Investigation of changes in optic nerve geometry and blood flow during lateral gaze to investigate the mechanism of glaucoma etiology.

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K09799
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56060:Ophthalmology-related
• Research Institution: Kitasato University
• Principal Investigator: Goseki Toshiaki 北里大学, 医学部, 講師 (30458799)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 眼球運動 / 緑内障 / 視神経 / 乳頭血流 / 眼血流 / 斜視

Outline of Final Research Achievements

Changes in blood flow in the optic nerve papilla during eye movement were compared in normal, primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG) eyes (30 eyes from 30 subjects each) by LSFG-NAVI. Compared with the frontal position, blood flow in the whole optic nerve papilla was decreased in adduction in the normal group, in adduction and abduction in the POAG group, and in adduction in the NTG group, proving a decrease in optic nerve papilla blood flow due to eye movement. Further studies were required to investigate the association between these changes and glaucoma progression. In addition, the changes in eye alignment during eye movement were measured in sagging eye syndrome (SES) and superior oblique palsy, which are representative diseases of strabismus, and it was found that SES had less vertical deviation at all gaze　and less extortion at down gaze compared to superior oblique palsy.

Free Research Field

眼科

Academic Significance and Societal Importance of the Research Achievements

緑内障ガイドラインでは緑内障治療の原則は眼圧下降であると定義されているが、眼圧を十分に下降させても進行する緑内障患者は存在する。眼圧下降以外にも視神経乳頭の血流改善や視神経保護が注目されている。眼球運動に伴う、視神経乳頭の機械的ストレスの既報はあるが、眼球運動に伴う視神経乳頭の血流低下は初めての報告である。以上から、眼球運動を制限することが可能であれば、新たな緑内障治療となることが示唆された。また、斜視患者に伴う視神経乳頭血流の変化は今後の課題となった。