Carotid Doppler imaging in glaucoma and glaucoma suspects

Purpose: To evaluate the association of carotid occlusive disease (COD) in glaucoma and glaucoma suspects. Methods: We retrospectively (January 2012 to June 2022) reviewed medical records and carotid Doppler reports of 485 eyes from 279 patients of glaucoma suspects, primary open-angle glaucoma (POAG), or normal tension glaucoma (NTG) with suspected vascular pathology or unexplained Humphrey visual field (HVF) progression. Carotid artery involvement was determined by the presence of significant stenosis as reported in carotid Doppler imaging. Results: Mean age of patients was 63 years (SD: 11.2), of whom 78.1% were males. Carotid artery involvement was seen in 7.4% POAG, 11.4% NTG, and 12% of those with unexplained HVF progression. In contrast, only 3% of individuals in the glaucoma suspect group had stenosis exceeding 10% ( P > 0.05). There was a weak correlation between worsening visual field index (VFI) values and increasing stenosis ( r = −0.22). Conclusion: COD was rare among glaucoma suspects but commoner among NTG and POAG eyes with unexplained progression and may have clinical relevance only in these subgroups.