Is Vascular Regulation in the Central Retinal Artery Altered in Persons With Vasospasm?

Abstract

To assess the relation between ocular perfusion pressure and blood flow velocity in the central retinal artery in patients with acral vasospasm. Subjects and Methods: Eighteen otherwise healthy subjects with acral vascular dysregulation, as demonstrated by nail-fold capillaroscopy, and 18 age-and sex-matched healthy volunteers without vasospasm were recruited. After subjects had rested for 20 minutes in a supine position, intraocular pressure and blood flow velocity in the central retinal artery were determined by applanation tonometry and color Doppler imaging, respectively. The peak systolic velocity, end-diastolic velocity, and resistivity index were assessed. Correlations between the mean ocular perfusion pressure (2/3 ϫ [2/3 × diastolic blood pressure + 1/3 ϫ systolic blood pressure] − intraocular pressure) and blood flow velocities in the central retinal artery were determined by the Pearson linear correlation factor. The Student t test was used to evaluate differences between controls and subjects with vasospasm. Results: The mean ± SD ocular perfusion pressure was 42.0 ± 7.4 mm Hg in the group with vasospasm and 47.1 ± 6.5 mm Hg in the control group (P = .04). In the subjects with vasospasm, the peak systolic and enddiastolic velocities and the resistivity index of the central retinal artery correlated significantly with the mean ocular perfusion pressure (R = 0.49, P = .04; R = 0.58, P = .01; and R = −0.67, P = .002, respectively). Such correlations were not found in the control group. Conclusion: An altered blood flow regulation is suggested in the ocular circulation of patients with acral vasospasm.

Choroidal Vascular Reaction to Hand-Grip Stress in Subjects with Vasospasm and Its Relevance in Glaucoma

“…Furthermore, those with vasospasm had a higher propensity to be female, to have low systemic blood pressure and low OPP, also confirming earlier results. 10 Comparable variations in blood pressure and pulse rate in the present study indicate a comparable sympathetic arousal in both experimental groups of healthy subjects. The calculated change in vascular resistance (perfusion pressure divided by choroidal blood flow) during the isometric exercise, however, reached 25.96% and 57.54% in control subjects and subjects with a positive history of cold hands, respectively.…”

Choroidal Vascular Reaction to Hand-Grip Stress in Subjects with Vasospasm and Its Relevance in Glaucoma

“…Furthermore, those with vasospasm had a higher propensity to be female, to have low systemic blood pressure and low OPP, also confirming earlier results. 10 Comparable variations in blood pressure and pulse rate in the present study indicate a comparable sympathetic arousal in both experimental groups of healthy subjects. The calculated change in vascular resistance (perfusion pressure divided by choroidal blood flow) during the isometric exercise, however, reached 25.96% and 57.54% in control subjects and subjects with a positive history of cold hands, respectively.…”

Study of Autonomic Activities in Primary Open Angle Glaucoma

“…Gherghel et al performed a modified cold pressor response test in 24 patients with POAG and 22 controls and found a differing blood pressure and ocular blood flow response in patients with POAG suggestive of systemic autonomic failure and ocular vascular dysregulation. 24 T-wave amplitude confirms the decrease of sympathetic activity. Table 4.5 shows (0.161±0.1535mV) in POAG cases.…”

Correlation Between Finger Blood Flow and Changes in Optic Nerve Head Blood Flow Following Therapeutic Intraocular Pressure Reduction

“…In a recent study by Hasler and coworkers 31 the authors, using single-point laser Doppler flowmetry, report a significant positive correlation between calculated ocular perfusion pressure and blood flow in the choroid of vasospastic subjects. A similar study by Gherghel et al, 32 using color Doppler imaging, reported a significant positive correlation between calculated ocular perfusion pressure and both peak-systolic velocity and end-diastolic velocity as well as a significant negative correlation with resistivity index in the central retinal artery of vasospastic subjects. Such correlations did not occur in the control group.…”

Choroidal Vascular Reaction to Hand-Grip Stress in Subjects with Vasospasm and Its Relevance in Glaucoma

“…Furthermore, those with vasospasm had a higher propensity to be female, to have low systemic blood pressure and low OPP, also confirming earlier results. 10 Comparable variations in blood pressure and pulse rate in the present study indicate a comparable sympathetic arousal in both experimental groups of healthy subjects. The calculated change in vascular resistance (perfusion pressure divided by choroidal blood flow) during the isometric exercise, however, reached 25.96% and 57.54% in control subjects and subjects with a positive history of cold hands, respectively.…”

Study of Autonomic Activities in Primary Open Angle Glaucoma

“…Gherghel et al performed a modified cold pressor response test in 24 patients with POAG and 22 controls and found a differing blood pressure and ocular blood flow response in patients with POAG suggestive of systemic autonomic failure and ocular vascular dysregulation. 24 T-wave amplitude confirms the decrease of sympathetic activity. Table 4.5 shows (0.161±0.1535mV) in POAG cases.…”

Correlation Between Finger Blood Flow and Changes in Optic Nerve Head Blood Flow Following Therapeutic Intraocular Pressure Reduction

“…In a recent study by Hasler and coworkers 31 the authors, using single-point laser Doppler flowmetry, report a significant positive correlation between calculated ocular perfusion pressure and blood flow in the choroid of vasospastic subjects. A similar study by Gherghel et al, 32 using color Doppler imaging, reported a significant positive correlation between calculated ocular perfusion pressure and both peak-systolic velocity and end-diastolic velocity as well as a significant negative correlation with resistivity index in the central retinal artery of vasospastic subjects. Such correlations did not occur in the control group.…”

Choroidal Vascular Reaction to Hand-Grip Stress in Subjects with Vasospasm and Its Relevance in Glaucoma

“…Furthermore, those with vasospasm had a higher propensity to be female, to have low systemic blood pressure and low OPP, also confirming earlier results. 10 Comparable variations in blood pressure and pulse rate in the present study indicate a comparable sympathetic arousal in both experimental groups of healthy subjects. The calculated change in vascular resistance (perfusion pressure divided by choroidal blood flow) during the isometric exercise, however, reached 25.96% and 57.54% in control subjects and subjects with a positive history of cold hands, respectively.…”

Study of Autonomic Activities in Primary Open Angle Glaucoma

“…Gherghel et al performed a modified cold pressor response test in 24 patients with POAG and 22 controls and found a differing blood pressure and ocular blood flow response in patients with POAG suggestive of systemic autonomic failure and ocular vascular dysregulation. 24 T-wave amplitude confirms the decrease of sympathetic activity. Table 4.5 shows (0.161±0.1535mV) in POAG cases.…”

Correlation Between Finger Blood Flow and Changes in Optic Nerve Head Blood Flow Following Therapeutic Intraocular Pressure Reduction

“…In a recent study by Hasler and coworkers 31 the authors, using single-point laser Doppler flowmetry, report a significant positive correlation between calculated ocular perfusion pressure and blood flow in the choroid of vasospastic subjects. A similar study by Gherghel et al, 32 using color Doppler imaging, reported a significant positive correlation between calculated ocular perfusion pressure and both peak-systolic velocity and end-diastolic velocity as well as a significant negative correlation with resistivity index in the central retinal artery of vasospastic subjects. Such correlations did not occur in the control group.…”