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Baseline retrobulbar blood flow is associated with both functional and structural glaucomatous progression after 4 years
  1. Nicholas A Moore,
  2. Alon Harris,
  3. Scott Wentz,
  4. Alice Chandra Verticchio Vercellin,
  5. Priyanka Parekh,
  6. Joshua Gross,
  7. Rehan M Hussain,
  8. Claudia Thieme,
  9. Brent Siesky
  1. Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA
  1. Correspondence to Professor Alon Harris, Department of Ophthalmology, Indiana University School of Medicine, 1160 West Michigan Street, Indianapolis, IN 46202, USA; alharris{at}


Background/aims Previous studies suggest that vascular abnormalities are involved in the pathogenesis of open-angle glaucoma. This study aims to examine the relationship of baseline retrobulbar blood flow measurements with functional and structural glaucomatous progression in patients with open-angle glaucoma over 4 years.

Methods In this study, 112 patients with open-angle glaucoma were examined at baseline and 78 with retrobulbar blood flow assessments were followed to 4 years. Colour Doppler imaging was used to evaluate retrobulbar blood flow. Structural disease progression was examined with optical coherence tomography and Heidelberg Retinal Tomography III. Functional disease progression was monitored with automated perimetry using Humphrey visual fields. Mixed-model analysis of covariance was used to test for significance of changes from baseline to 4-year follow-up. Two-sample t tests and χ2 tests were used to test for baseline blood flow differences between patients who progressed and those who did not progress.

Results Patients who progressed structurally had a statistically significant lower baseline mean ophthalmic artery peak systolic velocity (PSV) (p=0.024) and ophthalmic artery end diastolic velocity (EDV) (p=0.012) compared with those who did not progress. Similarly, a lower baseline mean ophthalmic artery PSV (p=0.031) and ophthalmic artery EDV (p=0.005) were associated with patients who progressed functionally compared with those who did not progress after 4 years.

Conclusions In this study population, lower baseline ophthalmic artery blood flow velocities were associated with simultaneous structural and functional glaucoma progression after 4 years.

  • Glaucoma
  • Imaging
  • Physiology
  • Optic Nerve

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  • Contributors All authors made a substantial contribution to the study design and acquisition and interpretation of the data. Each author participated in drafting or revising the manuscript and approved submission of this version for publication.

  • Funding Supported by an unrestricted grant from Research to Prevent Blindness (New York, New York, USA). The funding party did not have any role in the study design, collection of data, analysis of data, writing of the manuscript or decision to submit the manuscript.

  • Competing interests AH would like to disclose that he receives remuneration from Stemnion, Biolight, Nano Retina, AdOM, Science Based Health, Isarna Therapeutics, and Ono Pharmaceuticals for serving as a consultant. He also holds an ownership interest in AdOM, Nano Retina and Oxymap. All relationships listed above are pursuant to Indiana University's policy on outside activities.

  • Ethics approval Obtained by the Indiana University School of Medicine Institutional Review Board. All patients signed an informed consent prior to initiation of this study, which adhered to the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement This submitted manuscript contains the original data findings of the retrobulbar blood flow, functional progression, and structural progression from the 4-year portion of this study. The study is ongoing and is in the fifth year of data collection at Indiana University. Data from the ongoing study continues to be collected by AH and BS, who have been the primary investigators in this study since its initiation.

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