Functional Ophthalmodynamometry

Fn, Sayegh; Weigelin, E

doi:10.1159/000309326

Cited by 8 publications

(4 citation statements)

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“…Body inversion is known to be associated with a host of manifestations relevant to glaucoma, including IOP elevation, increased pressure of the central retinal artery and of the cerebrospinal fluid, vasoconstriction of the retinal arterioles, and orbital congestion. 33, 35, 36, 46–48498, 50 Body inversion is also known to be associated with optic nerve dysfunction as shown by loss of PERG signal, 1413 loss of VEP signal, 714 as well as loss of psychophysical visual function. 11 Prolonged head-down posture may cause irreversible ischemic damage in the optic nerve.…”

Section: Discussionmentioning

confidence: 99%

“…For each body position, mean arterial blood pressure (MAP) was calculated from diastolic blood pressure (DBP) and systolic blood pressure (SBP) according to the formula MAP = DBP+0.42 x (SBP – DBP). 3334 Ocular perfusion pressure (OPP) was defined as the difference between mean central artery pressure (MCAP) and IOP: OPP = MCAP-IOP. 35, 36 The MCAP is linked to the MAP by a posture coefficient, as the hydrostatic effect of the blood column between the heart and the eye depends on posture.…”

Section: Methodsmentioning

confidence: 99%

“…35, 36 Based on ophthalmodynamometric measurements of the MCAP obtained at different body positions and extrapolated to derive the posture coefficient in the seated position and at minus 10 degrees head-down body tilt, OPP seated was = (MAP x 0.74) – IOP, and OPP tilted was = (MAP x 0.86) – IOP. 15, 33, 34, 37, 38 …”

Section: Methodsmentioning

confidence: 99%

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Head-down Posture in Glaucoma Suspects Induces Changes in IOP, Systemic Pressure, and PERG That Predict Future Loss of Optic Nerve Tissue

Porciatti¹,

Feuer

Monsalve

et al. 2017

Journal of Glaucoma

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Purpose To obtain pilot data on posture-induced changes of IOP, systemic pressure and pattern electroretinogram (PERG) predictive of future optic nerve tissue loss glaucoma suspects (GS). Methods Mean peripapillary retinal fiber layer thickness (RNFLT) was measured with OCT two times/year in 28 GS aged 58 ± 8.9 years over 5.0 ± 0.73 years. All patients had a baseline PERG, IOP and brachial blood pressure measurements in the seated and – 10 degrees head-down-body-tilt position (HDT). Outcome measures were seated/HDT PERG amplitude and phase, IOP, mean arterial blood pressure (MAP), and estimated ocular perfusion pressure (OPP). An additional group of 11 similarly-aged controls (SAC) aged 56.9 ± 13 years was tested for comparison. Results While all GS had initial RNFLT in the normal range, 9/28 of them developed significant (P < 0.05) loss of mean RNFLT (thinners, T) over the follow-up period as opposed to 19/28 who did not (non-thinners, NT). Significant (P<0.05) differences between SAC, NT and T were found in PERG amplitude, PERG phase, MAP, IOP, and OPP. A nominal logistic regression using baseline PERG and hemodynamic variables was able to distinguish T from NT with an AUROC of 0.89 (SE 0.07). Conclusions Baseline PERG, IOP, and systemic blood pressure, together with their changes upon HDT, may have predictive value for future loss of optic nerve tissue in GS. This study supports the rationale for a full-scale clinical trial to identify patients at high-risk of development of glaucoma.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Head-down Posture in Glaucoma Suspects Induces Changes in IOP, Systemic Pressure, and PERG That Predict Future Loss of Optic Nerve Tissue

Porciatti¹,

Feuer

Monsalve

et al. 2017

Journal of Glaucoma

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“…OPP was calculated as difference between mean central artery pressure and IOP. As central retinal artery pressure was not directly measured, but derived from previous ophthalmodynamometric estimates 47, 49 , the lack of correlation between OPP and PERG should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

Head-down Posture Induces PERG Alterations in Early Glaucoma

Ventura

Golubev

Lee

et al. 2013

Journal of Glaucoma

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Purpose To probe susceptibility of retinal ganglion cells (RGC) to physiological stressors associated with moderate head-down body tilt in patients with suspicion of glaucoma or early manifest glaucoma. Methods One hundred nine subjects with best corrected visual acuity ≥20/20 and no disease other than glaucoma (glaucoma suspects, GS= 79, early manifest glaucoma, EMG=14, normal controls, NC= 16) and comparable age range were tested. Non-contact IOP, pattern electroretinogram (PERG), and brachial blood pressure/heart rate measurements were performed in three consecutive (~8 minutes apart) conditions: seated (baseline), −10 deg whole body head-down (HDT), and seated again (recovery). PERG amplitude and latency, IOP, and systolic/diastolic blood pressures, heart rate, calculated mean central retinal artery pressure, ocular perfusion pressure, and systolic/diastolic perfusion pressures were evaluated. Results During HDT, IOP significantly (P<0.001) increased in all groups approximately to the same extent (~20%). PERG amplitude did not change in NC but decreased significantly (P<0.001) in patients (GS, −25%, EMG −23%). PERG phase become delayed in NC (− 1.6%, P=0.04) but more so in patients (GS, −2.7%, P<0.001; EMG, −6.0%, P<0.001). The proportion of patients with PERG alterations significantly (P<0.05) exceeding those occurring in age- and baseline-adjusted NC were, GS: amplitude 20%, phase 15%; EMG: amplitude 14%, phase 50%. All measures recovered baseline values after HDT. Conclusions Moderate HDT induces temporary worsening of RGC function in a subpopulation of GS and EMG patients. This non-invasive protocol may help disclose abnormal susceptibility of RGCs in a subset of the patients at risk of glaucoma.

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