Decreased Ocular Pulse Amplitude Associated with Functional and Structural Damage in Open-Angle Glaucoma

Abstract

Purpose

To assess the relationship of ocular pulse amplitude (OPA), as measured by dynamic contour tonometry (DCT), with structural and functional damage in patients with open-angle glaucoma (OAG).

Methods

In this cross-sectional, observational study, 242 eyes of 139 patients with OAG underwent Goldmann applanation tonometry (GAT), DCT, central corneal thickness (CCT) measurement, visual fields examination (Octopus, Haag Streit), and complete ophthalmologic examination. Linear regression analysis was used to analyze the effect of OPA, DCT, GAT, and CCT to the mean defect (MD) of the visual fields and to the vertical cup to disc ratio (CDR).

Results

Ocular pulse amplitude was the only variable that showed a significant association with MD (slope=–1.1, p=0.012), in contrast to GAT (p=0.98), DCT (p=0.32), and CCT (p=0.42). Ocular pulse amplitude was also negatively associated with CDR (slope=–0.028, p=0.0001). Additional multiple regression analysis revealed that OPA (R2=0.12, r=–0.25, slope=–0.02, p=0.033), GAT (r=–0.27, slope=–0.01, p=0.027), and CCT (r=–0.18, slope=–0.001, p=0.012) were statistically significantly correlated to CDR, while DCT was not (r=–0.20, slope=0.003, p=0.46). Ocular pulse amplitude did not differ statistically significantly (p=0.93) between eyes with (2.79±1.42) and without (2.77±1.21) prior trabeculectomy. No statistically significant difference of OPA was observed between diagnosis groups (p=0.255).

Conclusions

Decreased OPA seems to be correlated with increased glaucomatous functional and structural damage in OAG. Assessment of OPA by DCT could therefore serve as an important additional parameter in the evaluation of glaucoma patients.