Peripapillary vessel parameters and mean ocular perfusion pressure in young healthy eyes: OCT angiography study

2020 ◽  
pp. bjophthalmol-2020-316222 ◽  
Author(s):  
Young In Yun ◽  
Yong Woo Kim ◽  
Hyung Bin Lim ◽  
Dong Hyun Lee ◽  
Ji Hong Kim ◽  
...  
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Perfusion Pressure ◽  
Corneal Thickness ◽  
Systemic Blood Pressure ◽  
Retinal Nerve Fibre Layer ◽  
Ocular Perfusion Pressure ◽  
Ocular Perfusion ◽  
Rnfl Thickness ◽  
Healthy Eyes

BackgroundTo investigate the relationship between estimated mean ocular perfusion pressure (MOPP) and peripapillary perfusion density (PD) or vessel density (VD) as measured by spectral-domain optical coherence tomography angiography (OCTA) in young healthy eyes.Methods132 healthy participants (264 eyes) under 45 years of age underwent optic disc OCTA scan sized 3×3 mm to acquire PD and VD in the superficial vascular complex (SVC). Optic nerve head (ONH) parameters including retinal nerve fibre layer (RNFL) thickness, rim area and disc area were measured. MOPP was estimated from systemic blood pressure and intraocular pressure (IOP). A linear mixed model was used to find the systemic and ocular factors associated with PD and VD.ResultsThe average age of the subjects was 25.8±6.5 years. PD and VD showed a significant correlation with RNFL thickness (r=0.224, p<0.001 and r=0.214, p<0.001, respectively), but with MOPP, the correlation was only marginally significant (r=0.105, p=0.09 and r=0.112, p=0.07, respectively). After controlling for confounding factors, including age, sex, IOP, central corneal thickness, axial length and OCTA signal strength, PD and VD were significantly associated with ONH parameters (all p<0.05) but not with estimated MOPP (all p>0.05).ConclusionPD and VD in the SVC were significantly associated with ONH parameters while showing no association with estimated MOPP. OCTA-derived VD may not represent perfusion pressure, but is rather more dependent on peripapillary structure.

scholarly journals The Effect of Ocular Perfusion Pressure on Retinal Thickness in Young People with Presumed Systemic Hypotension

Vision ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 36
Author(s):  
Naazia Vawda ◽  
Alvin Munsamy
Keyword(s):  
Perfusion Pressure ◽  
Retinal Thickness ◽  
Binary Logistic Regression ◽  
Retinal Nerve Fibre Layer ◽  
Binary Logistic Regression Analysis ◽  
Ganglion Cell Complex ◽  
Ocular Perfusion Pressure ◽  
Ocular Perfusion ◽  
Rnfl Thickness ◽  
Significant Difference

Low ocular perfusion pressure (OPP) may increase the risk of optic neuropathy. This study investigated the effects of OPP on the ganglion cell complex (GCC) and optic nerve head-retinal nerve fibre layer (ONH-RNFL) thickness in presumed systemic hypotensives (PSH). Fifteen participants with PSH and 14 controls underwent automated sphygmomanometry and Icare tonometry to calculate OPP: mean OPP (MOPP), systolic OPP (SOPP), and diastolic OPP (DOPP). ONH-RNFL and macula GCC thickness were evaluated using the Optovue iVue optical coherence tomographer. Statistical analysis comprised independent t-tests, the Mann–Whitney U test and binary logistic regression analysis. There was no significant difference when comparing ONH-RNFL and macula GCC thickness between both groups. Increased MOPP (OR = 0.51; 95% CI: 0.27–0.97; p = 0.039) and SOPP (OR = 0.79; 95% CI: 0.64–0.98; p = 0.035) were significantly associated with a decreased risk of reductions in GCC total thickness. Increased SOPP (OR = 0.11; 95% CI: 0.01–0.89; p = 0.027) was significantly associated with a decreased risk of reductions in the average ONH-RNFL thickness. The study found no significant retinal thickness changes in PSH’s, in comparison to the controls. The study established that, by increasing MOPP and SOPP, there was a decreased risk of reductions in the total GCC thickness and average ONH-RNFL thickness. Higher SOPP may decrease the possibility of retinal thinning of the GCC and ONH-RNFL. However, higher MOPP may decrease the odds of thinning of the GCC before ONH-RNFL changes.

scholarly journals Factors Related to a Right-Left Difference in Visual Field Defect in the Eyes with Untreated Normal Tension Glaucoma

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Haruka Moroi ◽  
Ayako Anraku ◽  
Kyoko Ishida ◽  
Goji Tomita
Keyword(s):  
Visual Field ◽  
Visual Field Defect ◽  
Central Corneal Thickness ◽  
Perfusion Pressure ◽  
Corneal Thickness ◽  
Normal Tension Glaucoma ◽  
Spherical Equivalent ◽  
Ocular Perfusion Pressure ◽  
Ocular Perfusion ◽  
Field Defect

Purpose. To investigate factors related to a right-left difference in visual field defect in untreated normal tension glaucoma (NTG). Methods. The medical records of 92 patients with untreated NTG were reviewed. Ocular blood flow was evaluated with laser speckle flowgraphy, and the mean blur rate (MBR) at the optic nerve head was analyzed. Relationships between right-left differences in mean deviation (MD), intraocular pressure, MBR, spherical equivalent, central corneal thickness, and mean ocular perfusion pressure were evaluated using Spearman’s rank correlation coefficient. Multiple regression analysis was used to detect factors contributing to a right-left difference in MD. Results. The right-left difference in MD was correlated with differences in intraocular pressure (r=−0.263, P=0.011), MBR (r=0.417, P<0.001), and spherical equivalent (r=0.213, P=0.042), but not with central corneal thickness or mean ocular perfusion pressure. Multiple regression analysis showed that a difference in MBR was the only significant contributor to a right-left difference in MD (slope 0.047, 95% confidence interval 0.025–0.069; P<0.001). Conclusion. In untreated NTG, a difference in blood flow at the optic nerve head was a significant contributor to a right-left difference in visual field defect.

scholarly journals A review of ocular perfusion pressure and retinal thickness: A case for the role of systemic hypotension in glaucoma

2021 ◽  
Vol 80 (1) ◽  
Author(s):  
Naazia Vawda ◽  
Alvin J. Munsamy
Keyword(s):  
Blood Flow ◽  
Perfusion Pressure ◽  
Retinal Thickness ◽  
Ocular Blood Flow ◽  
Retinal Nerve Fibre Layer ◽  
Ocular Perfusion Pressure ◽  
Systemic Hypotension ◽  
Ocular Perfusion ◽  
Nerve Fibre Layer

Background: Ocular perfusion pressure (OPP) is defined as blood pressure (BP) minus intraocular pressure (IOP). Low OPP may result in decreased ocular blood flow (OBF) and oxygen to the optic nerve head (ONH) and retina.Aim: To review the role of systemic hypotension and similar conditions in OPP and its influence on retinal nerve fibre layer (RNFL) thickness and the ganglion cell complex (GCC).Method: A literature search was conducted using the following search terms: ‘systemic hypotension’; ‘glaucoma’; ‘retinal nerve fibre layer’; ‘optic nerve’; ‘ocular blood flow’ and ‘ocular perfusion pressure’.Results: The Los Angeles Eye Study and Barbados Eye Study found that decreased OPP and BP increased the risk of glaucoma development by up to six times. Reduced retinal perfusion with resultant thinning of the RNFL in conditions with a similar mechanism, such as obstructive sleep apnoea syndrome, has indicated the importance of reduced OPP in retinal thickness. In the absence of any study directly showing the effect of systemic hypotension on OPP and retinal thickness, a working hypothesis proposes that reduced BP with or without normal-to-raised IOP will reduce OPP. The reduced OPP and OBF in those with systemic hypotension may result in oxidative stress and hypoxia which may then cause retinal ganglion cell death and the resultant retinal thinning.Conclusion: The increased risk of glaucoma development and progression relating to decreased BP and OPP has been proven to be of importance. Monitoring patients with systemic hypotension and evaluating the macula, ONH RNFL and GCC thickness may alert clinicians to possible glaucomatous changes.

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