Ocular blood flow evaluation in injured and healthy fellow eyes

PURPOSE. To assess if injured eyes develop ocular blood flow disturbances that may contribute to development of traumatic glaucoma. METHODS. Twenty-five eyes of 25 patients hospitalized from January 1997 to July 1999 for blunt (15) or penetrating (10) eye injury and elevated intraocular pressure (IOP) (> 23 mm Hg) were controlled at least 24 months after the trauma and underwent visual field examination, pulsatile ocular blood flow (pOBF), and color Doppler imaging (CDI) analysis of ophthalmic artery, central retinal artery, nasal and temporal short posterior ciliary arteries. Uninjured healthy eye was used as control. RESULTS. IOP was significantly higher in injured eyes (15.1 +/- 3.3 vs 13.0 2.7 mmHg; p < 0.01), but only 2 eyes (8%) were under medical treatment. pOBF values were significantly lower in injured eyes: 11.25 +/- 6.56 muL/sec in the trauma eyes and 15.40 +/- 7.29 in fellow eyes (p = 0.002). Resistivity index of all investigated retrobulbar vessels was very significantly higher in injured eyes than in fellow eyes (p < 0.0001). There is no significant correlation between IOP and ocular blood flow disturbance. CONCLUSIONS. Long-term follow-up (mean 39 +/- 12 months) of injured eyes shows, besides a slight but significant increase of IOP, a very significant impairment of ocular blood supply to injured eyes compared to healthy fellow eyes with reduction of pulsatile ocular blood flow and marked increase of resistance to flow in all retrobulbar vessels. These anomalies may be considered an independent risk factor to develop traumatic glaucoma.