Pulsatile ocular blood flow in patients with Graves' ophthalmopathy

Purpose: Graves' ophthalmopathy (GO) is a cosmetically disfiguring and vision-threatening complication of Graves' disease (GD). We investigated the clinical application of pulsatile ocular blood flow (POBF) measurement for detection of clinically active GO. Methods: In this prospective study, the OBF tonometer (OBF Labs, Wiltshire, UK) was used to measure POBF in 83 eyes of 83 patients with GD in two groups and 42 normal control subjects. Group A comprised 35 GD patients without ophthalmopathy, and group B composed 48 GD patients with ophthalmopathy. Results were compared with controls. Results: Pulse amplitude, pulse volume, and POBF were significantly lower in group B than that in group A and controls (P < 0.001). After adjusting for age, sex, systolic blood pressure, diastolic blood pressure, heart rate, intraocular pressure, and axial length, multivariate linear regression analysis showed that POBF was still significantly lower in eyes with GO (772.4 (SD 279.3) μl/min) than group A (1177.3 (SD 326.3) μl/min) and controls (1255.4 (SD 295.1) μl/min) (P < 0.001). Conclusions: These data show that the pulsatile ocular blood flow differences between the groups are relevant to the presence of GO. POBF measurement is a clinically useful adjunct for assessing the haemodynamic change in GO patients.