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. 1997 Sep;81(9):735–742. doi: 10.1136/bjo.81.9.735

Choroidal haemodynamics in glaucoma

H Duijm 1, T J T P van den Berg 1, E Greve 1
PMCID: PMC1722313  PMID: 9422924

Abstract

AIM—Quantification of haemodynamics of the peripapillary choroid in and the assessment of possible differences between normal subjects (N), ocular hypertensive (OHT), primary open angle (POAG), and normal pressure glaucoma (NPG) patients.
METHODS—Video fluorescein angiograms (Rodenstock SLO 101) were made in 22 N subjects, 12 OHT, 48 POAG, and 46 NPG patients. The angiographically derived dye build up curves were described by means of an exponential model. One of the model parameters is the time constant τ theoretically reflecting local blood refreshment time; the blood refreshment time τ is the time needed to replace the blood volume in the choriocapillaris, inversely proportional to the local choroidal blood flow. Other variables are maximal fluorescence (Fdt) and time of first fluorescence (t0). Mean variable values were calculated for disc area and circular areas around the disc.
RESULTS—Fdt of the disc was significantly lower in the POAG and NPG patients. There was no statistical difference in t0 between the study groups. The choroidal blood refreshment time was significantly longer in NPG patients and to a lesser extent in the POAG patients compared with the normal controls. The slowest choroidal blood refreshment can be found in the NPG group. The median choroidal blood refreshment times (25th-75th percentile) in the controls, OHT, POAG, and NPG patients were 4.1 (3.7-4.5), 4.4 (3.7-6.4), 5.8 (4.3-6.8), and 7.1 (5.5-9.3) seconds respectively.
CONCLUSIONS—With the help of parametrisation of dye curves, using a one compartmental model, choroidal haemodynamics can be quantified. The blood refreshment time of the peripapillary choriocapillaris was found to be significantly prolonged especially in NPG patients; this may indicate slower choroidal haemodynamics in NPG patients.



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Figure 1  .

Figure 1  

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The graphical representation of the model curve used to analyse the individual dye build up curves. The time course is described by four variables—initial fluorescence (Fmin), maximum fluorescence (Fdt), the time of first dye appearance (t0), and tau (τ), the time constant of the model, representing the refreshment time

Figure 2  .

Figure 2  

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Schematic drawing of the circular areas centred around the disc, used to divide the posterior pole into areas defined as fractions of disc diameters.

Figure 3  .

Figure 3  

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Standardised median parameter values and 25th-75th percentile plotted as a function of eccentricity for the four study groups (OHT, ocular hypertension; POAG, primary open angle glaucoma; NPG, normal pressure glaucoma). Fdt = maximum fluorescence, t0 = first appearance of dye, τ = the time constant of the model. There exists a significant relation between parameter value and eccentricity in all cases.

Figure 4  .

Figure 4  

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Mean τ values (seconds) for a choroidal area (c2) plotted against corrected pattern standard deviation (CPSD) (dB), showing a weak correlation (Pearson's r = 0.27, p<0.01). Note that if the visual field data from the normals are omitted, the relation loses statistical significance.

Selected References

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