doiSerbia

Changes in the retrobulbar arterial circulation after decrease of the elevated intraocular pressure in men and women with primary open angle glaucoma

Marjanović Ivan (Medicinski fakultet, Beograd + Klinički centar Srbije, Klinika za očne bolesti, Beograd)
Martinez Antonio (Instituto Gallego de Oftalmologia, Clinical Research Department, Science Research and Sports, Santiago de Compostela, La Coruna, Spain)
Marjanović Marija (Medicinski fakultet, Beograd + Klinički centar Srbije, Klinika za kardiologiju, Beograd)
Kontić Đorđe (Medicinski fakultet, Beograd + Klinički centar Srbije, Klinika za očne bolesti, Beograd)
Hentova-Senćanić Paraskeva (Medicinski fakultet, Beograd + Klinički centar Srbije, Klinika za očne bolesti, Beograd)
Marković Vujica (Medicinski fakultet, Beograd + Klinički centar Srbije, Klinika za očne bolesti, Beograd)
Božić Marija (Medicinski fakultet, Beograd + Klinički centar Srbije, Klinika za očne bolesti, Beograd)

Introduction. An altered perfusion of the optic nerve head has been proposed as a pathogenic factor of glaucoma. Objective. The aim of this study was to evaluate the changes of the hemodynamic parameters in the retrobulbar arterial circulation after decrease of the elevated intraocular pressure (IOP) in women and men with primary open angle glaucoma. Methods. The study included 60 patients (33 males and 27 females) older than 50 years, with diagnosed and treated primary open angle glaucoma (77 eyes of 39 patients had increased IOP, >25 mm Hg). They were examined at the Clinic of Eye Diseases (complete ophthalmologic exam) and Clinic of Neurology, Clinical Center of Serbia, Belgrade, from December 2009 to December 2010. Imaging of hemodynamic parameters of three retrobulbar arterial vessels: ophthalmic, central retinal and posterior ciliary arteries with color Doppler was performed. Results. Among women, hemodynamic arterial parameter of the peak-systolic velocity was increased in the central retinal artery and decreased in the ophthalmic artery and posterior ciliary arteries; end- diastolic velocity was increased in all three retrobulbar vascular levels; Pourcelot resistivity index was increased, but pulsatility index was decreased in all three vessels. Among men, peak-systolic velocity, end-diastolic velocity and pulsatility index were decreased in all three vessels; resistivity index was increased in the ophthalmic artery, but decreased in the central retinal artery and posterior ciliary arteries. There was a significant change of the ophthalmic artery pulsatility index in women, and the end-diastolic velocity of the ophthalmic artery in men. Conclusion. There was a difference of the retrobulbar arterial circulation between women and men with primary open angle glaucoma after decrease of the elevated intraocular pressure. The role of vascular factors in the supply of the optic disc neuroretinal rim is important.

Keywords: elevated intraocular pressure, retrobulbar arterial circulation, color Doppler imaging, primary open angle glaucoma