Abstract

SO.15.09

Clinical aspects of diagnosis and treatment of disorders of ocular hemodynamics

Oliver Zeitz, Lars Wagenfeld, Peter Galambos, Anne Wiermann, Gisbert Richard, Maren Klemm
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf

Objective
Dysregulated ocular perfusion plays a role in the course of various ocular diseases. Diagnostic and therapeutic approaches to evaluate and treat disorders of ocular hemodynamics will be discussed in this lecture through the clinician’s eyes.
Methods
Results from several studies will be demontsrated. The studies rely on color Doppler imaging with and without provocation, Heidelberg Retina-Flowmetry and Langham-OBF.
Results
Different methods applied in the same patient reveal results that correlate partially. Color Doppler imaging is the only method, which is capable to assess hemodynamics in retrobulbar vessels. Differences in perfusion can be visualized e.g. in glaucoma if the progression status of the disease is included or if the regulation of ocular hemodynamics is challenged by provocation protocols. In general, the discriminatory power of available methods is too weak to separat patients from the healthy population in clinical allday life. Regarding therapy only dorzolamide has a positive effect on ocular perfusion. For systemic modulation of ocular perfusion several concepts exist, but non has brought a real breakthrough. Surgical treatment of vascular occlusion showed promising results with respect to visual acuity. However, a positive effect on hemodynamics could not be identified.
Conclusions
In clinical practice diagnostic and therapy of ocular perfusion disorders remains a challenging issue and several aspects partcularly of therapy remain unsolved.

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