PROGNOSTIC VALUE OF OPHTHALMIC ARTERY COLOR DOPPLER SONOGRAPHY FOR PROGRESSION TO GLAUCOMA IN VITILIGO PATIENTS
2013
: The aim of this study was to assess the prognostic value, i.e. the role of hemodynamic changes in the ophthalmic artery determined by color Doppler imaging in patients with vitiligo in relation to the occurrence of primary open-angle glaucoma (POAG), and to call attention to the importance of examination of the vascular component in routine examinations of patients by clinical dermatologists and ophthalmologists, due to the possible correlation of vitiligo and ophthalmologic changes indicating POAG. Clinical observations and research have shown that patients treated for vitiligo are often diagnosed with POAG or have confirmed diagnosis in their medical history. These findings motivated the research of the vascular component as a possible correlation between vitiligo and POAG. The vascular component of POAG and its role in the dynamics of glaucoma progression has not been fully explained and is still somewhat controversial, and the resulting ischemic disorders are primarily related to optical nerve damage. During the course of a continuous two-year research started in March 2008 and completed in March 2010, a total of 42 patients with vitiligo were examined in the specialist dermatovenereology unit of the Department of Skin Diseases and Sexually Transmitted Diseases. Following clinical examination and Wood's lamp examination, patients with suspected glaucoma were referred to the glaucoma unit of the Department of Ophthalmology to detect or check the progression of POAG. At the Department of Internal Medicine, Split University Hospital Center, color Doppler imaging of ophthalmic artery was performed in all patients on both eyes to examine its hemodynamics. All study participants underwent complete ophthalmologic examination: visual acuity, fundus of the eye, eye pressure measurement, anterior eye segment biomicroscopy with gonioscopy and visual field. In conclusion, our study showed color Doppler imaging and investigation of vascular parameters in ophthalmic artery to provide an insight into the vascular function in differential analysis and can be determined as a correlation or potential risk factor related to vitiligo and POAG. For this reason, we suggest that patients treated for vitiligo, irrespective of their age, sex, affected area, localization and duration of the disease, should regularly undergo complete ophthalmologic examination with special emphasis on POAG diagnosis. Considering the relatively limited sample and trial period, we can already substantiate and confirm that the correlation is not random. Future research in a larger number of vitiligo and POAG patients should provide definitive answer concerning correlation between the two diseases and lead to final conclusion, along with investigation of other hematologic factors related to blood hypercoagulability in order to reach better understanding of the vascular component function.
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