Новости глаукомы - News of Glaucoma. Глаукома и кровоток: постерный доклад профессора Курышевой Н.И. с соавт. на EGS2012.

Профессор Курышева Н.И., Москва, Россия.
EGS: Европейское глаукомное общество.
Europian Glaucoma Society: EGS2012.

EGS2012
Сorrelation between ERG Response and Blood Flow in Glaucoma Patients.
Kurysheva N.I., Kiseleva T.N*.,Khodak N.A., Irtegova E.Y.
Ophthalmological Center of the Federal Medical and Biological Agency (Moscow, Russia), The Helmholtz Moscow Research Institute of Eye Diseases*

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Electroretinography (ERG) is a promising and highly sensitive method for early detection of function loss of viable retinal ganglion cells [4,6]. Abnormal ocular blood flow and/or vascular dysregulation are considered to play an important role in chronic tissue stress in open angle glaucoma [8]. However, only a few studies demonstrate a correlation between ocular/cerebral blood flow and electrophysiological function of the retina and optic nerve in glaucoma [1,3].
Purpose. To study the correlation between retinal bioelectrical response and retinal blood flow in glaucoma patients.

Methods. Electrophysiological data (ERG and VEP, Tomey EP-1000) was recorded in 12 POAG patients (age 59±11.3 years, mean IOP 20.3 ± 1.3 mm Hg, average RNFL 98.19 ± 15.94 μm, MD -5.86 ± 1.65 dB, PSD 4.3 ± 0.98 dB) and 10 healthy control subjects (age of 57±5.7 years). The K-index (b/a-wave amplitude of max ERG) was calculated. Color Doppler imaging of the vessels was performed using VOLUSON 730 Pro Ultrasound System (“Kretz”) with a 10-16 MHz linear probe. Blood flow velocity was measured in the ophthalmic artery (OA), short posterior ciliary arteries (sPCA), central retinal arteries (CRA), central retinal vein (CRV) and vortex vein (VV). Correlation between electro- physiological parameters and blood flow velocity was calculated using the “SPSS 11.0 for Windows” software.

Results. Blood flow velocity reduction in all the vessels, including veins, and the VEP and ERG amplitude decrease were obtained in
glaucoma patients in comparison to the control group (Table 1-3). High correlation between ERG b-wave amplitude and arterial blood flow velocity was obtained (Table 4). We observed an increase of the K- index from 1.9 ± 0.3 in early glaucoma to 2.4 ± 0.5 in advanced stage in comparison to 2.0±0.6 in control subjects, p

Discussion. We observed significant decrease of ERG parameters and blood flow velocity (including venous). Moreover, ERG parameters and blood flow velocity in ocular vessels correlated with each other.
The ERG b/a wave ratio (K-index) is considered to be a good indicator of retinal ischemia especially in central retinal vein disorders [5,9]. We obtained a reduced K-index in early glaucoma and low blood flow ve- locity in CRV in glaucoma in comparison to the control group. (Fig.1). An increased K-index in advanced glaucoma might be explained as glial activation, as a response to ischemia which is critical for the initiation of cascade reactions that cause damage to retinal ganglion cells and optic nerve in glaucoma [7].

Conclusions
1. Not only arterial, but also venous blood flow is reduced in POAG.
2. High correlation between blood flow velocity in CRA and PCA and ERG parameters demonstrates a role of blood flow in retinal function in glaucoma.
3. The obtained results might be explained as activation of glial cells during glaucoma progression and suggest the importance of venous blood flow in glaucoma pathogenesis.


References

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2. Forte R., Bonavolonta P., AmbrosioG. //Doc Ophthalmol. -2010. –Vol. 120. – No 2. –P. 187–192
3. Harris A., Siesky B., et al. //J Glaucoma. – 2007. – Vol. 16. –No 1. – P.159–163.
4. North R.V., Jones A.L., et al. //Invest Ophthalmol Vis Sci.–2010.–Vol. 51.– No 2.– P. 1216
5. Matsui Y., Katsumi O., // Br.J.Ophthalmol. – 1994.– Vol.78.–No2.–P.191-198.
6. Panagakis E., Moschos M. //Ophthalmologica. – 1998. –Vol. 212. –No 2. P.112–114.
7. Tezel G. // Invest. Ophthalmol. Vis. Sci. – 2009. – Vol. 50. – No 3. – P. 1001– 1012.
8. Weinreb R., Harris A., eds. Ocular blood flow in glaucoma: the 6th consensus report of the world glaucoma association. Amsterdam, the Netherlands: Kugler Publica-
tions, 2009. – P.1 – 159.
9. Yasuda S., et.al. //Invest. Ophthalmol. Vis.Sci. – 2011. – Vol.52. – No 8. – P.5737 – –1222. 5742.

Материал для публикации на портале Орган зрения www.organum-visus.com любезно предоставила профессор Курышева Наталия Ивановна.

Сorrelation between ERG Response and Blood Flow in Glaucoma Patients. Kurysheva N.I. et al.
EGS2012. Курышева Н.И. с соавт., объяснения в тексте.
EGS2012. Курышева Н.И. с соавт., объяснения в тексте.
EGS2012. Курышева Н.И. с соавт., объяснения в тексте.
EGS2012. Курышева Н.И. с соавт., объяснения в тексте.
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