Glaucoma: Diagnosis and Therapy

Re: Nemeth et al: Accuracy of orbital color Doppler flow...

Janos Nemeth M.D.

On Tue Dec 15, Jost B Jonas wrote
>Dear Professor Nemeth,
>congratulations for your study. I would like to ask you:
>1) What was the experience of the examiner. i.e. how many examinations had he performed before start of the study ?

Answer: They had great experience concerning blood flow measurements in larger vessels like carotid arteries, and examined about 50 healthy orbital cases before this study on glaucoma patients.

>2) On which factors did the measured values depend, such as arterial blood pressure, posture, gender, refractive error, axial length, day time, intake of coffein or alcohol, actual IOP, or previous exercise such as walking up of stairs ? To get repeatable measurements in clinical practice, it may be important to know the dependence of measured values on these external factors.

Answer: We have examined already the effect of blood pressure, heart rate, previous physical exercise and actual IOP on orbital flow (measurements) and significant correlations were found. So after intake of blood pressure or heart rate alterating durgs, changes in the orbital flow might be expected. There are sex and age differences published in the literature but we did not examined this aspects. The effect of refraction or axial eye length is unknown yet. According to the above facts we always try to keep a very strict examination protocol including 15-minute-rest, laying position and control of blood pressure, heart rate and IOP during color Doppler flow measurements.

>3) What was the reproducibility in the normal subjects ?

Answer: The coefficient of variation for all flow parameters were higher as this healthy group was the first 50 orbital cases for the examiners.

>4) How big was the inter-eye difference in your study population ?

Answer: We did not calculated this but we will. Thank you for the suggestion.
Thank you for your comments and questions. Kind regards
Janos Nemeth

[ This message was edited on Tue Dec 15 by the author ]

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