Search tips
Search criteria 


Logo of brjopthalBritish Journal of OphthalmologyVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Br J Ophthalmol. 1999 April; 83(4): 466–469.
PMCID: PMC1722989

Peripapillary retinal blood flow in normal tension glaucoma


AIMS—To determine if normal tension glaucoma (NTG) patients differ from age matched controls in blood flow to the peripapillary retina, as measured with confocal scanning laser Doppler flowmetry (cSLDF; "Heidelberg retinal flowmetry").
METHODS—12 NTG patients and 12 age matched controls were compared using (a) 10 × 10 pixel boxes (the instrument default sample size), taken from the nasal and temporal peripapillary retina, (b) the average from two of these boxes, and (c) every qualifying pixel within the peripapillary retina.
RESULTS—Patients and controls did not differ in blood flow measured using the default sample from a single 10 × 10 pixel box, placed in either the temporal or nasal peripapillary retina, or expressed as the average from these two boxes. However, in histograms using every pixel from the peripapillary retina, NTG patients displayed significantly higher percentages of minimal flow pixels (defined as less than one arbitrary unit of flow: 30% v 19%, p <0.01), and significantly lower flow in the 25th, 50th, and 75th percentile flow pixel (each p <0.05) than did age matched controls.
CONCLUSION—NTG is characterised by reduced blood flow in the peripapillary retina, a result suggesting that blood flow deficits accompany, and perhaps may contribute to, disease development in these patients.

Keywords: glaucoma; retina; blood flow; laser Doppler flowmeter

Full Text

The Full Text of this article is available as a PDF (103K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Quigley HA, Nickells RW, Kerrigan LA, Pease ME, Thibault DJ, Zack DJ. Retinal ganglion cell death in experimental glaucoma and after axotomy occurs by apoptosis. Invest Ophthalmol Vis Sci. 1995 Apr;36(5):774–786. [PubMed]
  • Nickells RW. Retinal ganglion cell death in glaucoma: the how, the why, and the maybe. J Glaucoma. 1996 Oct;5(5):345–356. [PubMed]
  • Hernandez MR, Pena JD. The optic nerve head in glaucomatous optic neuropathy. Arch Ophthalmol. 1997 Mar;115(3):389–395. [PubMed]
  • Butt Z, O'Brien C, McKillop G, Aspinall P, Allan P. Color Doppler imaging in untreated high- and normal-pressure open-angle glaucoma. Invest Ophthalmol Vis Sci. 1997 Mar;38(3):690–696. [PubMed]
  • Kaiser HJ, Schoetzau A, Stümpfig D, Flammer J. Blood-flow velocities of the extraocular vessels in patients with high-tension and normal-tension primary open-angle glaucoma. Am J Ophthalmol. 1997 Mar;123(3):320–327. [PubMed]
  • Duijm HF, van den Berg TJ, Greve EL. A comparison of retinal and choroidal hemodynamics in patients with primary open-angle glaucoma and normal-pressure glaucoma. Am J Ophthalmol. 1997 May;123(5):644–656. [PubMed]
  • O'Brart DP, de Souza Lima M, Bartsch DU, Freeman W, Weinreb RN. Indocyanine green angiography of the peripapillary region in glaucomatous eyes by confocal scanning laser ophthalmoscopy. Am J Ophthalmol. 1997 May;123(5):657–666. [PubMed]
  • Stroman GA, Stewart WC, Golnik KC, Curé JK, Olinger RE. Magnetic resonance imaging in patients with low-tension glaucoma. Arch Ophthalmol. 1995 Feb;113(2):168–172. [PubMed]
  • Michelson G, Langhans MJ, Groh MJ. Clinical investigation of the combination of a scanning laser ophthalmoscope and laser Doppler flowmeter. Ger J Ophthalmol. 1995 Nov;4(6):342–349. [PubMed]
  • Holló G, van den Berg TJ, Greve EL. Scanning laser Doppler flowmetry in glaucoma. Int Ophthalmol. 1996;20(1-3):63–70. [PubMed]
  • Kagemann L, Harris A, Chung HS, Evans D, Buck S, Martin B. Heidelberg retinal flowmetry: factors affecting blood flow measurement. Br J Ophthalmol. 1998 Feb;82(2):131–136. [PMC free article] [PubMed]
  • Strenn K, Menapace R, Rainer G, Findl O, Wolzt M, Schmetterer L. Reproducibility and sensitivity of scanning laser Doppler flowmetry during graded changes in PO2. Br J Ophthalmol. 1997 May;81(5):360–364. [PMC free article] [PubMed]
  • Langhans M, Michelson G, Groh MJ. Effect of breathing 100% oxygen on retinal and optic nerve head capillary blood flow in smokers and non-smokers. Br J Ophthalmol. 1997 May;81(5):365–369. [PMC free article] [PubMed]
  • Michelson G, Langhans MJ, Groh MJ. Perfusion of the juxtapapillary retina and the neuroretinal rim area in primary open angle glaucoma. J Glaucoma. 1996 Apr;5(2):91–98. [PubMed]
  • Nicolela MT, Hnik P, Drance SM. Scanning laser Doppler flowmeter study of retinal and optic disk blood flow in glaucomatous patients. Am J Ophthalmol. 1996 Dec;122(6):775–783. [PubMed]
  • Michelson G, Schmauss B. Two dimensional mapping of the perfusion of the retina and optic nerve head. Br J Ophthalmol. 1995 Dec;79(12):1126–1132. [PMC free article] [PubMed]
  • Nicolela MT, Hnik P, Schulzer M, Drance SM. Reproducibility of retinal and optic nerve head blood flow measurements with scanning laser Doppler flowmetry. J Glaucoma. 1997 Jun;6(3):157–164. [PubMed]
  • Minckler DS, Bunt AH, Johanson GW. Orthograde and retrograde axoplasmic transport during acute ocular hypertension in the monkey. Invest Ophthalmol Vis Sci. 1977 May;16(5):426–441. [PubMed]
  • Orgül S, Cioffi GA, Wilson DJ, Bacon DR, Van Buskirk EM. An endothelin-1 induced model of optic nerve ischemia in the rabbit. Invest Ophthalmol Vis Sci. 1996 Aug;37(9):1860–1869. [PubMed]

Figures and Tables

Figure 1
Confocal scanning laser Doppler flowmetry (cSLDF) of peripapillary retina. Left: arrow indicates 1 × 1 pixel (10 × 10 µm) measurement window, which, for pixel by pixel analysis, ...

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group