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First Author: J.Seo SOUTH KOREA
Co Author(s): T. Kim
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To investigate retinal nerve fiber layer (RNFL) thickness in eyes with primary open angle glaucoma (POAG) having asymmetric spontaneous retinal vein pulsations (SVPs).
Retrospective case control study, Seoul National University Bundang Hospital Glaucoma Clinic
One hundred fourteen eyes of 114 POAG patients showing SVPs were enrolled. All the participants underwent comprehensive ophthalmologic examinations including RNFL thickness measurement and SVPs movie recording using a confocal scanning laser ophthalmoloscope (Spectralis HRA + OCT, Heidelberg Engineering, Heidelberg, Germany). POAG patient were divided into three groups based on the locations and pattern of SVPs; superior asymmetric pulsation group (group A) showing only superior hemi-vein pulsation with the inferior hemi-vein with subtle movement or no movement, inferior asymmetric pulsation group (group B) showing only inferior hemi-vein pulsation with the superior hemi-vein with subtle movement or no movement, and symmetric SVP (group C) showing both of hemi-vein pulsations. The quadrant and sectoral RNFL thickness were compared among POAG patients with asymmetric SVPs (superior or inferior) and symmetric SVPs using one-way analysis of variance.
The RNFL thickness in group A was significantly thinner in the inferior quadrant (P = 0.04) and the temporal-inferior sector (P = 0.008), compared with those with group B and C. In addition, the RNFL thickness in group B was thinner in the superior quadrant (P < 0.001) and the temporal-superior sector (P < 0.001) and nasal-superior sector (P = 0.01) than those in group A and C.
The RNFL thickness in the hemifield of absence SHVPs was observed significantly thinner than hemifield of presence SHVPs in POAG patients with asymmetric SVPs. In addition, the RNFL thickness of POAG patients with asymmetric pulsation was thinner in the hemifield of absence SVPs, compared with symmetric pulsation. This finding suggests that glaucomatous damage may be related with the absence of SVPs in POAG patients with asymmetric SVPs.