Scanning laser Doppler flowmetry of nonperfused regions of the optic nerve head in patients with glaucoma.

BACKGROUND AND

OBJECTIVE

To examine the reliability of scanning laser Doppler flowmetry in measuring capillary flow in regions of the optic nerve head, which are manifested differently by confocal tomographic angiography.

PATIENTS AND

METHODS

Capillary blood flow of the optic nerve head was measured in 16 eyes of 13 patients who had glaucoma with moderate to severe visual field defects. Blood flow measurements were taken by the scanning laser Doppler flowmeter and analyzed using the automatic full-field perfusion image analyzer (AFFPIA). Flow values were compared between perfused and nonperfused halves of the optic nerve head. Vascular anatomy of the optic nerve head was evaluated by confocal laser tomography with indocyanine green injection, and visual field tests by a standard visual field analyzer.

RESULTS

Analysis of laser capillary flow parameters by the AFFPIA disclosed a mean lower flow value in nonperfused compared with perfused discs (426 +/- 310 vs 547 +/- 306; P = .006). There was also a positive correlation between visual field defect and capillary angiography of the optic nerve head.

CONCLUSIONS

Flow measurements of the optic nerve head by scanning laser Doppler flowmetry using the AFFPIA revealed a mean lower flow value in nonperfused discs of patients who had glaucoma with severe visual field defect. Capillary angiography demonstrated by Heidelberg retina angiography has a good correlation with the pattern of visual field defect.