Coexistence of macro- and micro-vascular abnormalities in newly diagnosed normal tension glaucoma patients

Stephanie Mroczkowska, Anikó Ekárt, Velota Sung, Anil Negi, Lu Qin, Suni Patel, Sarita Jacob, Carole Atkins, Alexandra Benavente-Pérez, Doina Gherghel

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate the coexistence of ocular microvascular and systemic macrovascular abnormalities in early stage, newly diagnosed and previously untreated normal tension glaucoma patients (NTG).
Methods: Retinal vascular reactivity to flickering light was assessed in 19 NTG and 28 age-matched controls by means of dynamic retinal vessel analysis (IMEDOS GmbH, Jena, Germany). Using a newly developed computational model, the entire dynamic vascular response profile to flicker light was imaged and used for analysis. In addition, assessments of carotid intima-media thickness (IMT) and pulse wave analysis (PWA) were conducted on all participants, along with blood pressure (BP) measurements and blood analyses for lipid metabolism markers.
Results: Patients with NTG demonstrated an increased right and left carotid IMT (p = 0.015, p = 0.045) and an elevated PWA augmentation index (p = 0.017) in comparison with healthy controls, along with an enhanced retinal arterial constriction response (p = 0.028), a steeper retinal arterial constriction slope (p = 0.031) and a reduced retinal venous dilation response (p = 0.026) following flicker light stimulation.
Conclusions: Early stage, newly diagnosed, NTG patients showed signs of subclinical vascular abnormalities at both macro- and micro-vascular levels, highlighting the need to consider multi-level circulation-related pathologies in the development and progression of this type of glaucoma.
Original languageEnglish
Article numberActa-12-01-0065
Pages (from-to)e553-e559
Number of pages7
JournalActa Ophthalmologica Scandinavica
Volume90
Issue number7
Early online date23 Sep 2012
DOIs
Publication statusPublished - Nov 2012

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Low Tension Glaucoma
Blood Vessels
Retinal Vessels
Carotid Intima-Media Thickness
Pulse Wave Analysis
Light
Constriction
Lipid Metabolism
Glaucoma
Germany
Dilatation
Pathology
Blood Pressure

Keywords

  • glaucoma
  • vascular dysregulation
  • microvessels
  • open-angle
  • microvasculature
  • retina

Cite this

Mroczkowska, Stephanie ; Ekárt, Anikó ; Sung, Velota ; Negi, Anil ; Qin, Lu ; Patel, Suni ; Jacob, Sarita ; Atkins, Carole ; Benavente-Pérez, Alexandra ; Gherghel, Doina. / Coexistence of macro- and micro-vascular abnormalities in newly diagnosed normal tension glaucoma patients. In: Acta Ophthalmologica Scandinavica. 2012 ; Vol. 90, No. 7. pp. e553-e559.
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abstract = "Purpose: To investigate the coexistence of ocular microvascular and systemic macrovascular abnormalities in early stage, newly diagnosed and previously untreated normal tension glaucoma patients (NTG).Methods: Retinal vascular reactivity to flickering light was assessed in 19 NTG and 28 age-matched controls by means of dynamic retinal vessel analysis (IMEDOS GmbH, Jena, Germany). Using a newly developed computational model, the entire dynamic vascular response profile to flicker light was imaged and used for analysis. In addition, assessments of carotid intima-media thickness (IMT) and pulse wave analysis (PWA) were conducted on all participants, along with blood pressure (BP) measurements and blood analyses for lipid metabolism markers.Results: Patients with NTG demonstrated an increased right and left carotid IMT (p = 0.015, p = 0.045) and an elevated PWA augmentation index (p = 0.017) in comparison with healthy controls, along with an enhanced retinal arterial constriction response (p = 0.028), a steeper retinal arterial constriction slope (p = 0.031) and a reduced retinal venous dilation response (p = 0.026) following flicker light stimulation.Conclusions: Early stage, newly diagnosed, NTG patients showed signs of subclinical vascular abnormalities at both macro- and micro-vascular levels, highlighting the need to consider multi-level circulation-related pathologies in the development and progression of this type of glaucoma.",
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Mroczkowska, S, Ekárt, A, Sung, V, Negi, A, Qin, L, Patel, S, Jacob, S, Atkins, C, Benavente-Pérez, A & Gherghel, D 2012, 'Coexistence of macro- and micro-vascular abnormalities in newly diagnosed normal tension glaucoma patients', Acta Ophthalmologica Scandinavica, vol. 90, no. 7, Acta-12-01-0065, pp. e553-e559. https://doi.org/10.1111/j.1755-3768.2012.02494.x

Coexistence of macro- and micro-vascular abnormalities in newly diagnosed normal tension glaucoma patients. / Mroczkowska, Stephanie; Ekárt, Anikó; Sung, Velota; Negi, Anil; Qin, Lu; Patel, Suni; Jacob, Sarita; Atkins, Carole; Benavente-Pérez, Alexandra; Gherghel, Doina.

In: Acta Ophthalmologica Scandinavica, Vol. 90, No. 7, Acta-12-01-0065, 11.2012, p. e553-e559.

Research output: Contribution to journalArticle

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T1 - Coexistence of macro- and micro-vascular abnormalities in newly diagnosed normal tension glaucoma patients

AU - Mroczkowska, Stephanie

AU - Ekárt, Anikó

AU - Sung, Velota

AU - Negi, Anil

AU - Qin, Lu

AU - Patel, Suni

AU - Jacob, Sarita

AU - Atkins, Carole

AU - Benavente-Pérez, Alexandra

AU - Gherghel, Doina

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Y1 - 2012/11

N2 - Purpose: To investigate the coexistence of ocular microvascular and systemic macrovascular abnormalities in early stage, newly diagnosed and previously untreated normal tension glaucoma patients (NTG).Methods: Retinal vascular reactivity to flickering light was assessed in 19 NTG and 28 age-matched controls by means of dynamic retinal vessel analysis (IMEDOS GmbH, Jena, Germany). Using a newly developed computational model, the entire dynamic vascular response profile to flicker light was imaged and used for analysis. In addition, assessments of carotid intima-media thickness (IMT) and pulse wave analysis (PWA) were conducted on all participants, along with blood pressure (BP) measurements and blood analyses for lipid metabolism markers.Results: Patients with NTG demonstrated an increased right and left carotid IMT (p = 0.015, p = 0.045) and an elevated PWA augmentation index (p = 0.017) in comparison with healthy controls, along with an enhanced retinal arterial constriction response (p = 0.028), a steeper retinal arterial constriction slope (p = 0.031) and a reduced retinal venous dilation response (p = 0.026) following flicker light stimulation.Conclusions: Early stage, newly diagnosed, NTG patients showed signs of subclinical vascular abnormalities at both macro- and micro-vascular levels, highlighting the need to consider multi-level circulation-related pathologies in the development and progression of this type of glaucoma.

AB - Purpose: To investigate the coexistence of ocular microvascular and systemic macrovascular abnormalities in early stage, newly diagnosed and previously untreated normal tension glaucoma patients (NTG).Methods: Retinal vascular reactivity to flickering light was assessed in 19 NTG and 28 age-matched controls by means of dynamic retinal vessel analysis (IMEDOS GmbH, Jena, Germany). Using a newly developed computational model, the entire dynamic vascular response profile to flicker light was imaged and used for analysis. In addition, assessments of carotid intima-media thickness (IMT) and pulse wave analysis (PWA) were conducted on all participants, along with blood pressure (BP) measurements and blood analyses for lipid metabolism markers.Results: Patients with NTG demonstrated an increased right and left carotid IMT (p = 0.015, p = 0.045) and an elevated PWA augmentation index (p = 0.017) in comparison with healthy controls, along with an enhanced retinal arterial constriction response (p = 0.028), a steeper retinal arterial constriction slope (p = 0.031) and a reduced retinal venous dilation response (p = 0.026) following flicker light stimulation.Conclusions: Early stage, newly diagnosed, NTG patients showed signs of subclinical vascular abnormalities at both macro- and micro-vascular levels, highlighting the need to consider multi-level circulation-related pathologies in the development and progression of this type of glaucoma.

KW - glaucoma

KW - vascular dysregulation

KW - microvessels

KW - open-angle

KW - microvasculature

KW - retina

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