Abnormal peripheral vascular response to occlusion provocation in normal tension glaucoma patients

Purpose: To assess peripheral vascular reactive hyperemia in response to occlusion provocation test, using two-channels laser Doppler probe in patients with normal tension glaucoma (NTG) and normal subjects. Methods: 15 patients with NTG (12 women and 4 men), mean aged 58,9 and 15 control subjects (13 women and 2 men), mean aged 60,6 were subjected to an occlusion test. The experiment comprised following steps: 1/ a 5-minute baseline-period 2/ a 2-minute occlusion of the left hand using a 15 cm wide cuff located directly over the elbow (the pressure in the cuff was 50 mmHg higher than the systolic pressure measured on the arm 3/ a 15- minute final recovery period after occlusion. Finger hyperemia was assessed by two-channels laser-Doppler flowmeter MBF-3d, Moor Instruments, Ltd., continuously during the experiment. For measurements of hyperemia two surface probes were attached to the pulp of the second finger (mean probe) and third finger (basic probe) of the left hand. The following hyperemia parameters were measured: RF (rest flow), BZ (biological zero), TM (time to peak flow), TH (half-time of hyperemia), MAX (maximum of hyperemia) and hyperemia amplitude (MAX-RF)/RF 100% was calculated. Kruskal-Wallis test analysis was used to test the differences between the group of patients and normal subjects for TM1,MXF1 (basic probe) and TM2, MXF2 (mean probe) parameters. Results: In NTG patients, TM1 was significantly higher comparing with healthy subjects whereas MAX was significantly lower as compared to the control group. Conclusions: Occlusion provocation test elicits a different systemic hyperemia response in patients with NTG compared with healthy subjects.