Consensus 6


6th 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

  • 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