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 Ocular Perfusion Pressure and Pulsatile Ocular Blood Flow in Normal and Systemic Hypertensive Patients

2015 ◽  
Vol 9 (1) ◽  
pp. 16-19 ◽  
Author(s):  
Syril Dorairaj ◽  
Fabio N Kanadani ◽  
Carlos R Figueiredo ◽  
Rafaela Morais Miranda ◽  
Patricia LT Cunha ◽  
...  
Keyword(s):  
Blood Flow ◽  
Perfusion Pressure ◽  
Ocular Blood Flow ◽  
Ocular Perfusion Pressure ◽  
Hypertensive Patients ◽  
Ocular Perfusion ◽  
Pulsatile Ocular Blood Flow

scholarly journals Ocular blood flow in steep Trendelenburg positioning during robotic-assisted radical prostatectomy

2017 ◽  
Vol 28 (3) ◽  
pp. 333-338 ◽  
Author(s):  
Christian L. Demasi ◽  
Francesco Porpiglia ◽  
Augusto Tempia ◽  
Savino D’Amelio
Keyword(s):  
Blood Flow ◽  
Radical Prostatectomy ◽  
Perfusion Pressure ◽  
Ocular Blood Flow ◽  
Ocular Perfusion Pressure ◽  
Trendelenburg Position ◽  
Robotic Assisted ◽  
Ocular Perfusion ◽  
Steep Trendelenburg Position ◽  
Pulsatile Ocular Blood Flow

Purpose: Several ischemic optic neuropathies that occurred during robotic-assisted laparoscopic radical prostatectomy (RALRP) have been reported to be due to the Trendelenburg position, which lowers ocular perfusion pressure (OPP). We examined changes in pulsatile ocular blood flow (POBF) and its correlation with OPP during RALRP in the steep Trendelenburg position. Methods: Pulsatile ocular blood flow and intraocular pressure (IOP) were measured in 50 patients by the OBF Langham System 5 times during RALRP. The mean arterial blood pressure (MAP), heart rate, plateau airway pressure, and end-tidal CO2 (EtCO2) at each time point were recorded. Ocular perfusion pressure was calculated from simultaneous IOP and MAP measurements. Results: Pulsatile ocular blood flow was 15.53 ± 3.32 µL/s at T0, 18.99 ± 4.95 µL/s at T1, 10.04 ± 3.24 µL/s at T2, 11.45 ± 3.02 µL/s at T3, and 15.07 ± 3.81 µL/s at T4. Ocular perfusion pressure was 70.15 ± 5.98 mm Hg at T0, 64.21 ± 6.77 mm Hg at T1, 57.71 ± 7.07 mm Hg at T2, 51.73 ± 11.58 mm Hg at T3, and 64.21 ± 12.37 mm Hg at T4. Repeated-measures analysis of variance on POBF and OPP was significant (p>0.05). This difference disappeared when the correlation between MAP and POBF, EtCO2 and POBF, and EtCO2 and OPP were considered, while correlation between MAP and OPP confirmed the difference. The regression analysis between POBF and OPP showed a statistically significant difference at T0 and T3 (r = 0.047, p = 0.031 and r = 0.096, p = 0.002, respectively). Conclusions: Pulsatile ocular blood flow and OPP reached the lowest level at the end of surgery.

scholarly journals Ocular Blood Flow Autoregulation Mechanisms and Methods

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Xue Luo ◽  
Yu-meng Shen ◽  
Meng-nan Jiang ◽  
Xiang-feng Lou ◽  
Yin Shen
Keyword(s):  
Blood Flow ◽  
Perfusion Pressure ◽  
Ocular Blood Flow ◽  
Flow Regulation ◽  
Main Function ◽  
Ocular Diseases ◽  
Ocular Perfusion Pressure ◽  
Metabolic Demand ◽  
Ocular Perfusion ◽  
Sufficient Oxygen

The main function of ocular blood flow is to supply sufficient oxygen and nutrients to the eye. Local blood vessels resistance regulates overall blood distribution to the eye and can vary rapidly over time depending on ocular need. Under normal conditions, the relation between blood flow and perfusion pressure in the eye is autoregulated. Basically, autoregulation is a capacity to maintain a relatively constant level of blood flow in the presence of changes in ocular perfusion pressure and varied metabolic demand. In addition, ocular blood flow dysregulation has been demonstrated as an independent risk factor to many ocular diseases. For instance, ocular perfusion pressure plays key role in the progression of retinopathy such as glaucoma and diabetic retinopathy. In this review, different direct and indirect techniques to measure ocular blood flow and the effect of myogenic and neurogenic mechanisms on ocular blood flow are discussed. Moreover, ocular blood flow regulation in ocular disease will be described.

Role of Adenosine in the Control of Choroidal Blood Flow during Changes in Ocular Perfusion Pressure

2011 ◽  
Vol 52 (8) ◽  
pp. 6035 ◽  
Author(s):  
Doreen Schmidl ◽  
Guenther Weigert ◽  
Guido T. Dorner ◽  
Hemma Resch ◽  
Julia Kolodjaschna ◽  
...  
Keyword(s):  
Blood Flow ◽  
Perfusion Pressure ◽  
Ocular Perfusion Pressure ◽  
Choroidal Blood Flow ◽  
Ocular Perfusion

scholarly journals Role of nitric oxide in optic nerve head blood flow regulation while experimental increase of ocular perfusion pressure

2011 ◽  
Vol 11 (Suppl 2) ◽  
pp. A47
Author(s):  
Reinhard Told ◽  
Doreen Schmidl ◽  
Michael Lasta ◽  
Agnes Boltz ◽  
Berthold Pemp ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Flow ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Perfusion Pressure ◽  
Flow Regulation ◽  
Ocular Perfusion Pressure ◽  
Ocular Perfusion ◽  
Blood Flow Regulation

Role of NO in the Control of Choroidal Blood Flow during a Decrease in Ocular Perfusion Pressure

2009 ◽  
Vol 50 (1) ◽  
pp. 372 ◽  
Author(s):  
Christian Simader ◽  
Solveig Lung ◽  
Gu¨nther Weigert ◽  
Julia Kolodjaschna ◽  
Gabriele Fuchsja¨ger-Mayrl ◽  
...  
Keyword(s):  
Blood Flow ◽  
Perfusion Pressure ◽  
Ocular Perfusion Pressure ◽  
Choroidal Blood Flow ◽  
Ocular Perfusion

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.

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