Ocular blood flow biomarkers may predict long-term glaucoma progression

Background/aim To examine the relationship between baseline blood flow biomarkers and long-term open-angle glaucoma (OAG) progression. Methods 112 patients with early to moderate OAG (mean age 64.9±11.0 years; 68 female) were evaluated at baseline and every 6 months from 2008 to 2013. Biomarkers of retinal capillary blood flow were assessed by Heidelberg retinal flowmetry. Functional disease progression was monitored via Humphrey visual field examinations, defined as two consecutive visits with a mean deviation decrease ≥2 decibels and/or Advanced Glaucoma Intervention Study score increase ≥2 compared with baseline. Structural progression was monitored with optical coherence tomography and Heidelberg retinal tomograph, defined as two consecutive visits with retinal nerve fibre layer thickness decrease ≥8% and/or horizontal or vertical cup/disk ratio increase ≥0.2 compared with baseline. Mixed-model analysis of covariance was used to test for significant change from baseline to 5-year follow-up. Times to functional and structural progression were analysed using Cox proportional hazards models. Results Lower HRF retinal capillary blood flow in the superior retina was significantly associated with structural progression (p=0.0009). Conclusion In our OAG sample, baseline lower retinal capillary perfusion in the superior retina was predictive of structural progression after 5 years. Trial registration number NCT01145911 .