Color Doppler imaging analysis of retrobulbar blood flow velocities in primary open-angle glaucomatous eyes: a meta-analysis_Chinese Journal of Ocular Fundus Diseases

Authors：

MengNana ,  QuYi

Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan 250012, China;

Corresponding author：

QuYi, Email: yiqucn@sdu.edu.cn

Keywords：

Glaucoma, open-angle/ultrasonography; Hemodynamics; Ultrasonography, doppler, color; Meta-analysis

DOI：

10.3760/cma.j.issn.1005-1015.2014.06.017

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Objective To observe the hemodynamic parameters of retrobulbar vessels of eyes with primary open-angle glaucoma (POAG) by using color Doppler imaging (CDI) technique. Methods Pertinent publications were retrieved from the PubMed of The National Library of Medicine, the ISI Web of Knowledge of The Institute for Scientific Information, and Cochrane Central Register of Controlled Trials. Case control studies involved POAG patients were included. Changes in retrobulbar blood flow parameters including peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) of the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary artery (SPCA) were evaluated by CDI. The searching time was from the data base established up to April, 2014. Meta analysis was used on the included articles, the mean difference (MD) along with 95% confidence interval (95% CI) of the blood flow parameters were calculated. Results Twenty-four articles were retrieved, including 1336 eyes as cases, 1102 eyes as controls. PSV of POAG eyes was statistically signiflcantly lower than controls in the OA (MD=-3.05, 95%CI:-4.49--1.61, P < 0.001), CRA (MD=-1.66, 95%CI:-1.95--1.38, P < 0.001), SPCA (MD=-0.87, 95% CI:-1.49--0.26, P=0.005). EDV of POAG eyes was statistically significantly reduced than controls in the OA (MD=-1.78, 95%CI:-2.14--1.41, P < 0.001), CRA (MD=-0.95, 95%CI:-1.17--0.74, P < 0.001), SPCA (MD=-0.53, 95%CI:-0.71--0.36, P < 0.001). Statistically significant increases in RI of POAG eyes than controls in the OA (MD=0.04, 95%CI: 0.03-0.05, P < 0.001), CRA (MD=0.06, 95%CI: 0.05-0.07, P < 0.001), SPCA (MD=0.04, 95%CI: 0.03-0.06, P < 0.001). Conclusion This meta-analysis suggests that significant decreased velocity and increased resistance of retrobulbar blood flow are found in POAG eyes.

Citation： MengNana, QuYi. Color Doppler imaging analysis of retrobulbar blood flow velocities in primary open-angle glaucomatous eyes: a meta-analysis. Chinese Journal of Ocular Fundus Diseases, 2014, 30(6): 608-613. doi: 10.3760/cma.j.issn.1005-1015.2014.06.017 Copy

1.	Resch H, Garhofer G, Fuchsjager-Mayrl G, et al. Endothelial dysfunction in glaucoma[J]. Acta Ophthalmol, 2009, 87:4-12.
2.	Leske MC, Heijl A, Hyman L, et al. Predictors of long-term progression in the early manifest glaucoma trial[J]. Ophthalmology, 2007, 114:1965-1972.
3.	Costa VP, Harris A, Stefansson E, et al. The effects of antiglaucoma and systemic medications on ocular blood flow[J]. Prog Retin Eye Res, 2003, 22:769-805.
4.	Flammer J, Orgul S, Costa VP, et al. The impact of ocular blood flow in glaucoma[J]. Prog Retin Eye Res, 2002, 21:359-393.
5.	Garhofer G, Fuchsjager-Mayrl G, Vass C, et al. Retrobulbar blood flow velocities in open angle glaucoma and their association with mean arterial blood pressure[J]. Invest Ophthalmol Vis Sci, 2010, 51:6652-6657.
6.	Cellini M, Possati GL, Caramazza N, et al. Colour Doppler analysis of the choroidal circulation in chronic open-angle glaucoma[J]. Ophthalmologica, 1996, 210:200-202.
7.	Harris A, Sergott RC, Spaeth GL, et al. Color Doppler analysis of ocular vessel blood velocity in normal-tension glaucoma[J]. Am J Ophthalmol, 1994, 118:642-649.
8.	Erickson SJ, Hendrix LE, Massaro BM, et al. Color Doppler flow imaging of the normal and abnormal orbit[J]. Radiology, 1989, 173:511-516.
9.	Abegao Pinto L, Vandewalle E, Stalmans I. Disturbed correlation between arterial resistance and pulsatility in glaucoma patients[J]. Acta Ophthalmol, 2012, 90:214-220.
10.	Butt Z, O'Brien C, McKillop G, et al. Color Doppler imaging in untreated high-and normal-pressure open-angle glaucoma[J]. Invest Ophthalmol Vis Sci, 1997, 38:690-696.
11.	Butt Z, McKillop G, O'Brien C, et al. Measurement of ocular blood flow velocity using colour Doppler imaging in low tension glaucoma[J]. Eye (Lond), 1995, 9:29-33.
12.	Rankin SJ, Walman BE, Buckley AR, et al. Color Doppler imaging and spectral analysis of the optic nerve vasculature in glaucoma[J]. Am J Ophthalmol, 1995, 119:685-693.
13.	Abegao Pinto L, Vandewalle E, de Clerck E, et al. Lack of spontaneous venous pulsation:possible risk indicator in normal tension glaucoma?[J]. Acta Ophthalmol, 2013, 91:514-520.
14.	Birinci H, Danaci M, Oge I, et al. Ocular blood flow in healthy and primary open-angle glaucomatous eyes[J]. Ophthalmologica, 2002, 216:434-437.
15.	Detorakis ET, Achtaropoulos AK, Drakonaki EE, et al. Hemodynamic evaluation of the posterior ciliary circulation in exfoliation syndrome and exfoliation glaucoma[J]. Graefe's Arch Clin Exp Ophthalmol, 2007, 245:516-521.
16.	Galambos P, Vafiadis J, Vilchez SE, et al. Compromised autoregulatory control of ocular hemodynamics in glaucoma patients after postural change[J]. Ophthalmology, 2006, 113:1832-1836.
17.	Gherghel D, Orgul S, Gugleta K, et al. Relationship between ocular perfusion pressure and retrobulbar blood flow in patients with glaucoma with progressive damage[J]. Am J Ophthalmol, 2000, 130:597-605.
18.	Gugleta K, Orgul S, Flammer J. Is corneal temperature correlated with blood-flow velocity in the ophthalmic artery?[J]. Curr Eye Res, 1999, 19:496-501.
19.	Kaiser HJ, Schoetzau A, Stumpfig D, et al. Blood-flow velocities of the extraocular vessels in patients with high-tension and normal-tension primary open-angle glaucoma[J]. Am J Ophthalmol, 1997, 123:320-327.
20.	Liu CJ, Chiou HJ, Chiang SC, et al. Variations in ocular hemodynamics in patients with early and late glaucoma[J]. Acta Ophthalmol Scand, 1999, 77:658-662.
21.	Pemp B, Garhofer G, Lasta M, et al. The effects of moxaverine on ocular blood flow in patients with age-related macular degeneration or primary open angle glaucoma and in healthy control subjects[J]. Acta Ophthalmol, 2012, 90:139-145.
22.	Sekeroglu MA, Irkec M, Mocan MC, et al. The association of ocular blood flow with haemorheological parameters in primary open-angle and exfoliative glaucoma[J]. Acta Ophthalmol, 2011, 89:429-434.
23.	Stalmans I, Harris A, Fieuws S, et al. Color Doppler imaging and ocular pulse amplitude in glaucomatous and healthy eyes[J]. Eur J Ophthalmol, 2009, 19:580-587.
24.	Yuksel N, Karabas VL, Demirci A, et al. Comparison of blood flow velocities of the extraocular vessels in patients with pseudoexfoliation or primary open-angle glaucoma[J]. Ophthalmologica, 2001, 215:424-429.
25.	Galassi F, Giambene B, Menchini U. Ocular perfusion pressure and retrobulbar haemodynamics in pseudoexfoliative glaucoma[J]. Graefe's Arch Clin Exp Ophthalmol, 2008, 246:411-416.
26.	Martinez A, Gonzalez F, Capeans C, et al. Dorzolamide effect on ocular blood flow[J]. Invest Ophthalmol Vis Sci, 1999, 40:1270-1275.
27.	Hosking SL, Harris A, Chung HS, et al. Ocular haemodynamic responses to induced hypercapnia and hyperoxia in glaucoma[J]. Br J Ophthalmol, 2004, 88:406-411.
28.	Liu X, Ge J, Zhou W, et al. Hemodynamics of ophthalmic artery and central retinal artery and correlation with other factors in patients with primary open angle glaucoma[J]. Yan Ke Xue Bao, 1998, 14:138-144.
29.	Januleviciene I, Sliesoraityte I, Siesky B, et al. Diagnostic compatibility of structural and haemodynamic parameters in open-angle glaucoma patients[J]. Acta Ophthalmol, 2008, 86:552-557.
30.	Akarsu C, Bilgili MY. Color Doppler imaging in ocular hypertension and open-angle glaucoma[J]. Graefe's Arch Clin Exp Ophthalmol, 2004, 242:125-129.
31.	Zhong Y, Min Y, Jiang Y, et al. Color Doppler imaging and pattern visual evoked potential in normal tension glaucoma and hypertension glaucoma[J]. Doc Ophthalmol, 2009, 119:171-180.
32.	Simsek T, Yanik B, Conkbayir I, et al. Comparative analysis of the effects of brimonidine and dorzolamide on ocular blood flow velocity in patients with newly diagnosed primary open-angle glaucoma[J]. J Ocul Pharmacol Ther, 2006, 22:79-85.
33.	Adeyinka OO, Olugbenga A, Helen OO, et al. Ocular blood flow velocity in primary open angle glaucoma--a tropical African population study[J]. Middle East Afr J Ophthalmol, 2006, 20:174-178.
34.	Hansen NB, Stonestreet BS, Rosenkrantz TS, et al. Validity of Doppler measurements of anterior cerebral artery blood flow velocity:correlation with brain blood flow in piglets[J]. Pediatrics, 1983, 72:526-531.
35.	Taylor GA, Short BL, Walker LK, et al. Intracranial blood flow:quantification with duplex Doppler and color Doppler flow US[J]. Radiology, 1990, 176:231-236.
36.	Brusini P, Zeppieri M, Tosoni C, et al. Stratus-OCT imaging in early glaucomatous and in ocular hypertensive patients with and without frequency-doubling technology abnormalities[J]. Eye (Lond), 2008, 22:406-413.
37.	Baxter GM, Williamson TH, McKillop G, et al. Color Doppler ultrasound of orbital and optic nerve blood flow:effects of posture and timolol 0.5%[J]. Invest Ophthalmol Vis Sci, 1992, 33:604-610.
38.	Steigerwalt RD Jr, Belcaro G, Cesarone MR, et al. Doppler ultrasonography of the central retinal artery in normals treated with topical timolol[J]. Eye (Lond), 1993, 7:403-406.

1. Resch H, Garhofer G, Fuchsjager-Mayrl G, et al. Endothelial dysfunction in glaucoma[J]. Acta Ophthalmol, 2009, 87:4-12.
2. Leske MC, Heijl A, Hyman L, et al. Predictors of long-term progression in the early manifest glaucoma trial[J]. Ophthalmology, 2007, 114:1965-1972.
3. Costa VP, Harris A, Stefansson E, et al. The effects of antiglaucoma and systemic medications on ocular blood flow[J]. Prog Retin Eye Res, 2003, 22:769-805.
4. Flammer J, Orgul S, Costa VP, et al. The impact of ocular blood flow in glaucoma[J]. Prog Retin Eye Res, 2002, 21:359-393.
5. Garhofer G, Fuchsjager-Mayrl G, Vass C, et al. Retrobulbar blood flow velocities in open angle glaucoma and their association with mean arterial blood pressure[J]. Invest Ophthalmol Vis Sci, 2010, 51:6652-6657.
6. Cellini M, Possati GL, Caramazza N, et al. Colour Doppler analysis of the choroidal circulation in chronic open-angle glaucoma[J]. Ophthalmologica, 1996, 210:200-202.
7. Harris A, Sergott RC, Spaeth GL, et al. Color Doppler analysis of ocular vessel blood velocity in normal-tension glaucoma[J]. Am J Ophthalmol, 1994, 118:642-649.
8. Erickson SJ, Hendrix LE, Massaro BM, et al. Color Doppler flow imaging of the normal and abnormal orbit[J]. Radiology, 1989, 173:511-516.
9. Abegao Pinto L, Vandewalle E, Stalmans I. Disturbed correlation between arterial resistance and pulsatility in glaucoma patients[J]. Acta Ophthalmol, 2012, 90:214-220.
10. Butt Z, O'Brien C, McKillop G, et al. Color Doppler imaging in untreated high-and normal-pressure open-angle glaucoma[J]. Invest Ophthalmol Vis Sci, 1997, 38:690-696.
11. Butt Z, McKillop G, O'Brien C, et al. Measurement of ocular blood flow velocity using colour Doppler imaging in low tension glaucoma[J]. Eye (Lond), 1995, 9:29-33.
12. Rankin SJ, Walman BE, Buckley AR, et al. Color Doppler imaging and spectral analysis of the optic nerve vasculature in glaucoma[J]. Am J Ophthalmol, 1995, 119:685-693.
13. Abegao Pinto L, Vandewalle E, de Clerck E, et al. Lack of spontaneous venous pulsation:possible risk indicator in normal tension glaucoma?[J]. Acta Ophthalmol, 2013, 91:514-520.
14. Birinci H, Danaci M, Oge I, et al. Ocular blood flow in healthy and primary open-angle glaucomatous eyes[J]. Ophthalmologica, 2002, 216:434-437.
15. Detorakis ET, Achtaropoulos AK, Drakonaki EE, et al. Hemodynamic evaluation of the posterior ciliary circulation in exfoliation syndrome and exfoliation glaucoma[J]. Graefe's Arch Clin Exp Ophthalmol, 2007, 245:516-521.
16. Galambos P, Vafiadis J, Vilchez SE, et al. Compromised autoregulatory control of ocular hemodynamics in glaucoma patients after postural change[J]. Ophthalmology, 2006, 113:1832-1836.
17. Gherghel D, Orgul S, Gugleta K, et al. Relationship between ocular perfusion pressure and retrobulbar blood flow in patients with glaucoma with progressive damage[J]. Am J Ophthalmol, 2000, 130:597-605.
18. Gugleta K, Orgul S, Flammer J. Is corneal temperature correlated with blood-flow velocity in the ophthalmic artery?[J]. Curr Eye Res, 1999, 19:496-501.
19. Kaiser HJ, Schoetzau A, Stumpfig D, et al. Blood-flow velocities of the extraocular vessels in patients with high-tension and normal-tension primary open-angle glaucoma[J]. Am J Ophthalmol, 1997, 123:320-327.
20. Liu CJ, Chiou HJ, Chiang SC, et al. Variations in ocular hemodynamics in patients with early and late glaucoma[J]. Acta Ophthalmol Scand, 1999, 77:658-662.
21. Pemp B, Garhofer G, Lasta M, et al. The effects of moxaverine on ocular blood flow in patients with age-related macular degeneration or primary open angle glaucoma and in healthy control subjects[J]. Acta Ophthalmol, 2012, 90:139-145.
22. Sekeroglu MA, Irkec M, Mocan MC, et al. The association of ocular blood flow with haemorheological parameters in primary open-angle and exfoliative glaucoma[J]. Acta Ophthalmol, 2011, 89:429-434.
23. Stalmans I, Harris A, Fieuws S, et al. Color Doppler imaging and ocular pulse amplitude in glaucomatous and healthy eyes[J]. Eur J Ophthalmol, 2009, 19:580-587.
24. Yuksel N, Karabas VL, Demirci A, et al. Comparison of blood flow velocities of the extraocular vessels in patients with pseudoexfoliation or primary open-angle glaucoma[J]. Ophthalmologica, 2001, 215:424-429.
25. Galassi F, Giambene B, Menchini U. Ocular perfusion pressure and retrobulbar haemodynamics in pseudoexfoliative glaucoma[J]. Graefe's Arch Clin Exp Ophthalmol, 2008, 246:411-416.
26. Martinez A, Gonzalez F, Capeans C, et al. Dorzolamide effect on ocular blood flow[J]. Invest Ophthalmol Vis Sci, 1999, 40:1270-1275.
27. Hosking SL, Harris A, Chung HS, et al. Ocular haemodynamic responses to induced hypercapnia and hyperoxia in glaucoma[J]. Br J Ophthalmol, 2004, 88:406-411.
28. Liu X, Ge J, Zhou W, et al. Hemodynamics of ophthalmic artery and central retinal artery and correlation with other factors in patients with primary open angle glaucoma[J]. Yan Ke Xue Bao, 1998, 14:138-144.
29. Januleviciene I, Sliesoraityte I, Siesky B, et al. Diagnostic compatibility of structural and haemodynamic parameters in open-angle glaucoma patients[J]. Acta Ophthalmol, 2008, 86:552-557.
30. Akarsu C, Bilgili MY. Color Doppler imaging in ocular hypertension and open-angle glaucoma[J]. Graefe's Arch Clin Exp Ophthalmol, 2004, 242:125-129.
31. Zhong Y, Min Y, Jiang Y, et al. Color Doppler imaging and pattern visual evoked potential in normal tension glaucoma and hypertension glaucoma[J]. Doc Ophthalmol, 2009, 119:171-180.
32. Simsek T, Yanik B, Conkbayir I, et al. Comparative analysis of the effects of brimonidine and dorzolamide on ocular blood flow velocity in patients with newly diagnosed primary open-angle glaucoma[J]. J Ocul Pharmacol Ther, 2006, 22:79-85.
33. Adeyinka OO, Olugbenga A, Helen OO, et al. Ocular blood flow velocity in primary open angle glaucoma--a tropical African population study[J]. Middle East Afr J Ophthalmol, 2006, 20:174-178.
34. Hansen NB, Stonestreet BS, Rosenkrantz TS, et al. Validity of Doppler measurements of anterior cerebral artery blood flow velocity:correlation with brain blood flow in piglets[J]. Pediatrics, 1983, 72:526-531.
35. Taylor GA, Short BL, Walker LK, et al. Intracranial blood flow:quantification with duplex Doppler and color Doppler flow US[J]. Radiology, 1990, 176:231-236.
36. Brusini P, Zeppieri M, Tosoni C, et al. Stratus-OCT imaging in early glaucomatous and in ocular hypertensive patients with and without frequency-doubling technology abnormalities[J]. Eye (Lond), 2008, 22:406-413.
37. Baxter GM, Williamson TH, McKillop G, et al. Color Doppler ultrasound of orbital and optic nerve blood flow:effects of posture and timolol 0.5%[J]. Invest Ophthalmol Vis Sci, 1992, 33:604-610.
38. Steigerwalt RD Jr, Belcaro G, Cesarone MR, et al. Doppler ultrasonography of the central retinal artery in normals treated with topical timolol[J]. Eye (Lond), 1993, 7:403-406.

Chinese Journal of Ocular Fundus Diseases

Color Doppler imaging analysis of retrobulbar blood flow velocities in primary open-angle glaucomatous eyes: a meta-analysis

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