Relationship of cerebral blood flow and central visual function in primary open-angle glaucoma

Purpose: To investigate the relations between middle cerebral artery (MCA) blood flow velocities and central visual function measured by foveal cone electroretinograms (ERG) and visual field. Methods: Fifteen primary open-angle glaucoma patients were recruited. The eye with the more severe visual field defect (full threshold 24-2) and/or optic disc damage was chosen. Measurements included brachial arterial pressure, heart rate, visual acuity (logMAR), contrast sensitivity (CSV-1000), central visual field (Humphrey SITA 10-2), foveal cone ERG, and transcranial Doppler. Pearson correlation coefficients were estimated to assess the strength of the linear relationship between the MCA flow velocity and the other measured parameters. Results: Visual field was successfully completed in 12 eyes. We were unable to obtain ERG responses and MCA velocity readings for 1 patient. A significant correlation was observed between MCA mean flow velocity and focal cone ERG amplitude [r 0.69, n = 13, confidence interval (CI) 0.22, 0.90, P = 0.009], but correlation between mean foveal cone ERG implicit time and middle cerebral was not statistically significant (r = 0.011, n = 13, CI 0.47, 0.63). A significant correlation was also observed between MCA mean flow velocity and mean sensitivity (r = 0.76, n = 12, CI 0.32, 0.93, P = 0.005), and mean defect (r = 0,73, n = 12, CI 0.28, 0.92, P = 0.007) of the central visual field, logMAR visual acuity (r = 0.57, It 14, CI 0.05, 0.84, P = 0.036), and contrast sensitivity (r = 0.61, n = 13, CI 0.09, 0.87, P = 0.027). Conclusions: Our findings suggest that in certain primary open-angle glaucoma patients diminished central visual function may be one manifestation of widespread cerebrovascular insufficiency.