Laser Cyclophotocoagulation Enhances the Regulative Capacity of Retinal Vessels in Glaucoma



Stephan Kremmer*, 1, 2, Gerasimos Anastassiou 1, 2, Maurice Schallenberg 2, Klaus-Peter Steuhl 2, Vilser W3, 4, Michael Selbach J1, 2
1 Department of Ophthalmology, Evangelische Kliniken Gelsenkirchen, Munckelstr. 27, 45879 Gelsenkirchen, Germany
2 Department of Ophthalmology, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany
3 Institut of Biomedical Engineering and Informatics, Ilmenau University of Technology, Ilmenau, Gustav-Kirchhoff-Str.2, Germany
4 Imedos Systems UG, Jena, Am Naßtal 4, Germany


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© Kremmer et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Ophthalmology, Evangelische Kliniken Gelsenkirchen, Munckelstr. 27, 45879 Gelsen-kirchen, Germany; Tel: 0049 – 209 – 37261; Fax: 0049 – 209 – 378555; E-mail: stephan.kremmer@arcor.de


Abstract

Purpose:

To determine the effects of laser surgical IOP reduction by means of transscleral cyclophotocoagulation (CPC) on retinal blood flow parameters in glaucoma patients using Dynamic Vessel Analysis (DVA).

Materials and Methodology:

26 patients (average age: 70 years) with a long history of primary open angle glaucoma underwent CPC. The effect on the reactive capacity of retinal vessels was assessed before and 6-8 weeks after CPC by means of the Dynamic Vessel Analyzer (DVA) using flicker light provocation.

Results:

In our group of POAG patients, IOP was significantly reduced about approximately 20% by CPC while systemic blood pressure and heart rate were not changed.

The most obvious differences between the pre- and postoperative DVA measurements could be observed in the maximal dilation of the retinal arteries which increased from 0.75 % (+/- 0.6) to 3.17 % (+/- 0.5) with an average increase of 2.4 % (p<0.01). In addition, the ability of the arteries for constriction improved significantly (p<0.05) while the dynamic responses of the veins and the initial baseline values (MU) of the vessel diameters did not change.

Conclusions:

Our results of DVA measurements after an IOP-lowering laser surgical intervention (CPC) reveal a significant recovery of the regulative capacity of retinal arteries in glaucoma patients that has up to now neither been properly documented nor appreciated. Future studies with long-term follow-up must determine the clinical importance of these findings for the treatment of glaucoma patients.

Keywords: Cyclophotocoagulation (CPC), glaucoma, IOP, retinal vessel autoregulation, dynamic vessel analyzer (DVA), vascular dysregulation.