Purpose To determine whether changes in central retinal vein pulsation characteristics occur in glaucoma,and how these are related to indices of glaucoma severity.Design A large,consecutive,prospective,c ase-controlled study.Participants Ninety-four consecut ive glaucoma patients and105glaucoma suspects seen in a terti ary referral clinic were examined.Forty-one age-match ed normal subjects also were examined.Methods The presence or absence of spontaneous venous pulsation was ob served in these 3groups.The ophthalmodyna mometric force(ODF)re-quired to induce venous pulsation at the optic disc was measured in those without spontaneous pulsation.Optic disc photographs were obtained and v isual field testing was performed for all subjects.Main out come measures The prevalence of spontaneous venous pulsation between these3groups was compared.The relationship between ODF and visual field mean deviation,neu roretinal rim area,age,intraocular pressure(IOP),gender,and diagnosis of glaucoma was investigated using lin ear mixed models fitted by Gibbs sampling.Results Significantly fewer(chi-square,27.7;P<0.001)glaucoma patients(54%)were observed to have spontaneous venous pulsa-tion than suspects(75%)or normals(98%).A worse visual field mean deviation was show n to be the most significant predictor of a higher ODF(P<0.000),with younger age(P<0.000)also predictive of a higher ODF.A strong relationship between ODF and mean devi-ation was found in the glaucoma patie nts(r=0.59,n=52,P<0.001).Conclusions Spontaneous venous pulsation is less common in glaucoma .The ODF required to induce venous pulsation is increased in glaucoma,andthis ODF is greater in those with more severe field loss.
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