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.

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 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.

scholarly journals Correlation between ocular perfusion pressure and estimated translamina cribrosa pressure difference in healthy young adults

Biomedicine ◽  
2020 ◽  
Vol 39 (2) ◽  
pp. 326-332
Author(s):  
Ramya Channarayapatna Madhusetty ◽  
Rajalakshmi Ramashetty ◽  
Mamatha Sunaganahalli Dyapegowda
Keyword(s):  
Young Adults ◽  
Pressure Difference ◽  
Perfusion Pressure ◽  
Fluid Pressure ◽  
Normal Tension Glaucoma ◽  
Lamina Cribrosa ◽  
Ocular Perfusion Pressure ◽  
Medical College ◽  
Ocular Perfusion ◽  
Significant Difference

Introduction and Aim: Glaucoma is a chronic optic neuropathy which is the leading cause of irreversible blindness across the globe. It is known that Intraocular pressure is responsible for these altered changes but recent experimental and clinical studies have reported that cerebrospinal fluid pressure (CSFP) and trans-lamina cribrosa pressure difference (TLCPD), may be an important cause of glaucomatous optic nerve damage, especially in subjects with normal-tension glaucoma. To assess the correlation between ocular perfusion pressure (OPP) and TLCPD in healthy young adults. Materials and Methods: One hundred healthy young adult volunteers comprising of 50 obese (25 males and 25 females) and 50 non-obese (25 males and 25 females) in the age group of 18-19 years among MBBS Phase I students of JSS Medical College, JSSU, Mysore were the subjects for the study. Blood Pressure and Intra Ocular Pressure were recorded. Mean arterial pressure (MAP), OPP, CSFPand TLCPD were calculated. Results: There exists a positive correlation (0.50) between OPP and TLCPD. There was a statistically significant difference in OPP, CSFP and TLCPD between obese and non-obese groups. Conclusion: The present study provides information on the relationship of TLCPD with CSFP and OPP that are higher in obese individuals.  

scholarly journals Comparison of Optic Nerve Head Blood Flow Autoregulation among Quadrants Induced by Decreased Ocular Perfusion Pressure during Vitrectomy

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Ryuya Hashimoto ◽  
Tetsuya Sugiyama ◽  
Takatoshi Maeno
Keyword(s):  
Blood Flow ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Perfusion Pressure ◽  
Medical Center ◽  
Ocular Perfusion Pressure ◽  
Software Analysis ◽  
Ocular Perfusion ◽  
Significant Difference ◽  
Time Courses

Purpose. The present study aimed to examine changes in optic nerve head (ONH) blood flow autoregulation in 4 quadrants (superior, nasal, inferior, and temporal) with decreased ocular perfusion pressure (OPP) during vitrectomy in order to determine whether there is a significant difference of autoregulatory capacity in response to OPP decrease at each ONH quadrant. Methods. This study included 24 eyes with an epiretinal membrane or macular hole that underwent vitrectomy at Toho University Sakura Medical Center. Following vitrectomy, the tissue mean blur rate (MBR), which reflects ONH blood flow, was measured. Mean tissue MBRs in the four quadrants were generated automatically in the software analysis report. Measurements were conducted before and 5 and 10 min after intraocular pressure (IOP) elevation of approximately 15 mmHg in the subjects without systemic disorders. Results. The baseline tissue MBR of the temporal quadrant was significantly lower than that of the other 3 quadrants (all P<0.05). However, the time courses of tissue MBR in response to OPP decrease were not significantly different among the four quadrants during vitrectomy (P=0.23). Conclusions. There is no significant difference in the autoregulatory capacity of the four ONH quadrants in patients without systemic disorders during vitrectomy.

scholarly journals Ganglion cell complex scan in the early prediction of glaucoma

2012 ◽  
Vol 4 (2) ◽  
pp. 236-241
Author(s):  
S Ganekal
Keyword(s):  
Ganglion Cell ◽  
Cell Complex ◽  
P Value ◽  
Ganglion Cell Complex ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Color Code ◽  
Rnfl Thickness ◽  
Significant Difference

Objective: To compare the macular ganglion cell complex (GCC) with peripapillary retinal fiber layer (RNFL) thickness map in glaucoma suspects and patients. Subjects and methods: Forty participants (20 glaucoma suspects and 20 glaucoma patients) were enrolled. Macular GCC and RNFL thickness maps were performed in both eyes of each participant in the same visit. The sensitivity and specificity of a color code less than 5% (red or yellow) for glaucoma diagnosis were calculated. Standard Automated Perimetry was performed with the Octopus 3.1.1 Dynamic 24-2 program. Statistics: The statistical analysis was performed with the SPSS 10.1 (SPSS Inc. Chicago, IL, EUA). Results were expressed as mean ± standard deviation and a p value of 0.05 or less was considered significant. Results: Provide absolute numbers of these findings with their units of measurement. There was a statistically significant difference in average RNFL thickness (p=0.004), superior RNFL thickness (p=0.006), inferior RNFL thickness (p=0.0005) and average GCC (p=0.03) between the suspects and glaucoma patients. There was no difference in optic disc area (p=0.35) and vertical cup/disc ratio (p=0.234) in both groups. While 38% eyes had an abnormal GCC and 13% had an abnormal RNFL thickness in the glaucoma suspect group, 98% had an abnormal GCC and 90% had an abnormal RNFL thickness in the glaucoma group.Conclusion: The ability to diagnose glaucoma with macular GCC thickness is comparable to that with peripapillary RNFL thickness. Macular GCC thickness measurements may be a good alternative or a complementary measurement to RNFL thickness assessment in the clinical evaluation of glaucoma.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6538 Nepal J Ophthalmol 2012; 4 (2): 236-241 

Use of neutrophil/lymphocyte ratio as a marker in patients with suspicious diaphragmatic attenuation artifact

2021 ◽  
Vol 8 (12) ◽  
pp. 706-710
Author(s):  
Kemal Göçer ◽  
Ahmet Çağrı Aykan ◽  
Bayram Öztürk ◽  
Alihan Erdoğan
Keyword(s):  
Risk Factors ◽  
Binary Logistic Regression ◽  
Myocardial Perfusion Spect ◽  
Binary Logistic Regression Analysis ◽  
Inferior Wall ◽  
Roc Curve Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Significant Difference ◽  
Attenuation Artifact ◽  
Artery Disease

Objective: This study aimed to evaluate whether neutrophil/lymphocyte (N/L) ratio assists in the diagnosis of coronary artery disease (CAD) in patients with suspected diaphragmatic attenuation artifact (DAA) on myocardial perfusion SPECT (MP-SPECT). Material and Methods: A total of 255 patients undergoing coronary angiography between 2015-2020 due to unclear DAA of the inferior wall on MP-SPECT were included in this retrospective study. Patients were divided into two groups (CAD and non-CAD) according to angiographic images. Significant CAD was defined as ≥50% stenosis of coronary arteries feeding the inferior wall. White blood cell count, biochemical parameters, and risk factors for CAD were compared between the two groups. Results: There was no statistically significant difference between the two groups in terms of age (p = 0.055), gender (p = 0.482), and body mass index (p = 0.305). N/L ratio (OR = 1.397 p = 0.002 95% Cl = 1.128-1.732) and left ventricle ejection fraction (OR = 0.896 p = 0.023 95% Cl = 0.815-0.985) were independent risk factors for CAD in multivariate binary logistic regression analysis. Receiver Operating Characteristic (ROC) curve analysis showed that a cut-off value of ≥2 for N/L ratio predicted the presence of CAD (sensitivity=63.5%, specificity=60.7%, AUC=0.668, 95% CI=0.596 – 0.740, p<0.001). Conclusion: N/L ratio is a simple and accessible test and may increase the diagnostic accuracy of MP-SPECT for CAD in patients with suspicious diaphragmatic attenuation on MP-SPECT.

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