NR 3-4/2002

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Ocena grubości warstwy włókien nerwowych siatkówki i przepływu krwi w naczyniach krwionośnych oka u chorych z jaskrą

Retinal nerve fiber layer analysis and evaluation of eye blood flow in patients with glaucoma

Danuta Karczewicz, Monika Modrzejewska, Leszek Kuprjanowicz

Z Katedry Okulistyki z Kliniką i Zakładem Patofizjologii Narządu Wzroku Pomorskiej Akademii Medycznej w Szczecinie
Kierownik: prof. dr hab. n. med. Danuta Karczewicz

Summary: Purpose: The aim of this research was to evaluate the changes of blood flow velocity in ocular arteries (ophtalmic artery, central retinal artery and short posterior ciliary arteries) and the amount of ocular nerve fibers in patients with primary open angle glaucoma (POAG) and normal tension glaucoma (NTG).
Material and method: The research was done on 17 patients with diagnosed POAG and 13 patients with NTG. No ocular surgery was performed on any of these patients prior to our examinations. The blood flow measurements were made with ACUSON Color Doppler USG 128*P10 type with 7,5 MHz sector phased probe. Parameters of diastolic velocity (Vr), systolic flow velocity (Vs), Golsing pulsation index (PI) and pourcelate resistivity index (RI) were registered, together with the instant spectrography of examined artery. Quantitative retinal nerve fiber layer (RNFL) measurements were obtained by scanning laser polarimetry GDx (software version 1.0.14). RNFL was measured automatically in each of 256x 256 pixels and results were compared to the age-, sex- and race- norms. Approximately 15O wide field of view was used. Average thickness, Superior Maximum, Inferior Maximum, maximum modulation and GDx Number were analysed. All results were compared to age norms. Student`s t test was used for statistical analysis.
Results: In patients with POAG a statistically significant decrease of Vs in ophtalmic artery was detected in 27% of eyes, in central retinal artery in 51% of eyes and in short posterior ciliary arteries in 45% of eyes. In patients with NTG a statistically significant decrease of Vs was detected in ophtalmic artery in 27% of eyes, in central retinal artery in 65% of eyes and in short posterior cilliary arteries in 53% of eyes.
RNFL analysis in eyes with POAG showed a decrease in avg. thickness in 80% of analysed eyes, decrease of Superior Maximum in 84% of analysed eyes, decrease of Inferior Maximum in 77,4% of analysed eyes, decrease in maximal modulation in 87% of analysed eyes and increase of GDx Number in 77% of analysed eyes. RNFL analysis in patients with NTG showed a decrease in av. thickness in 73% of analysed eyes, decrease of Superior Maximum in 80,7% of analysed eyes, decrease of Inferior Maximum in 65,7% of analysed eyes, decrease in maximal modulation in 61,5% of analysed eyes and increase of GDx Number in 57,6% of analysed eyes.
Słowa kluczowe: ultrasonografia dopplerowska, skaningowa laserowa polarymetria, jaskra normalnego ciśnienia, jaskra pierwotna otwartego kąta.
Key words: Doppler Ultrasonography, Scanning Laser Polarimetry, Normal Pressure Glaucoma, Primary Open Angle Glaucoma.



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