The Retinal Venous Pulse

Hedges, Thomas R.; Baron, Edward; Sinclair, Stephen H.

doi:10.1016/s0161-6420(94)31302-9

Cited by 36 publications

(13 citation statements)

References 15 publications

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“…Comparison of our results with earlier studies shows that SVP is visible in the vast majority (99%) of eyes of patients with normal ICP using infrared video, compared with 67%-81% of eyes in patients with normal ICP using a direct ophthalmoscope (16,17,20).…”

Section: Discussionsupporting

confidence: 73%

“…Our study showed a clear relationship between a smaller cup:disc ratio and higher proportion of eyes with low-amplitude or absent SVP. There was a much higher rate of SVP in all disc categories in our videographic study than in any of the disc categories reported by Hedges et al using conventional ophthalmoscopy (20).…”

Section: Discussioncontrasting

confidence: 61%

“…Hedges et al (20) reported that discs with large cups, and those where veins could be viewed end-on, had higher rates of visible SVP (69%). Crowded discs without cups, and those in which disc veins were obscured by arterioles or glial tissue had much lower rates of visible SVP (6%).…”

Section: Discussionmentioning

confidence: 99%

“…In humans, SVP are not observable in up to a third of healthy individuals when examined with either an ophthalmoscope or slit lamp (16,17,20). We have found that spontaneous venous pulsation is more easily visible using the en-face infrared image of the fundus seen during image acquisition with the Spectralis ocular coherence tomography (OCT) system (Heidelberg Engineering GmbH, Germany).…”

Section: Introductionmentioning

confidence: 99%

“…All videos were motion-stabilised using the Spectralis' inbuilt software. The presence and amplitude of venous pulsation were graded using the system described by Hedges et al and later used by Wong and White (17,20): grade 0 = no SVP, grade 1 = <33% change in venous diameter, grade 2= between 33% and 67% change in venous diameter, grade 3 = >67% change in venous diameter.…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Venous Pulsations Detected With Infrared Videography

McHugh

D’Antona

Toma

et al. 2020

Journal of Neuro-Ophthalmology

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Background Assessment of spontaneous venous pulsation (SVP) is commonly undertaken to help determine whether intracranial pressure (ICP) is elevated. Previous studies using direct ophthalmoscopy or slit lamp assessments have found that SVP is not observed in up to a third of subjects with normal ICP, and that SVP grading has relatively poor inter-observer agreement. Methods Patients (n=105) undergoing clinically indicated retinal ocular coherence tomography (OCT), who were all thought to have normal intracranial pressure, had 10-second infrared video recordings performed with the Heidelberg Spectralis OCT system (Heidelberg Engineering GmbH, Germany). The presence and amplitude of SVP in each video was independently graded by two neuroophthalmologists. Results The two observers found SVP present in 97% and 98% of right eyes, and in one or both eyes in 99% and 100% of subjects. There was a high rate of inter-observer agreement in SVP amplitude grading (Cohen's Kappa 0.82 for right eyes). Optic discs with a smaller cup had a significantly lower SVP amplitude (Spearman's rho = 0.22, p=0.02). Conclusion Infrared video is widely available in eye clinics via the use of OCT imaging systems, and is substantially more sensitive in detecting SVP than traditional assessments using ophthalmoscopy. SVP are absent in as few as 1% of people with presumed normal ICP.

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Section: Discussionsupporting

confidence: 73%

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spontaneous Venous Pulsations Detected With Infrared Videography

McHugh

D’Antona

Toma

et al. 2020

Journal of Neuro-Ophthalmology

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Association of Intracranial Pressure and Spontaneous Retinal Venous Pulsation

et al. 2019

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IMPORTANCE A convenient and reliable method for noninvasive intracranial pressure assessments is desirable to reduce the need for invasive procedures (eg, intracranial pressure monitoring and lumbar punctures) and allow clinicians to identify and treat patients with intracranial hypertension in a timely manner.OBJECTIVE To determine whether infrared video assessment of spontaneous retinal venous pulsation is associated with intracranial pressure and is a valid tool to indicate the presence or absence of raised intracranial pressure in patients without papilledema. DESIGN, SETTING, AND PARTICIPANTSA single-center prospective study was conducted at a tertiary referral center between January 2017 and May 2018. Patients consecutively admitted for clinically indicated elective 24-hour invasive intracranial pressure monitoring had ophthalmic review including infrared video recording of their spontaneous venous pulsation. Two neuro-ophthalmologists, who were masked to the intracranial pressure monitoring results, independently graded the spontaneous venous pulsation (grade 0 to 3). Analysis began in June 2018. MAIN OUTCOMES AND MEASURESThe association between simultaneously recorded intracranial pressure and spontaneous venous pulsation (binary variable: present/absent) assessed through retinal infrared video recordings was evaluated using a multiple linear regression model. RESULTSOf 105 patients, the mean (SD) age was 39 (14) years, and 79 (75%) were women. The mean (SD) simultaneous intracranial pressure was 1 (5) mm Hg for 91 patients (86.7%) with spontaneous venous pulsations and 13 (14) mm Hg for 14 patients (13.3%) without spontaneous venous pulsations. A multiple linear regression model adjusted for 7 potential confounders confirmed a statistically significant association between intracranial pressure and spontaneous venous pulsation (β = −9.1; 95% CI, −13.7 to −4.6; P < .001; adjusted R 2 = 0.42). CONCLUSIONS AND RELEVANCEThe absence of spontaneous venous pulsation on retinal infrared video recordings is significantly associated with higher levels of intracranial pressure and should raise the suspicion of intracranial hypertension.

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Spontaneous Pulsation of the Retinal Veins

Levine

1998

Microvascular Research

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The Retinal Venous Pulse

Cited by 36 publications

References 15 publications

Spontaneous Venous Pulsations Detected With Infrared Videography

Spontaneous Venous Pulsations Detected With Infrared Videography

Association of Intracranial Pressure and Spontaneous Retinal Venous Pulsation

Spontaneous Pulsation of the Retinal Veins

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