Choroidal Blood Flow Response to Isometric Exercise in Glaucoma Patients and Patients with Ocular Hypertension

Portmann, Natalie; Gugleta, Konstantin; Kochkorov, Asan; Polunina, Anna; Flammer, Josef; Orgül, Selim

doi:10.1167/iovs.11-7758

Cited by 39 publications

(41 citation statements)

References 35 publications

(45 reference statements)

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“…Choroidal, retinal, and ONH blood flow have been found to be reduced in patients with glaucoma compared with healthy controls. [28][29][30] In addition, also autoregulation of ocular blood flow appears to be disturbed in this group of patients. [30][31][32] Autoregulation is defined as the capability of a vascular bed to keep its blood flow constant despite changes in OPP.…”

Section: Pathophysiology Of Glaucomamentioning

confidence: 81%

“…[28][29][30] In addition, also autoregulation of ocular blood flow appears to be disturbed in this group of patients. [30][31][32] Autoregulation is defined as the capability of a vascular bed to keep its blood flow constant despite changes in OPP. 33 Large-scale studies also found low OPP, which can be estimated as the difference between mean arterial blood pressure and IOP, as a risk factor for the onset and progression of glaucoma.…”

Section: Pathophysiology Of Glaucomamentioning

confidence: 81%

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Pharmacotherapy of Glaucoma

Schmidl

Schmetterer²,

Garhöfer³

et al. 2015

Journal of Ocular Pharmacology and Therapeutics

129

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Glaucoma is a group of diseases involving the optic nerve and associated structures, which is characterized by progressive visual field loss and typical changes of the optic nerve head (ONH). The only known treatment of the disease is reduction of intraocular pressure (IOP), which has been shown to reduce glaucoma progression in a variety of large-scale clinical trials. Nowadays, a relatively wide array of topical antiglaucoma drugs is available, including prostaglandin analogues, carbonic anhydrase inhibitors, beta-receptor antagonists, adrenergic agonists, and parasympathomimetics. In clinical routine, this allows for individualized treatment taking risk factors, efficacy, and safety into account. A major challenge is related to adherence to therapy. Sustained release devices may help minimize this problem but are not yet available for clinical routine use. Another hope arises from non-IOP-related treatment concepts. In recent years, much knowledge has been gained regarding the molecular mechanisms that underlie the disease process in glaucoma. This also strengthens the hope that glaucoma therapy beyond IOP lowering will become available. Implementing this concept with clinical trials remains, however, a challenge.

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Section: Pathophysiology Of Glaucomamentioning

confidence: 81%

Section: Pathophysiology Of Glaucomamentioning

confidence: 81%

Pharmacotherapy of Glaucoma

Schmidl

Schmetterer²,

Garhöfer³

et al. 2015

Journal of Ocular Pharmacology and Therapeutics

129

View full text Add to dashboard Cite

show abstract

“…[5][6][7][8][9][10][11][12][13][14][15][16] Alterations of the response in ChBF have been observed in smokers 17 and vasospastics, 18 as was well as in patients with diabetic retinopathy, 19 central serous chorioretinopathy, 20 agerelated macular degeneration, 21 and glaucoma. 22 By contrast only few studies have investigated optic nerve head blood flow (ONHBF) during changes in OPP. [23][24][25][26][27][28] The aim of our study was to extend our understanding of ONHBF regulation during changes in OPP.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Choroidal and Optic Nerve Head Blood Flow Regulation during Changes in Ocular Perfusion Pressure

Schmidl¹,

Boltz

Kaya³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. We compared the response of choroidal and optic nerve head blood flow (ChBF, ONHBF) in response to an increase in ocular perfusion pressure (OPP) during isometric exercise and during a decrease in OPP during an artificial increase in intraocular pressure (IOP). METHODS.We included 96 healthy subjects in our study. In 48 subjects OPP was increased by 6 minutes of squatting, and either ONHBF (n ¼ 24) or ChBF (n ¼ 24) was measured continuously. In 48 other healthy subjects either ONHBF (n ¼ 24) or ChBF (n ¼ 24) was measured continuously during a period of artificial increase in IOP using a suction cup. All blood flow measurements were done using laser Doppler flowmetry. RESULTS.During all experiments the response in blood flow was less pronounced than the response in OPP, indicating for flow regulation. During isometric exercise ChBF regulated better than ONHBF (P ¼ 0.023). During artificial IOP increase ONHBF regulated better than ChBF (P ¼ 0.001). Interindividual variability in blood flow responses was high. During squatting ONHBF decreased considerably below baseline ONHBF when OPP fluctuated in 3 subjects, although OPP still was much higher than at baseline. This phenomenon was not observed in the choroid. CONCLUSIONS.Our data indicate that regulation of ChBF and ONHBF during changes in OPP is different and complex. In some subjects performing squatting, considerable ONHBF reductions were observed during OPP fluctuations, although OPP still was high. Whether this predisposes to ocular disease remains unclear. (Invest Ophthalmol Vis Sci. 2012;53:4337-4346)

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“…3 These unstable vascular abnormalities might also affect ocular blood flow, which can be assessed using color duplex imaging, laser speckle method, or Doppler flowmetry. 4,5 However, because the choroid receives approximately 95% of all ocular blood flow, changes in its structure could help to evaluate choroidal, thus ocular blood flow. 6 In several recent studies, optical coherence tomography (OCT) was introduced as an effective tool for evaluating choroidal thickness.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of choroidal thickness using spectral-domain optical coherence tomography in migraine patients during acute migraine attacks: a comparative study

Karalezlı

Şimşek

Çelik

et al. 2014

Eye

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Purpose The purpose of this study was to assess choroidal thickness in migraine patients during acute migraine attacks and compare them with healthy controls, using spectral domain optical coherence tomography (OCT). Patients and methods In this prospective case-control study, choroidal thicknesses of 46 migraine patients during acute migraine attacks and 46 age-and sex-matched healthy subjects were measured using a high-speed, high-resolution frequency domain-OCT device. All patients underwent a complete ophthalmic examination before the measurements. OCT measurements were taken at the same time of day (0900 hours), in order to minimize the effects of diurnal variation. Results There was a statistically significant difference in mean choroidal thickness between the migraine patients during acute migraine attacks (356.3 ± 21.46 mm) and the controls (302.3 ± 18.34 mm; P ¼ 0.000). There were significant differences at all measurement points (Po0.001 for all). Conclusion The increased choroidal thickness of the migraine patients during acute migraine attacks might be related to the vascular pathology of the disease. Further studies are needed to evaluate the etiopathologic relationship between choroidal thickness and acute migraine attack.

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Choroidal Blood Flow Response to Isometric Exercise in Glaucoma Patients and Patients with Ocular Hypertension

Abstract: Baseline ChBF was lower in both the POAG and the OHT patients, compared with that in the controls. The stronger increase in ChBF in POAG patients in the face of an exercise-induced blood pressure increase indicates less active regulatory capacity in glaucoma patients.

Cited by 39 publications

References 35 publications

Pharmacotherapy of Glaucoma

Pharmacotherapy of Glaucoma

Comparison of Choroidal and Optic Nerve Head Blood Flow Regulation during Changes in Ocular Perfusion Pressure

Evaluation of choroidal thickness using spectral-domain optical coherence tomography in migraine patients during acute migraine attacks: a comparative study

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