Retinal venous pressure is higher than the airway pressure and the intraocular pressure during the Valsalva manoeuvre

Stodtmeister, Richard; Heyde, M N van der; Georgii, Sylvana; Matthé, Egbert; Spoerl, Eberhard; Pillunat, Lutz E

doi:10.1111/aos.13485

Cited by 18 publications

(16 citation statements)

References 31 publications

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“…Fear of a negative effect of vaginal delivery on the worsening of eye functions among women with eye disorders stems mostly from measurements showing that intraocular pressure increases, on average, by 0.8 mm Hg during the Valsalva maneuver, and the pressure in ocular veins rises even more significantly . However, vaginal delivery is safe from an ophthalmologic point of view, and there is currently no existing ophthalmologic indication for cesarean .…”

Section: Discussionmentioning

confidence: 99%

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Impact of introducing specific measures to reduce the frequency of cesarean delivery for non‐obstetric indications

Pšenková

Bucko

Braticak

et al. 2018

Intl J Gynecology & Obste

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Section: Discussionmentioning

confidence: 99%

“…6 In the pres- veins rises even more significantly. 8 However, vaginal delivery is safe from an ophthalmologic point of view, and there is currently no existing ophthalmologic indication for cesarean. 9 In spite of this, 74.0% of obstetricians in Europe indicate cesarean for women with a history of rhegmatogenous retinal detachment.…”

Section: Discussionmentioning

confidence: 99%

Impact of introducing specific measures to reduce the frequency of cesarean delivery for non‐obstetric indications

Pšenková

Bucko

Braticak

et al. 2018

Intl J Gynecology & Obste

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“…; Wong & White ; Stodtmeister et al. ). This leads to a lower than expected OPP, since current formulas oversimplify the complex physiology by assuming that IOP is a correct measure for ocular venous pressure in all patients.…”

Section: Discussionmentioning

confidence: 99%

“…Central retinal vein (CRV) pressure has been shown to be higher than the IOP in a large part of glaucoma patients (Stodtmeister 2015). This was objectively measured, but could also be hinted by the absence of CRV pulsation on fundoscopy (Morgan et al 2004(Morgan et al , 2005Harder & Jonas 2007;Abegao Pinto et al 2013;Wong & White 2013;Stodtmeister et al 2018). This leads to a lower than expected OPP, since current formulas oversimplify the complex physiology by assuming that IOP is a correct measure for ocular venous pressure in all patients.…”

Section: Discussionmentioning

confidence: 99%

Heterogeneity in arterial hypertension and ocular perfusion pressure definitions: Towards a consensus on blood pressure‐related parameters for glaucoma studies

Barbosa‐Breda

Abegão‐Pinto

Keer

et al. 2018

Acta Ophthalmologica

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Purpose Glaucoma studies have long taken into account the blood pressure (BP) status of patients. This study summarizes and evaluates the impact of the different criteria that have been used for BP‐related variables in glaucoma research. Methods Studies included in two meta‐analyses that reviewed the role of BP in glaucoma were analyzed. Additional studies published after the search periods of the meta‐analyses were also included. Criteria for the definition of arterial hypertension and other BP‐related variables, such as mean arterial pressure (MAP) and mean ocular perfusion pressure (MOPP), were retrieved. Results Sixty‐four studies were evaluated. One‐third used 140 mmHg as a systolic BP cut‐off to define hypertension, 20% used 160 mmHg and the remaining half used various other criteria. Less than 20% of studies reported MAP and/or MOPP. While eight of the ten studies reporting MAP used a correct formula that only happened for five of the eleven studies reporting MOPP. Using as an example average blood pressure values, incorrectly used formulas could have led to an overestimation of more than 100% of the expected values. Conclusion Considerable heterogeneity exists in BP‐related variables in glaucoma research and different definitions can lead to large disparities. Glaucoma research would benefit from a consensus regarding blood pressure parameters.

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“…There is also evidence that the VM may lead to an increase in intraocular pressure (IOP), although the mechanisms remains unclear [3,[9][10][11]. Schuman et al suggested that an elevation in IOP is caused by increased uveal volume via the VM, although the observed IOP was much less than the calculated effect on IOP based on the measured change in uveal volume [12].…”

Section: Introductionmentioning

confidence: 99%

Dual effect of the Valsalva maneuver on autonomic nervous system activity, intraocular pressure, Schlemm’s canal, and iridocorneal angle morphology

Sun

Chen

et al. 2019

Preprint

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Background: The Valsalva maneuver (VM) is widely used in daily life, and has been reported to cause high intraocular pressure (IOP). This study aimed to assess changes in IOP, the Schlemm’s canal (SC), autonomic nervous system activity, and iridocorneal angle morphology in healthy individuals during different phases of the VM. Methods: The high frequency (HF) of heart rate (HR) variability, the ratio of low frequency power (LF) and HF (LF/HF), heart rate (HR), IOP, systolic (SBP) and diastolic blood pressure (DBP), the area of SC (SCAR), pupil diameter (PD), and some iridocorneal angle parameters (AOD500, ARA750, TIA500 and TISA500) were measured in 29 young healthy individuals at baseline, phase 2, and phase 4 of the VM. SBP and DBP were measured to calculate mean arterial pressure (MAP) and mean ocular perfusion pressure (MOPP). HF and the LF/HF ratio were recorded using Kubios HR variability premium software to evaluate autonomic nervous system activity. The profiles of the anterior chamber were captured by a Spectralis optical coherence tomography device (anterior segment module). Results: Compared with baseline values, in phase 2 of the VM, HR, LF/HF, IOP (15.1±2.7 vs. 18.8±3.5 mmHg, P < 0.001), SCAR(mean) (7712.112±2992.14 vs. 8921.12±4482.79 μm2, P = 0.039), and PD increased significantly, whereas MOPP, AOD500, TIA500, and TISA500 decreased significantly. In phase 4, DBP, MAP, AOD500, ARA750, TIA500and TISA500 were significantly lower than baseline value, while PD and HF were remarkably larger than baseline. The comparison between phase 2 and phase 4 showed that HR, IOP (18.8±3.5 vs. 14.7±2.9 mmHg, P < 0.001) and PD decreased significantly from phase 2 to phase 4, but there were no significant differences in other parameters. Conclusions: The expansion and collapse of the SC in different phases of the VM may arise from changes in autonomic nervous system activity. Further, the effects of the VM on IOP may be attributed to changes in blood flow and ocular anatomy.

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Retinal venous pressure is higher than the airway pressure and the intraocular pressure during the Valsalva manoeuvre

Cited by 18 publications

References 31 publications

Impact of introducing specific measures to reduce the frequency of cesarean delivery for non‐obstetric indications

Impact of introducing specific measures to reduce the frequency of cesarean delivery for non‐obstetric indications

Heterogeneity in arterial hypertension and ocular perfusion pressure definitions: Towards a consensus on blood pressure‐related parameters for glaucoma studies

Dual effect of the Valsalva maneuver on autonomic nervous system activity, intraocular pressure, Schlemm’s canal, and iridocorneal angle morphology

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