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The association between retinal vein pulsation pressure and optic disc haemorrhages in glaucoma

PURPOSE: To explore the potential relationship between optic disc haemorrhage, venous pulsation pressure (VPP), ocular perfusion pressures and visual field change in glaucomatous and glaucoma suspect eyes. MATERIALS AND METHODS: This prospective observational study examined 155 open angle glaucoma o...

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Autores principales: An, Dong, House, Philip, Barry, Christopher, Turpin, Andrew, McKendrick, Allison M., Chauhan, Balwantray C., Manners, Siobhan, Graham, Stuart L., Yu, Dao-Yi, Morgan, William H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536188/
https://www.ncbi.nlm.nih.gov/pubmed/28759054
http://dx.doi.org/10.1371/journal.pone.0182316
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author An, Dong
House, Philip
Barry, Christopher
Turpin, Andrew
McKendrick, Allison M.
Chauhan, Balwantray C.
Manners, Siobhan
Graham, Stuart L.
Yu, Dao-Yi
Morgan, William H.
author_facet An, Dong
House, Philip
Barry, Christopher
Turpin, Andrew
McKendrick, Allison M.
Chauhan, Balwantray C.
Manners, Siobhan
Graham, Stuart L.
Yu, Dao-Yi
Morgan, William H.
author_sort An, Dong
collection PubMed
description PURPOSE: To explore the potential relationship between optic disc haemorrhage, venous pulsation pressure (VPP), ocular perfusion pressures and visual field change in glaucomatous and glaucoma suspect eyes. MATERIALS AND METHODS: This prospective observational study examined 155 open angle glaucoma or glaucoma suspect eyes from 78 patients over 5 years. Patients were followed with 3 monthly non-mydriatic disc photographs, 6 monthly standard automated perimetry and annual ophthalmodynamometry. The number of disc haemorrhages in each hemidisc was counted across the study period. Visual field rate of change was calculated using linear regression on the sensitivity of each location over time, then averaged for the matching hemifield. VPP and central retinal artery diastolic pressure (CRADP) were calculated from the measured ophthalmodynanometric forces (ODF). The difference between brachial artery diastolic pressure (DiastBP) and CRADP was calculated as an index of possible flow pathology along the carotid and ophthalmic arteries. RESULTS: Mean age of the cohort was 71.9 ± 7.3 Years. 76 out of 155 eyes (49%) followed for a mean period of 64.2 months had at least 1 disc haemorrhage. 62 (81.6%) of these 76 eyes had recurrent haemorrhages, with a mean of 5.94 recurrences over 64.2 months. Using univariate analysis, rate of visual field change (P<0.0001), VPP (P = 0.0069), alternative ocular perfusion pressure (CRADP–VPP, P = 0.0036), carotid resistance index (DiastBP–CRADP, P = 0.0108) and mean brachial blood pressure (P = 0.0203) were significantly associated with the number of disc haemorrhages. Using multivariate analysis, increased baseline visual field sensitivity (P = 0.0243, coefficient = 0.0275) was significantly associated with disc haemorrhage, in conjunction with higher VPP (P = 0.0029, coefficient = 0.0631), higher mean blood pressure (P = 0.0113, coefficient = 0.0190), higher carotid resistance index (P = 0.0172, coefficient = 0.0566), and rate of visual field loss (P<0.0001, coefficient = -2.0695). CONCLUSIONS: Higher VPP was associated with disc haemorrhage and implicates the involvement of venous pathology, but the effect size is small. Additionally, a greater carotid resistance index suggests that flow pathology in the ophthalmic or carotid arteries may be associated with disc haemorrhage.
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spelling pubmed-55361882017-08-07 The association between retinal vein pulsation pressure and optic disc haemorrhages in glaucoma An, Dong House, Philip Barry, Christopher Turpin, Andrew McKendrick, Allison M. Chauhan, Balwantray C. Manners, Siobhan Graham, Stuart L. Yu, Dao-Yi Morgan, William H. PLoS One Research Article PURPOSE: To explore the potential relationship between optic disc haemorrhage, venous pulsation pressure (VPP), ocular perfusion pressures and visual field change in glaucomatous and glaucoma suspect eyes. MATERIALS AND METHODS: This prospective observational study examined 155 open angle glaucoma or glaucoma suspect eyes from 78 patients over 5 years. Patients were followed with 3 monthly non-mydriatic disc photographs, 6 monthly standard automated perimetry and annual ophthalmodynamometry. The number of disc haemorrhages in each hemidisc was counted across the study period. Visual field rate of change was calculated using linear regression on the sensitivity of each location over time, then averaged for the matching hemifield. VPP and central retinal artery diastolic pressure (CRADP) were calculated from the measured ophthalmodynanometric forces (ODF). The difference between brachial artery diastolic pressure (DiastBP) and CRADP was calculated as an index of possible flow pathology along the carotid and ophthalmic arteries. RESULTS: Mean age of the cohort was 71.9 ± 7.3 Years. 76 out of 155 eyes (49%) followed for a mean period of 64.2 months had at least 1 disc haemorrhage. 62 (81.6%) of these 76 eyes had recurrent haemorrhages, with a mean of 5.94 recurrences over 64.2 months. Using univariate analysis, rate of visual field change (P<0.0001), VPP (P = 0.0069), alternative ocular perfusion pressure (CRADP–VPP, P = 0.0036), carotid resistance index (DiastBP–CRADP, P = 0.0108) and mean brachial blood pressure (P = 0.0203) were significantly associated with the number of disc haemorrhages. Using multivariate analysis, increased baseline visual field sensitivity (P = 0.0243, coefficient = 0.0275) was significantly associated with disc haemorrhage, in conjunction with higher VPP (P = 0.0029, coefficient = 0.0631), higher mean blood pressure (P = 0.0113, coefficient = 0.0190), higher carotid resistance index (P = 0.0172, coefficient = 0.0566), and rate of visual field loss (P<0.0001, coefficient = -2.0695). CONCLUSIONS: Higher VPP was associated with disc haemorrhage and implicates the involvement of venous pathology, but the effect size is small. Additionally, a greater carotid resistance index suggests that flow pathology in the ophthalmic or carotid arteries may be associated with disc haemorrhage. Public Library of Science 2017-07-28 /pmc/articles/PMC5536188/ /pubmed/28759054 http://dx.doi.org/10.1371/journal.pone.0182316 Text en © 2017 An et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
An, Dong
House, Philip
Barry, Christopher
Turpin, Andrew
McKendrick, Allison M.
Chauhan, Balwantray C.
Manners, Siobhan
Graham, Stuart L.
Yu, Dao-Yi
Morgan, William H.
The association between retinal vein pulsation pressure and optic disc haemorrhages in glaucoma
title The association between retinal vein pulsation pressure and optic disc haemorrhages in glaucoma
title_full The association between retinal vein pulsation pressure and optic disc haemorrhages in glaucoma
title_fullStr The association between retinal vein pulsation pressure and optic disc haemorrhages in glaucoma
title_full_unstemmed The association between retinal vein pulsation pressure and optic disc haemorrhages in glaucoma
title_short The association between retinal vein pulsation pressure and optic disc haemorrhages in glaucoma
title_sort association between retinal vein pulsation pressure and optic disc haemorrhages in glaucoma
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536188/
https://www.ncbi.nlm.nih.gov/pubmed/28759054
http://dx.doi.org/10.1371/journal.pone.0182316
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