Frequency of Spontaneous Pulsations of the Central Retinal Vein in Glaucoma

Purpose: To assess the prevalence of spontaneous pulsations of the central retinal vein in eyes with chronic open-angle glaucoma versus normal eyes in the setting of a general ophthalmic practice. Methods: The clinical observational case-series study included 167 eyes of 84 subjects with chronic open-angle glaucoma and 704 eyes (352 subjects) of a control group. The optic disc was ophthalmoscopically examined using a noncontact ophthalmoscopic lens at the slit lamp in medical mydriasis. Results: Spontaneous pulsations of the central retinal vein were observed in significantly (P = 0.005; odds ratio, 0.59; 95% confidence interval, 0.41-0.84) fewer eyes of the glaucoma group (107/167 or 64.1% +/- 3.7%%) than in the eyes of the control group (530/704 or 75.3% +/- 1.6%). In both groups, the presence of a spontaneous central retinal vein pulsation was statistically (P > 0.10) independent of age, sex, refractive error, and intraocular pressure. Conclusions: As examined in a nonreferral ophthalmic practice, eyes with chronic open-angle glaucoma compared with normal eyes show a significantly lower frequency of detected spontaneous pulsations of the central retinal vein. Confirming previous hospital-based Studies, the results suggest that assessment of the central retinal vessel pulsations, as part of an optic disc examination may clinically be useful for the diagnosis of glaucoma.