Doppler ophthalmic blood pressure measurement in the hemodynamic evaluation of occlusive carotid artery disease.

Abstract

1 -3 Unfortunately, the circle of Willis is subject to considerable morphologic variation and differs among individuals in its functional efficiency. 4As the ophthalmic artery is the first large branch of the internal carotid artery, the study of the ophthalmic artery pressure (OAP) provides information about the amount of distal internal carotid artery blood pressure.1 ' 3 -5 Furthermore, examination of the ophthalmic artery flow direction in patients with occlusive carotid artery disease may help to detect the sources of collateral pathways. 6 We recently developed a simple and safe method Received August 15, 1988; accepted February 1, 1989. for OAP determination, called ophthalmomanometryDoppler (OMD). 7 Based on Doppler ultrasound principles, OMD provides simultaneous information about both the maximum perfusion pressure and the flow direction in the ophthalmic circulation. In a previous paper, 8 we validated this new OAP measurement technique and presented baseline data from normal subjects.The purpose of our present study is to describe the findings of Doppler OAP and flow direction measurements in a series of patients with angiographically documented occlusive carotid artery disease of known severity, to analyze their hemodynamic disturbances, and to compare these results with normal data obtained previously in healthy subjects. Subjects and MethodsWe selected 102 patients (85 men and 17 women) aged 37-74 (mean 59) years who had undergone both bilateral OAP determination by OMD and subsequent carotid angiography. To be included in the study, the patients had to present 60-100% diameter obstruction of the carotid arteries proxiby guest on May 11, 2018 http://stroke.ahajournals.org/ Downloaded from

Ocular Perfusion Pressure During Pars Plana Vitrectomy: A Pilot Study

“…29 Considering that most PPVs may last more than that, it is conceivable that intraoperative MOPP reduction can result in ischemic changes, especially in predisposed patients. 6 Patients' comorbidity could also contribute to intraoperative cellular damage: Aging, high myopia, diabetes, atherosclerosis, carotid stenosis, 30 and retinal detachment, all impair significantly optic nerve head perfusion regulatory mechanisms. 25 Moreover, surgical trauma, photic stress, low infusion fluid temperature, and extensive laser treatment increase metabolic demand, worsening hypoperfusion consequences.…”