruikang K Wang Journal: JAMA Ophthalmol Date: 2017-05-01 Impact factor: 7.389
Authors: Adeleh Yarmohammadi; Linda M Zangwill; Alberto Diniz-Filho; Min Hee Suh; Siamak Yousefi; Luke J Saunders; Akram Belghith; Patricia Isabel C Manalastas; Felipe A Medeiros; Robert N Weinreb Journal: Ophthalmology Date: 2016-10-07 Impact factor: 12.079
Authors: Xinbo Zhang; Anna Dastiridou; Brian A Francis; Ou Tan; Rohit Varma; David S Greenfield; Joel S Schuman; Mitra Sehi; Vikas Chopra; David Huang Journal: Am J Ophthalmol Date: 2016-09-17 Impact factor: 5.258