Dark Adaptation in Patients with Primary Open-Angle Glaucoma, Pseudoexfoliation Glaucoma and Childhood Glaucoma

Abstract

Purpose To investigate the state of dark adaptation and macular blood flow in different forms of glaucoma.

Methods Eighteen eyes of 18 patients with primary open-angle glaucoma, 14 eyes of 14 patients with pseudoexfoliation glaucoma, and 10 eyes of 10 patients with childhood glaucoma (CG) were examined by means of dark adaptometry, scanning-laser retinal flowmetry, and retinal tomography.

Results All glaucomatous eyes had comparable optic disc excavation (one-way ANOVA, p = 0.138). Eyes with CG had significantly lower best-corrected visual acuity than the other groups (Tukey, all p < 0.0001). Macular perfusion was comparable in all three groups (one – way ANOVA, p = 0.08). The delay in rod-cone break time in the CG group was significantly higher than in the other groups (Tukey, all p < 0.0001). The scotopic sensitivity threshold in the CG group was significantly greater than in the other groups (Tukey, all p < 0.01).

Conclusion This underlying dysfunction of dark adaptation may contribute, at least to some extent, to the decreased visual perception observed in patients with CG.

Zusammenfassung

Ziel Zu untersuchen sind die Dunkeladaptation und die makuläre Blutperfusion bei unterschiedlichen Glaukomformen.

Methoden Achtzehn Augen von 18 Patienten mit primärem Offenwinkelglaukom, 14 Augen von Patienten mit Pseudoexfoliationsglaukom und 10 Augen von 10 Patienten mit kindlichem Glaukom (CG) wurden mittels Dunkeladaptometrie, scanning-laser retinaler Flowmetrie und retinaler Kohärenztomografie untersucht.

Resultate Alle Augen hatten vergleichbare Papillenexkavation (One-way Anova, p = 0.138). Die Augen mit CG hatten signifikant reduzierte bestkorrigierte Sehkraft im Vergleich zu den anderen Gruppen (Tukey, all p < 0.0001). Die makuläre Blutperfusion war vergleichbar bei allen 3 Gruppen (One–way Anova, p = 0.08). Die Zeitverzögerung der Stäbchen-Zapfen-Break-Time (Kohlrausch-Knick) war bei CG signifikant höher im Vergleich zu den anderen Gruppen (Tukey, all p < 0.0001). Die skotopische Lichtempfindlichkeit war bei CG auch signifikant höher im Vergleich zu den anderen Gruppen (Tukey, all p < 0.01).

Key words

glaucoma - dark adaptation - macular blood flow

Schlüsselwörter

Glaukoma - Dunkeladaptation - makuläre Blutperfusion

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