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Retrobulbar Hemodynamics in Nonarteritic Anterior Ischemic Optic Neuropathy and Normal-tension Glaucoma

Kaup M., Plange N., Remky A., Arend O.,
RWTH Aachen, Universitätsaugenklinik (Aachen)

Purpose: The acute circulatory disorder of the optic nerve head in nonarteritic anterior ischemic optic neuropathy (AION) is caused by hypoperfusion of the short posterior ciliar arteries. In normal-tension glaucoma (NTG) a vascular insufficiency of the optic nerve head is discussed.
Method: We examined 10 patients with nonarteritic AION (age 70±8 years), 20 patients with NTG (age 70±5 years) and 20 healthy volunteers (age 50±15 years). By means of color doppler imaging (Siemens Sonoline Sienna) the blood flow velocities of the ophthalmic artery (OA), central retinal artery (CRA) and nasal and temporal short posterior arteries (PCA) were measured. Peak systolic (PSV) and end-diastolic velocity (EDV) and Pourcelot resistance index (RI) were determined.
Results: The groups showed no significant difference in blood flow velocities and RI of the OA. The PSV in CRA and nasal PCA was significantly decreased in patients with AION compared to healthy controls (p<0,05). This difference was not detectable for temporal PCA. The EDV of CRA, nasal and temporal PCA was significantly reduced in patients with AION and NTG (p<0,05). The RI of CRA, nasal and temporal PCA was significantly increased in patients with NTG compared to controls (p<0,05). No significant differences in blood flow velocities or RI in either vessel were detected between AION and NTG.
Conclusions: While the OA showed no changes of hemodynamics, CRA and PCA had significant differences in AION and NTG patients to healthy controls. The EDV was significantly reduced in these arteries. An increased RI could be detected in patients with NTG, while in patients with AION a general reduction of blood flow velocities existed. AION and NTG showed no difference in retrobulbar hemodynamics to each other.