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Ocular Hemodynamics in Acute Nonarteritic Anterior Ischemic Optic Neuropathy Compared With Normal Tension Glaucoma

Kuerten, David, MD; Fuest, Matthias, MD; Bienert, Marion, MD; Walter, Peter, MD; Plange, Niklas, MD

doi: 10.1097/IJG.0000000000001177
Original Studies

Purpose: The purpose of this study was to evaluate ocular hemodynamics in patients with a disease believed to be related to a chronic vascular damage [ie, normal tension glaucoma (NTG)] in comparison with an entity with an acute ischemic impact on the optic nerve [ie, acute nonarteritic anterior ischemic optic neuropathy (NAION)].

Materials and Methods: Blood-flow velocities [peak systolic velocity (PSV), enddiastolic velocity (EDV)] of the ophthalmic artery (OA), central retinal artery (CRA), and nasal and temporal posterior ciliary arteries were measured using color Doppler imaging. Resistive index (RI) of all vessels was calculated (PSV-EDV/PSV). A total of 41 patients suffering from acute NAION (onset of symptoms <10 d) and 64 age-matched patients suffering from NTG were included in this prospective study.

Results: No significant differences were recorded for either age or intraocular pressure inbetween the 2 groups. Systolic blood pressure was significantly higher in the NAION group, whereas no significant differences were recorded for the diastolic blood pressure. Only 3 color Doppler imaging parameters were found to differ significantly. The PSV (P<0.005) and EDV (P<0.02) in the CRA were significantly higher in NTG patients. Furthermore, the RI in the OA was significantly higher in the NAION patients (P<0.005).

Conclusions: Decreased blood-flow velocities in the CRA and a higher RI in the OA can be recorded in NAION patients as compared with NTG. No differences with regard to the posterior ciliary arteries’ velocities were recorded. Ocular hemodynamics are suspected to play a critical role in NAION and NTG, whereas the blood-flow disturbances seem to be more severe in NAION than in NTG.

Department of Ophthalmology, RWTH Aachen University, Pauwelsstr., Aachen, Germany

All examinations were performed in accordance with the declaration of Helsinki and approved by the local ethics committee.

Disclosure: The authors declare no conflict of interest.

Reprints: David Kuerten, MD, Department of Ophthalmology, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany (e-mail:

Received July 23, 2018

Accepted December 8, 2018

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