Consensus 6

6^th Consensus Meeting: Ocular Blood Flow in Glaucoma

Fort Lauderdale, FL, May 2, 2009

edited by Robert N. Weinreb and Alon Harris
2009. 3 tables and 27 figures of with 1 in full color. Hardbound.
ISBN-10: 90 62992 222 6.
ISBN-13: 978-90-6299-222-5
Published by: Kugler Publications.
Click here for more information on all publications in the Consensus series.

See meeting photos

Summary Consensus Points

• Anatomy and physiology
• Clinical measurement of ocular blood flow
• Clinical relevance of ocular blood flow (obf) measurements including effects of general medications or specific glaucoma treatment
• Should measurements of ocular blood flow be implemented into clinical practice?
• What do we still need to know?

Anatomy and physiology

• Anatomy of blood from the heart to the eye
• Blood supply of the optic nerve
• Overview of blood flow regulation in general
• The mediators of autoregulation
• The anatomic underpinning of ocular blood flow control
• The ocular vasculature and its role in regulating blood flow to the optic
  nerve and retina

Clinical measurement of ocular blood flow

• Color Doppler imaging
• Laser Doppler flowmetry and scanning laser flowmetry
• Retinal vessel analyzer
• Blue field entopic stimulation
• Laser interferometric measurement of fundus pulsation
• Dynamic contour tonometry and ocular pulse amplitude
• Pulsatile ocular blood flow (POBF) analyzer
• Laser speckle method (laser speckle flowgraphy)
• Digital scanning laser ophthalmoscope angiography
• Bi-directional laser Doppler velocimetry and simultaneous vessel densitometry
• Doppler optical coherence tomography
• Retinal oximetry

Clinical relevance of ocular blood flow (obf) measurements including effects of general medications
or specific glaucoma treatment

• What is the evidence supporting a role for ocular blood flow in glaucoma patients?
• Clinical evidence derived from different measurement parameters
• Evidence from experimental animal studies
• What disease mechanisms lead to impaired blood flow in glaucoma?
• Ocular versus systemic causes
• Systemic factors
• Vascular dysregulation/perfusion instability
• What is the impact of medication and other modifiable factors on ocular blood flow?
• IOP-lowering topical medication
• Systemic drugs
• Ocular surgery, exercise
• Does modulation of blood flow alter glaucoma progression?
• Glaucoma and systemic vascular disease
• Systemic disease and glaucoma patients
• Diabetes
• Cardiovascular diseases

Should measurements of ocular blood flow be implemented into clinical practice?

• Interpreting clinical studies

What do we still need to know?

• Ocular blood flow and visual function in glaucoma patients
• Ocular perfusion pressure and prevalence and progression of glaucoma
• Ocular blood flow and optic nerve head structure
• The relationship between intraocular pressure and ocular blood flow
• The relationship between cerebrospinal fluid pressure and glaucoma
• Future research
• Summary of consensus points
• Index of authors