Role of Colour Doppler Imaging in Early Diagnosis and Prediction of Progression of Glaucoma

Authors: Amrutha Aravindakshan, Meenakshi Yadav Dhar, Bindu Malini Mudduveerappa

DOI: 10.18231/j.ijceo.9864.1761717346

Keywords: Ocular blood flow, visual field progression, Resistivity Index, colour Doppler imaging

Abstract: Introduction Glaucoma is the second leading cause of blindness worldwide and affects approximately 60 million people. Glaucoma-related blindness can be prevented in most of the cases by early detection and proper management. Various studies suggest that vascular factors play a critical role in the pathophysiology of glaucoma, as in low ocular blood flow may lead to ischemic retinal ganglion cell damage. In our study, we assessed whether reduced retinal blood flow in glaucoma, as measured by Colour Doppler Imaging of ocular blood flow, is associated with an independent vascular dysfunction that leads to visual field loss. Objectives: Primary- To study the correlation of Ocular blood flow and Visual field progression in glaucoma patients Secondary- To study the relationship between ocular blood flow and ocular perfusion pressure Methods: Ours is an observational cross-sectional study assessed between Sept 2017 to Aug 2019, which included patients who attended ophthalmology outpatient department and diagnosed with glaucoma after relevant ophthalmological investigations. They were divided into two groups – visual field progressors and non-progressors, and were referred to Dept. of Radiology for colour Doppler imaging of ocular blood flow. Results: We found that out of 106 eyes of 54 patients, 41 eyes (38.6%) were visual field progressors, and 65 eyes (61.3%) were non-progressors. Ocular blood flow parameters studied in ophthalmic artery, posterior ciliary arteries and central retinal artery, were end diastolic velocity (EDV), peak systolic velocity (PSV), and Resistivity index (RI). Of the visual field progressors, 87.8% had high RI and 12.2% had normal RI on ocular blood flow. There was a negative correlation between RI of ophthalmic artery and visual field progression Conclusion: High RI showed statistically significant correlation with visual field progression, considering all the four vessels studied. On analyzing individual vessels, there was significant correlation between RI and visual field progression in ophthalmic artery.