Blood flow studies and serological testing in the diagnostic evaluation of glaucoma: A pilot study

BACKGROUND AND OBJECTIVE: To evaluate the prevalence of hemodynamically significant carotid artery stenosis, peripapillary blood flow, and serologic abnormalities in a pilot study among patients with glaucoma. PATIENTS AND METHODS: All subjects underwent complete eye examination, standard automated perimetry, carotid Doppler ultrasonography, serum laboratory testing, and scanning laser Doppler flowmetry (SLDF). Subjects were subdivided into two groups based on glaucoma subtype (normal-tension vs primary open-angle glaucoma) and severity (mild vs moderate-advanced). RESULTS: Twenty eyes of 20 patients with associated glaucomatous visual field loss were enrolled. No significant differences in age, gender, intraocular pressure, systemic comorbidity, number of antiglaucoma medications, and prior filtration surgery were observed between the groups based on the type and severity of glaucoma. The prevalence of clinically significant (> 70%) carotid stenosis, mean peripapillary blood flow assessed by SLDF, mean erythrocyte sedimentation rate, mean hematocrit, mean hemoglobin, and positive FTA-ABS was similar in both groups. Severity of glaucomatous damage as determined by visual field mean defect did not correlate with the degree of carotid artery stenosis (R² < 0.0001, P = .99) or peripapillary blood flow derived from mean SLDF (R² = 0.0005, P =.92). CONCLUSION: Data from this pilot study demonstrate that the prevalence of hemodynamically significant carotid stenosis, peripapillary blood flow, and serologic abnormalities are similar in patients with normal-tension and primary open-angle glaucoma, and do not correlate with glaucoma severity.