AbstractPurposeTo determine the correlation between ocular blood flow velocities and ocular pulse amplitude (OPA) in glaucoma patients using colour Doppler imaging (CDI) waveform analysis.MethodA prospective, observer‐masked, case‐control study was performed.OPAand blood flow variables from central retinal artery and vein (CRA,CRV), nasal and temporal short posterior ciliary arteries (NPCA,TPCA) and ophthalmic artery (OA) were obtained through dynamic contour tonometry andCDI, respectively. Univariate and multiple regression analyses were performed to explore the correlations betweenOPAand retrobulbarCDIwaveform and systemic cardiovascular parameters (blood pressure, blood pressure amplitude, mean ocular perfusion pressure and peripheral pulse).ResultsOne hundred and ninety‐two patients were included [healthy controls: 55; primary open‐angle glaucoma (POAG): 74; normal‐tension glaucoma (NTG): 63].OPAwas statistically different between groups (Healthy: 3.17 ± 1.2 mmHg;NTG: 2.58 ± 1.2 mmHg;POAG: 2.60 ± 1.1 mmHg; p < 0.01), but not between the glaucoma groups (p = 0.60). Multiple regression models to explainOPAvariance were made for each cohort (healthy: p < 0.001,r = 0.605;NTG: p = 0.003,r = 0.372;POAG: p < 0.001,r = 0.412).OPAwas independently associated with retrobulbarCDIparameters in the healthy subjects andPOAGpatients (healthyCRVresistance index:β = 3.37,CI: 0.16–6.59; healthyNPCAmean systolic/diastolic velocity ratio:β = 1.34,CI: 0.52–2.15;POAG TPCAmean systolic velocity:β = 0.14,CI0.05–0.23).OPAin theNTGgroup was associated with diastolic blood pressure and pulse rate (β = −0.04,CI: −0.06 to −0.01;β = −0.04,CI: −0.06 to −0.001, respectively).ConclusionsVascular‐related models provide a better explanation toOPAvariance in healthy individuals than in glaucoma patients. The variables that influenceOPAseem to be different in healthy,POAGandNTGpatients.