Asymmetric visual field loss and retrobulbar haemodynamics in primary open-angle glaucoma

Purpose: To investigate interocular differences in retrobulbar flow velocities in patients with asymmetric glaucomatous visual field loss. Methods: Twenty-five patients with primary open-angle glaucoma (POAG) and asymmetric visual field loss were included in this study. Asymmetric visual field loss was defined as a difference of the global index mean deviation (MD) > 6 dB between the two eyes. Flow velocities (peak systolic velocity PSV and end-diastolic velocity EDV) and resistive indices (RI) of the ophthalmic artery (OA), central retinal artery (CRA), and nasal and temporal posterior ciliary arteries were measured by means of colour Doppler imaging. Results: MD of eyes with more severe glaucomatous visual field loss was -18.3 +/- 7.8 dB vs -6.8 +/- 5.5 dB (p < 0.0001) in the less affected eyes. The PSV and the EDV of the CRA and the PSV of the OA were significantly decreased in eyes with more severe glaucomatous visual field loss (CRA PSV: 7.6 +/- 2.0 cm/s vs 8.3 +/- 1.7 cm/s, p=0.04; CRA EDV: 2.24 +/- 0.5 cm/s vs 2.55 +/- 0.6 cm/s, p < 0.007; OA PSV: 29.7 +/- 9.9 cm/s vs 32.7 +/- 11.5 cm/s, p < 0.02). None of the other differences in velocity or resistive index were significant. Conclusions: Patients with asymmetric glaucomatous visual field loss exhibit asymmetric flow velocities of the CRA and OA. Patients with more severe damage display reduced flow velocities in retrobulbar vessels in POAG.