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Current Concepts on Ocular Bloodflow in Glaucoma

edited by: L.E. Pillunat & A. Harris & D.R. Anderson & E.L. Greve

Price: € 68.00 / US $ 85.00

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Publication details: Book. 1999. ix and 275 pages. Publication date: 1999-10-19. 95 figures of which 10 in full color, and 34 tables. Hardbound.

ISBN: 978-90-6299-173-0 (ISBN 10: 90-6299-173-4; Kugler Publications)



Nowadays, glaucoma has to be regarded as a multifactorial disease. For many years, however, research was mainly focused on intraocular pressure as being the only pathogenic factor. In the last two decades, it has become more and more obvious that variables other than intraocular pressure are important in the development of glaucomatous optic nerve damage. In particular, the role of a disturbed blood supply to the eye has been controversially discussed. Therefore, in 1988, the first international workshop on the subject of ocular blood flow measurements in glaucoma, initiated by Erik L. Greve, was held under the auspices of the European Glaucoma Society and generously sponsored by Chibret International. The complete proceedings of the meeting were published in the book ‘Ocular Blood Flow in Glaucoma’, which is still the key reference in this field. Between 1988 and 1998, the subject of ocular blood flow in glaucoma gained more and more importance, and many new measurement technologies were developed. New methodologies that seem to be promising, but were not available at the time of the first workshop, are color Doppler imaging, laser Doppler flowmetry, scanning laser Doppler flowmetry, and others. In order to take all these new technologies and ideas into account, the idea of organizing a second workshop on ocular blood flow in glaucoma was suggested. This proposal was very well accepted by Professor Erik Greve, President of the European Glaucoma Society, and was generously supported by MSD, who had already sponsored the first meeting. And therefore, the workshop ‘Update on Ocular Blood Flow in Glaucoma’ took place in Southern France in 1998 under the auspices of the European Glaucoma Society. Many experts active in basic and clinical research on optic nerve head blood flow gathered for the presentation of new findings and concepts. As it was the case at the first meeting, the desirability of discussions was stressed. This book contains the contributions and edited discussions presented at the ‘Update on Ocular Blood Flow in Glaucoma’ meeting. These complete proceedings present the reader with up-to-date knowledge on the subject, including the uncertainties, controversies, and clinical applications.

Lutz E. Pillunat
Alon Harris
Douglas R. Anderson
Erik L. Greve

Table of Contents

Table of Contents


Basic Aspects of Ocular Blood Flow in Glaucoma:

Blood Supply of the Optic Nerve Head. A ‘reality check’
S.S. Hayreh

Update on Nitric Oxide and Endothelin Glaucoma
I.O. Haefliger, E.S. Dettmann and J. Flammer

Vascular Anatomy of the Anterior Optic Nerve
G.A. Cioffi

General and Clinical Aspects of Ocular Blood Flow in Glaucoma:

Blood Pressure Monitoring in Glaucoma and Normal Pressure Glaucoma
A. Béchetoille and H. Bresson-Dumont

Vascular Risk Factors in Glaucoma
H.C. Geijssen and E.L. Greve

Epidemiology of Normal Tension Glaucoma and the Incidence of Optic Disc Hemorrhage
Y. Kitazawa, T. Hayakawa, K. Sugiyama and G. Tomita


Methods to Measure Ocular Blood Flow – CDI/OBF:

Basic Principles of the OBF System
K.-G. Schmidt

Pulsatile Ocular Blood Flow Investigation in Asymmetric Normal Tension Glaucoma and Normal Subjects
R.A. Hitchings, L. Fontana, D. Poinoosawmy, C.V. Bunce and C. O’Brien

Comparison of Pulsatile Ocular Blood Flow and Color Doppler Imaging
B. Migdal

Basics and Limitations of Color Doppler Imaging
L. Kagemann, A. Harris, H. Sung Chung V.P. Costa and H.J. Garzozi

Pulsatile Ocular Blood Flow and Vascular Endothelial Dilator Dysfunction in Normal Pressure Glaucoma
C. O’Brien, Z. Butt, B. Williams and P. Hadoke

Results of Color Doppler Imaging in Various Types of Glaucoma
F. Galassi, A. Sodi, M.G. Rossi and F. Ucci

Observations on So-Called Normal Controls for Color Doppler Imaging Measurements
H.F.A. Duijm, M. Soudijn, F.-J. Hulsmans and E.L. Greve


Methods to Measure Ocular Blood Flow – Angiography:

Differences in Association between Increased Fluorescein Filling Defect Areas and Decreased Retinal Nerve Fiber Layer Thickness by Stage of Ocular Hypertension and Open-Angle Glaucoma
A. Schwartz, T. Takamoto and G. Tomita

Assessment of Choroidal Blood Flow by Image Processing of Fluorescein and Indocyanin Green Angiograms
G.N. Lambrou

Simultaneous Retinal and Choroidal Angiography and Its Relationship to Other Measurements
E.L. Greve, H.F.A. Duijm and H.C. Geijssen

Some Statistical Considerations in the Analysis of Blood Flow Measurements
B.C. Chauhan


Methods to Measure Ocular Blood Flow – LDF/HRF:

Laser Doppler Flowmetry in the Optic Nerve Head. Principle and Technique
B.L. Petrig and C.E. Riva

Regional Distribution of Optic Nerve Head Blood Flow and Penetration Depth of
Continuous Laser Doppler Flowmetry
L.E. Pillunat and A.G. Böhm

Optic Nerve Head Blood Flow Response to Flicker. Characteristics and Possible Mechanisms
C.E. Riva, B. Falsini, M.H. Geiser and B.L. Petrig

Scanning Laser Doppler Flowmetry. Principle and Technique
G. Zinser

Automated Full-Field Blood Flow Analysis of Heidelberg Retina Flowmeter Perfusion Images in Healthy Subjects and in Low Tension Glaucoma
G. Michelson, J. Welzenbach, I. Pal and J. Harazny

A New Concept of HRF Image Analysis
H. Sung Chung, A. Harris, L. Kagemann, A.C. Tsang and H.J. Garzozi


Ocular Blood Flow, Visual Function and Pharmacology:

Optic Nerve Blood Flow and Visual Function in Glaucoma
J.E. Grunwald, J. Piltz, S.M. Hariprasad and J. Dupont

Calcium Channel Blockers and Ocular Blood Flow in Normal Tension Glaucoma
Y. Kitazawa, T. Yamamoto, G. Tomita and Y. Niwa


Drug Effects on Ocular Blood Flow:

Retinal Hemodynamics in Normal Tension Glaucoma. Asymmetry of Visual Field or Optic Nerve Head Excavation
O. Arend, A. Remky and A. Harris

Topical Carbonic Anhydrase Inhibitors and Visual Function. Association with Retinal Circulation and Intraocular Pressure in Normal Eyes
W.E. Sponsel

Effect of Dorzolamide on the Blood Flow in the Optic Nerve Head of Normal Pigs
P. Koch Jensen, T. Eysteinsson, K. Bang, J. Folke Kiilgaard, J. Dollerup, E. Scherfig, M. Lacour and E. Stefánsson


Index of authors



  • Canadian Journal of Ophthalmology, volume. 35, no 5, 2000 p. 283
    By: Neeru Gupta, MD, PhD, FRCSC

Four- star rating

Presentation ***
Depth ****
Understandability ***
Clinical applicability ***

This compact hard-cover book is a multiauthored compilation of clinical and basic science studies presented at the "Update on Ocular Blood Flow in Glaucoma" workshop held in southern France in 1993. The authors are well-known authorities in this area, and each chapter provides an excellent independent study unit. The book is introduced with a well-written and thorough chapter on the blood supply of the optic nerve. This is followed by a review of basic mechanisms involved in the modulation of ocular blood flow and its relevance to glaucoma. Short chapters on blood pressure monitoring, vascular risk factors and disc hemorrhages fall within the section on general and clinical aspects of ocular blood flow in glaucoma and are written in a direct and clear style.

Most of the textbook is devoted to methods of measuring ocular blood flow, including colour Doppler imaging, pulsatile ocular blood flow, angiography, laser Doppler flowmetry and the Heidelberg Retinal Flowmeter. The reader is adequately presented with the principles and techniques while also being made aware of the controversies and limitations of the technologies. Final sections on ocular blood flow, visual function and pharmacology, and drug effects are composed of five short papers followed by relevant and stimulating discussions.

The editors have successfully brought together in a single source a critical update and discussion of the fundamentals of ocular blood flow, its study and its relation to glaucoma. For clinicians and researchers wishing to learn more about vascular pathology in glaucoma  reach for this one!

Neeru Gupta, MD, PhD, FRCSC Director, Glaucoma Unit St. Michael's Hospital Toronto, Ont.

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