Nocturnal ophthalmic arterial hemodynamics in primary open-angle glaucoma

Purpose: Recent studies suggest that progression of visual field loss in glaucoma may be associated with nocturnal hypotensive episodes. Accordingly, we investigated nocturnal variations in ophhtlamic arterial hemodyanmics in primary open angle glaucoma (POAG) patients as compared with healthy controls. Methods: Nine POAG patients and nine age-matched controls were examined at 9:00 p.m. and then at 12:00, 3:00, and 6:00 a.m. during sleep. Each examination included color Doppler imaging of the ophthalmic artery, and blood pressure and intraocular pressure (IOP) recordings. Results: Patients and controls both showed steady declines in ophthalmic arterial resistance (p < .05). When compared with each other patients and controls showed similar Doppler velocity characteristics (peak systolic and end diastolic velocities, and resistance index) and blood pressure throughout the night. IOP did not show consistent nocturnal changes in either group. Conclusions: Nocturnal reductions in ophthalmic arterial resistance index apparently represent a normal response still possessed by POAG patients. No evidence for episodes of either nocturnal hypotension or ocular vascular insufficiency was found in these POAG patients.