Pulse Waveform Analysis of the Ocular Blood Flow Using Laser Speckle Flowgraphy before and after Glaucoma Treatment

摘要： Although reduction in intraocular pressure (IOP) is the principle of glaucoma treatment, impaired ocular blood ?ow is believed to play a role in the progression of glaucoma. This study evaluated the e?ect of glaucoma treatment on pulse waveforms for optic nerve head (ONH) microcirculation in patients with glaucoma. Fifty-one subjects were included on the basis of the glaucoma treatment administered, which involved instillation of prostaglandin (PG) analogs (PG group; n ? 28) or trabeculectomy (trabeculectomy group; n ? 23). ONH blood ?ow, represented by the mean blur rate (MBRT) and pulse waveforms, was measured using laser speckle ?owgraphy before and 1 and 3 months after treatment. Three months after treatment, IOP exhibited a signi?cant decrease (p < 0.05). Although there was no signi?cant change in MBRT after treatment, the acceleration time index (ATI) signi?cantly decreased (p ? 0.034) in the PG group. In the trabeculectomy group, there was no signi?cant change in the MBRT after treatment, while ?uctuation (p ? 0.019) and blowout score (BOS) (p ? 0.036) exhibited signi?cant decrease and increase, respectively. Multiple regression analysis showed that mean deviation was signi?cantly associated with the rate of change in the BOS (p ? 0.013), age was a signi?cant contributing factor for the rate of change in ?uctuation in the trabeculectomy group, re?ection was signi?cantly associated with the ATI (p ? 0.037) in the in the PG group. Both glaucoma treatments can change the pulse waveforms, with MBRT remaining unchanged, and IOP reduction owing to the treatment may contribute to stable blood ?ow in the tissue area of the ONH. As impaired ocular blood ?ow plays a role in the progression of glaucomatous damage, it would be bene?cial if glaucoma treatment could improve the stability of ONH microcirculation.