A cohort study of duplex Doppler examinations of the carotid artery in primary open angle glaucoma

Vincent J Marmion, Munther I Aldoori, John P Woodcock, John Stephenson

Research output: Contribution to journalArticle

Abstract

Objectives:
To explore the possibility of pathological change in the common carotid artery at the bifurcation and in the internal carotid artery beyond the bifurcation which could contribute to a reduced diastolic pressure as observed in primary open angle glaucoma.

Design:
Duplex ultrasonic examinations of carotid bifurcations were conducted on 80 patients. Carotid artery defects were allocated into three types: no demonstrable flow defects, internal carotid artery abnormalities and disease in the carotid bulb.

Setting:
Bristol Royal Infirmary Vascular Laboratory.

Participants:
Eighty patients (mean age 69.6 years) providing a total of 160 sides to the analysis.

Main outcome measures:
An estimated central retinal artery pressure, intraocular pressure and field loss were recorded for each side measured.

Results:
Doppler investigations revealed significant levels of pathological change in the internal carotid distinct from changes at the carotid bulb. The disease revealed in the internal carotid artery was significantly associated with intraocular pressure (p = 0.032), with an effect small to medium in magnitude. The Q2 measure, derived from mean arterial pressure and intraocular pressure, was also substantively associated with disease in the internal carotid artery. Both intraocular pressure and the Q2 measure effectively discriminated between groups, with field loss providing rather less discriminating capability. There was a strong trend towards a higher intraocular pressures and a greater visual field loss with internal carotid artery disease.

Conclusions:
Pathological changes in the extra cranial carotid artery in primary open angle glaucoma exceed those in the arteries classified as normal. The presence of disease specifically in the internal carotid artery emphasised the need for a mechanism for the evaluation of the internal carotid apart from the carotid bulb. A basis for clarifying the presence of an ischaemic zone is proposed.
Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalJRSM Open
Volume5
Issue number8
DOIs
Publication statusPublished - 8 Jul 2014

Fingerprint

Intraocular Pressure
Carotid Arteries
Cohort Studies
Carotid Artery Diseases
Internal Carotid Artery
Retinal Artery
Common Carotid Artery
Visual Fields
Ultrasonics
Blood Vessels
Arterial Pressure
Arteries
Outcome Assessment (Health Care)
Primary Open Angle Glaucoma
Blood Pressure
Pressure

Cite this

Marmion, Vincent J ; Aldoori, Munther I ; Woodcock, John P ; Stephenson, John. / A cohort study of duplex Doppler examinations of the carotid artery in primary open angle glaucoma. In: JRSM Open. 2014 ; Vol. 5, No. 8. pp. 1-6.
@article{2bd79712f7c94914913c31f928d6697f,
title = "A cohort study of duplex Doppler examinations of the carotid artery in primary open angle glaucoma",
abstract = "Objectives:To explore the possibility of pathological change in the common carotid artery at the bifurcation and in the internal carotid artery beyond the bifurcation which could contribute to a reduced diastolic pressure as observed in primary open angle glaucoma.Design:Duplex ultrasonic examinations of carotid bifurcations were conducted on 80 patients. Carotid artery defects were allocated into three types: no demonstrable flow defects, internal carotid artery abnormalities and disease in the carotid bulb.Setting:Bristol Royal Infirmary Vascular Laboratory.Participants:Eighty patients (mean age 69.6 years) providing a total of 160 sides to the analysis.Main outcome measures:An estimated central retinal artery pressure, intraocular pressure and field loss were recorded for each side measured.Results:Doppler investigations revealed significant levels of pathological change in the internal carotid distinct from changes at the carotid bulb. The disease revealed in the internal carotid artery was significantly associated with intraocular pressure (p = 0.032), with an effect small to medium in magnitude. The Q2 measure, derived from mean arterial pressure and intraocular pressure, was also substantively associated with disease in the internal carotid artery. Both intraocular pressure and the Q2 measure effectively discriminated between groups, with field loss providing rather less discriminating capability. There was a strong trend towards a higher intraocular pressures and a greater visual field loss with internal carotid artery disease.Conclusions:Pathological changes in the extra cranial carotid artery in primary open angle glaucoma exceed those in the arteries classified as normal. The presence of disease specifically in the internal carotid artery emphasised the need for a mechanism for the evaluation of the internal carotid apart from the carotid bulb. A basis for clarifying the presence of an ischaemic zone is proposed.",
keywords = "primary open angle glaucoma, vascular resistance, internal carotid artery, ischaemic index",
author = "Marmion, {Vincent J} and Aldoori, {Munther I} and Woodcock, {John P} and John Stephenson",
year = "2014",
month = "7",
day = "8",
doi = "10.1177/2054270414527933",
language = "English",
volume = "5",
pages = "1--6",
journal = "JRSM Open",
issn = "2054-2704",
publisher = "SAGE Publications",
number = "8",

}

A cohort study of duplex Doppler examinations of the carotid artery in primary open angle glaucoma. / Marmion, Vincent J; Aldoori, Munther I; Woodcock, John P; Stephenson, John.

In: JRSM Open, Vol. 5, No. 8, 08.07.2014, p. 1-6.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A cohort study of duplex Doppler examinations of the carotid artery in primary open angle glaucoma

AU - Marmion, Vincent J

AU - Aldoori, Munther I

AU - Woodcock, John P

AU - Stephenson, John

PY - 2014/7/8

Y1 - 2014/7/8

N2 - Objectives:To explore the possibility of pathological change in the common carotid artery at the bifurcation and in the internal carotid artery beyond the bifurcation which could contribute to a reduced diastolic pressure as observed in primary open angle glaucoma.Design:Duplex ultrasonic examinations of carotid bifurcations were conducted on 80 patients. Carotid artery defects were allocated into three types: no demonstrable flow defects, internal carotid artery abnormalities and disease in the carotid bulb.Setting:Bristol Royal Infirmary Vascular Laboratory.Participants:Eighty patients (mean age 69.6 years) providing a total of 160 sides to the analysis.Main outcome measures:An estimated central retinal artery pressure, intraocular pressure and field loss were recorded for each side measured.Results:Doppler investigations revealed significant levels of pathological change in the internal carotid distinct from changes at the carotid bulb. The disease revealed in the internal carotid artery was significantly associated with intraocular pressure (p = 0.032), with an effect small to medium in magnitude. The Q2 measure, derived from mean arterial pressure and intraocular pressure, was also substantively associated with disease in the internal carotid artery. Both intraocular pressure and the Q2 measure effectively discriminated between groups, with field loss providing rather less discriminating capability. There was a strong trend towards a higher intraocular pressures and a greater visual field loss with internal carotid artery disease.Conclusions:Pathological changes in the extra cranial carotid artery in primary open angle glaucoma exceed those in the arteries classified as normal. The presence of disease specifically in the internal carotid artery emphasised the need for a mechanism for the evaluation of the internal carotid apart from the carotid bulb. A basis for clarifying the presence of an ischaemic zone is proposed.

AB - Objectives:To explore the possibility of pathological change in the common carotid artery at the bifurcation and in the internal carotid artery beyond the bifurcation which could contribute to a reduced diastolic pressure as observed in primary open angle glaucoma.Design:Duplex ultrasonic examinations of carotid bifurcations were conducted on 80 patients. Carotid artery defects were allocated into three types: no demonstrable flow defects, internal carotid artery abnormalities and disease in the carotid bulb.Setting:Bristol Royal Infirmary Vascular Laboratory.Participants:Eighty patients (mean age 69.6 years) providing a total of 160 sides to the analysis.Main outcome measures:An estimated central retinal artery pressure, intraocular pressure and field loss were recorded for each side measured.Results:Doppler investigations revealed significant levels of pathological change in the internal carotid distinct from changes at the carotid bulb. The disease revealed in the internal carotid artery was significantly associated with intraocular pressure (p = 0.032), with an effect small to medium in magnitude. The Q2 measure, derived from mean arterial pressure and intraocular pressure, was also substantively associated with disease in the internal carotid artery. Both intraocular pressure and the Q2 measure effectively discriminated between groups, with field loss providing rather less discriminating capability. There was a strong trend towards a higher intraocular pressures and a greater visual field loss with internal carotid artery disease.Conclusions:Pathological changes in the extra cranial carotid artery in primary open angle glaucoma exceed those in the arteries classified as normal. The presence of disease specifically in the internal carotid artery emphasised the need for a mechanism for the evaluation of the internal carotid apart from the carotid bulb. A basis for clarifying the presence of an ischaemic zone is proposed.

KW - primary open angle glaucoma

KW - vascular resistance

KW - internal carotid artery

KW - ischaemic index

U2 - 10.1177/2054270414527933

DO - 10.1177/2054270414527933

M3 - Article

VL - 5

SP - 1

EP - 6

JO - JRSM Open

JF - JRSM Open

SN - 2054-2704

IS - 8

ER -