Analysis of Retinal Vasodilation after Flicker Light Stimulation in Relation to Vasospastic Propensity

Gugleta, Konstantin; Zawinka, Claudia; Rickenbacher, Ines; Kochkorov, Asan; Katamay, Robert; Flammer, Josef; Orgül, Selim

doi:10.1167/iovs.06-0351

Cited by 64 publications

(65 citation statements)

References 47 publications

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“…It is reported to demonstrate the effect of spontaneous variations in vessel diameter that occur under normal resting conditions to flicker light. 38 Tentative links have been made in previous studies between the occurrence of increased arterial diameter fluctuations and the presence of vascular disturbance in both smokers and vasospastic subjects 19,39,40 and between increased retinal venous diameters and the presence of retinal ischemia and hypoxia. 41,42 On this basis, it could be hypothesized that the increased BDF identified in our IGT patients may represent an indicator that common alterations in retinal vascular function may exist in these individuals, perhaps related to an increased variation in vascular tone or compliance.…”

Section: Discussionmentioning

confidence: 98%

Abnormal Retinal Vascular Reactivity in Individuals with Impaired Glucose Tolerance: A Preliminary Study

Patel¹,

Bellary

Qin³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate the relationship between vascular function parameters measured at the retinal and systemic level and known markers for cardiovascular risk in patients with impaired glucose tolerance (IGT). METHODS.Sixty age-and sex-matched white European adults (30 with IGT and 30 with normal glucose tolerance [NGT]) were recruited for the study. Fasting plasma glucose, lipids, and 24-hour blood pressure (BP) were measured in all subjects. Systemic vascular and endothelial function was assessed by using carotid-artery intimal media thickness (cIMT) and flowmediated dilation (FMD). Retinal vascular reactivity was assessed by the dynamic retinal vessel analyzer. Additionally, blood glutathione (reduced glutathione [GSH], glutathione disulfide [GSSG], and total glutathione [tGSH]) and plasma von Willebrand (vWF) factor levels were also measured.RESULTS. Individuals with IGT demonstrated higher BP values (P < 0.001), fasting triglyceride (TG) levels and TG:high-density lipoprotein (HDL) ratios (P < 0.001) than NGT subjects. Furthermore, total:HDL-cholesterol (HDL-C) ratios and Framingham scores were raised (P ¼ 0.010 and P < 0.001, respectively). Blood glutathione levels (GSH, GSSG, and tGSH) were lower (P < 0.001, P ¼ 0.039, and P < 0.001, respectively) while plasma vWF was increased (P ¼ 0.014) in IGT subjects compared to controls. IGT individuals also demonstrated higher IMT in right and left carotid arteries (P ¼ 0.017 and P ¼ 0.005, respectively) alongside larger brachial artery diameter (P ¼ 0.015) and lower FMD percentage (P ¼ 0.026) and glyceryl trinitrate-induced dilation (P ¼ 0.012) than healthy controls. At the retinal arterial level, the IGT subjects showed higher baseline diameter fluctuations (BDFs) (P ¼ 0.026), longer reaction time (RT) (P ¼ 0.032), and reduced baseline-corrected flicker response (bFR) (P ¼ 0.045). In IGT subjects, retinal BDF correlated with total:HDL (P ¼ 0.003) and HDL-C (P ¼ 0.004). Arterial RT also correlated with FMD (P ¼ 0.017) in IGT but not NGT subjects.CONCLUSIONS. In IGT individuals there is a relationship between macro-and microvascular function, as well as a direct correlation between the observed retinal microcirculatory changes and established plasma markers for cardiovascular diseases. Multifactorial preventive interventions to decrease vascular risk in these individuals should be considered. (Invest Ophthalmol Vis Sci. 2012;53:5102-5108)

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Section: Discussionmentioning

confidence: 98%

Abnormal Retinal Vascular Reactivity in Individuals with Impaired Glucose Tolerance: A Preliminary Study

Patel¹,

Bellary

Qin³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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“…In the study from 2006 [16], the retinal vessel response dynamics was analyzed in healthy vasospastic and nonvasospastic subjects, and the non-vasospastic group demonstrated a response augmentation in three flicker periods. There are, however, important differences to the present study cohort and design: neither controls nor the patients were subdivided according to their vasospastic propensity, the grouping criteria here was solely the presence of the disease.…”

Section: Discussionmentioning

confidence: 99%

“…Details on the device and its application have been published previously [4,5,7,16]. In short, this device consists of a fundus camera (FF450, Zeiss Jena, Germany) for the examination and recording of the ocular fundus, and the RVA control computer which allows continuous as well as offline readings of the retinal vessel diameter.…”

Section: Methods -Retinal Vessel Analyzermentioning

confidence: 99%

Dynamics of retinal vessel response to flicker light in glaucoma patients and ocular hypertensives

Gugleta

Kochkorov

Waldmann

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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Purpose To analyze dynamics of retinal vessel dilation response to flicker light in patients with glaucoma and ocular hypertension. Patients and methods Response to flicker light was measured in retinal vessels by means of Retinal Vessel Analyzer. After the baseline 50 seconds long diameter recording of inferior and superior temporal artery and vein, three flicker stimulations of 20 seconds duration was applied, with a 80 seconds break in between. Area under the curve of the vessel diameter (AUC) was compared during 3 flicker periods in the open angle glaucoma patients group (POAG, n=47) and ocular hypertensives (OHT, n=46) and age-matched healthy controls (n=56) Results POAG eyes demonstrated smaller response of all vessels to flicker light in general than the other two groups (p=0.0008), but the response dynamics was significantly different between the groups (p=0.038), showing in three flicker periods a delayed increasing response in the POAG and OHT groups, and remaining stable in healthy subjects. Conclusion General vessel response to flicker light was decreased in POAG patients despite the slow improvement in repeated flicker stimulation, indicating an altered response pattern.

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“…Particularly, ET-1 (ET-1), autonomic dysfunction, and oxidative stress may link the differing vascular beds involved in FS. Consequently, FS may inflict heart [109] and brain [112,113] as a systemic state.…”

Section: Endothelial Dysregulation In Flammer Syndromementioning

confidence: 99%

Endothelial dysfunction in cardiovascular disease and Flammer syndrome—similarities and differences

et al. 2017

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The endothelium has increasingly been recognized as a smart barrier and a key regulator of blood flow in microand macrovascular beds. Endothelial dysfunction marks a stage of atherosclerosis and is an important prognostic marker for cardiovascular disease. Yet, some people who tend to be slim and physically active and with rather low blood pressure show a propensity to respond to certain stimuli such as emotional stress with endothelial-mediated vascular dysregulation (Flammer syndrome). This leads to characteristic vascular symptoms such as cold hands but also a risk for vascularmediated diseases such as normal-tension glaucoma. It is the aim of this review to delineate the differences between Flammer syndrome and its Bcounterpart^endothelial dysfunction in the context of cardiovascular diseases.

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Analysis of Retinal Vasodilation after Flicker Light Stimulation in Relation to Vasospastic Propensity

Cited by 64 publications

References 47 publications

Abnormal Retinal Vascular Reactivity in Individuals with Impaired Glucose Tolerance: A Preliminary Study

Abnormal Retinal Vascular Reactivity in Individuals with Impaired Glucose Tolerance: A Preliminary Study

Dynamics of retinal vessel response to flicker light in glaucoma patients and ocular hypertensives

Endothelial dysfunction in cardiovascular disease and Flammer syndrome—similarities and differences

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