Br J Ophthalmol 1997;81:735-742 ( September )
Choroidal haemodynamics in glaucoma
H Ferdinand A Duijm,a b c
Thomas J T P van den Berg,b c
Erik L Grevea
a Glaucoma Center, Department of Ophthalmology,
Academic Medical Center, University of Amsterdam, Netherlands, b Department of Medical Physics,
University of Amsterdam, Netherlands, c The Netherlands Ophthalmic Research Institute,
Amsterdam, Netherlands
Correspondence to: H Ferdinand A Duijm, Glaucoma Center,
Department of Ophthalmology, AMC, University of Amsterdam, PO Box
22700, 1100 DD Amsterdam, Netherlands.
Accepted for publication 14 May 1997
AIM
Quantification of haemodynamics of the
peripapillary choroid in and the assessment of possible differences
between normal subjects (N), ocular hypertensive (OHT), primary open
angle (POAG), and normal pressure glaucoma (NPG) patients.
METHODS
Video fluorescein angiograms (Rodenstock
SLO 101) were made in 22 N subjects, 12 OHT, 48 POAG, and 46 NPG
patients. The angiographically derived dye build up curves were
described by means of an exponential model. One of the model parameters
is the time constant
theoretically reflecting local blood
refreshment time; the blood refreshment time
is the time needed to
replace the blood volume in the choriocapillaris, inversely
proportional to the local choroidal blood flow. Other variables are
maximal fluorescence (Fdt) and time of first fluorescence (t0). Mean variable values were calculated for disc area
and circular areas around the disc.
RESULTS
Fdt of the disc was
significantly lower in the POAG and NPG patients. There was no
statistical difference in t0 between the study groups. The
choroidal blood refreshment time was significantly longer in NPG
patients and to a lesser extent in the POAG patients compared with the
normal controls. The slowest choroidal blood refreshment can be found
in the NPG group. The median choroidal blood refreshment times
(25th-75th percentile) in the controls, OHT, POAG, and NPG patients
were 4.1 (3.7-4.5), 4.4 (3.7-6.4), 5.8 (4.3-6.8), and 7.1 (5.5-9.3)
seconds respectively.
CONCLUSIONS
With the help of parametrisation of
dye curves, using a one compartmental model, choroidal haemodynamics
can be quantified. The blood refreshment time of the peripapillary
choriocapillaris was found to be significantly prolonged especially in
NPG patients; this may indicate slower choroidal haemodynamics in NPG patients.
© 1997 by British Journal of Ophthalmology