Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1996 Dec;80(12):1055–1059. doi: 10.1136/bjo.80.12.1055

Acute IOP elevation with scleral suction: effects on retrobulbar haemodynamics.

A Harris 1, K Joos 1, M Kay 1, D Evans 1, R Shetty 1, W E Sponsel 1, B Martin 1
PMCID: PMC505702  PMID: 9059269

Abstract

AIMS/BACKGROUND: Mechanical and vascular factors may both contribute to glaucoma. This study investigated the relation of mechanical to vascular factors by examining how acute IOP elevation altered flow velocities in the central retinal and ophthalmic arteries. METHODS: IOP was elevated from a baseline near 14 to approximately 45 mm Hg using suction ophthalmodynamometry. During recovery from scleral suction, IOP fell to near 8 mm Hg. At each IOP, peak systolic and end diastolic velocities (PSV and EDV) were measured in the central retinal and ophthalmic arteries using colour Doppler imaging (Siemens Quantum 2000). Eleven healthy people served as subjects. RESULTS: Acute elevation in IOP had no effect upon PSV, EDV, or the derived resistance index in the ophthalmic artery: flow velocities in this vessel were identical at IOP of 8 mm Hg or 45 mm Hg. In contrast, in the central retinal artery, PSV and EDV fell, and the resistance index rose, in steady progression as IOP was acutely elevated (each p < 0.01). At IOP of 45 mm Hg, EDV was virtually absent and the resistance index was very nearly 1.0. CONCLUSION: Ophthalmic arterial haemodynamics are unrelated to acute fluctuations of the IOP over a wide range, suggesting that ocular hypertension itself cannot induce vascular dysfunction in this artery. In contrast, flow velocities in the central retinal artery were highly IOP dependent, implying that haemodynamic and mechanical factors are closely linked in this vascular bed.

Full text

PDF
1058

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BILL A. The uveal venous pressure. Arch Ophthalmol. 1963 Jun;69:780–782. doi: 10.1001/archopht.1963.00960040786021. [DOI] [PubMed] [Google Scholar]
  2. Carter C. J., Brooks D. E., Doyle D. L., Drance S. M. Investigations into a vascular etiology for low-tension glaucoma. Ophthalmology. 1990 Jan;97(1):49–55. doi: 10.1016/s0161-6420(90)32627-1. [DOI] [PubMed] [Google Scholar]
  3. Crick R. P., Vogel R., Newson R. B., Shipley M. J., Blackmore H., Palmer A., Bulpitt C. J. The visual field in chronic simple glaucoma and ocular hypertension; its character, progress, relationship to the level of intraocular pressure and response to treatment. Eye (Lond) 1989;3(Pt 5):536–546. doi: 10.1038/eye.1989.85. [DOI] [PubMed] [Google Scholar]
  4. Galassi F., Nuzzaci G., Sodi A., Casi P., Cappelli S., Vielmo A. Possible correlations of ocular blood flow parameters with intraocular pressure and visual-field alterations in glaucoma: a study by means of color Doppler imaging. Ophthalmologica. 1994;208(6):304–308. doi: 10.1159/000310526. [DOI] [PubMed] [Google Scholar]
  5. Guthoff R. F., Berger R. W., Winkler P., Helmke K., Chumbley L. C. Doppler ultrasonography of the ophthalmic and central retinal vessels. Arch Ophthalmol. 1991 Apr;109(4):532–536. doi: 10.1001/archopht.1991.01080040100037. [DOI] [PubMed] [Google Scholar]
  6. Hayreh S. S., Revie I. H., Edwards J. Vasogenic origin of visual field defects and optic nerve changes in glaucoma. Br J Ophthalmol. 1970 Jul;54(7):461–472. doi: 10.1136/bjo.54.7.461. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Kiel J. W., van Heuven W. A. Ocular perfusion pressure and choroidal blood flow in the rabbit. Invest Ophthalmol Vis Sci. 1995 Mar;36(3):579–585. [PubMed] [Google Scholar]
  8. Lieb W. E., Cohen S. M., Merton D. A., Shields J. A., Mitchell D. G., Goldberg B. B. Color Doppler imaging of the eye and orbit. Technique and normal vascular anatomy. Arch Ophthalmol. 1991 Apr;109(4):527–531. doi: 10.1001/archopht.1991.01080040095036. [DOI] [PubMed] [Google Scholar]
  9. Morgan J. E. Selective cell death in glaucoma: does it really occur? Br J Ophthalmol. 1994 Nov;78(11):875–880. doi: 10.1136/bjo.78.11.875. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Quigley H. A., Hohman R. M., Sanchez R., Addicks E. M. Optic nerve head blood flow in chronic experimental glaucoma. Arch Ophthalmol. 1985 Jul;103(7):956–962. doi: 10.1001/archopht.1985.01050070082035. [DOI] [PubMed] [Google Scholar]
  11. Riva C. E., Sinclair S. H., Grunwald J. E. Autoregulation of retinal circulation in response to decrease of perfusion pressure. Invest Ophthalmol Vis Sci. 1981 Jul;21(1 Pt 1):34–38. [PubMed] [Google Scholar]
  12. Schwartz B., Kern J. Age, increased ocular and blood pressures, and retinal and disc fluorescein angiogram. Arch Ophthalmol. 1980 Nov;98(11):1980–1986. doi: 10.1001/archopht.1980.01020040832007. [DOI] [PubMed] [Google Scholar]
  13. Sossi N., Anderson D. R. Effect of elevated intraocular pressure on blood flow. Occurrence in cat optic nerve head studied with iodoantipyrine I 125. Arch Ophthalmol. 1983 Jan;101(1):98–101. doi: 10.1001/archopht.1983.01040010100018. [DOI] [PubMed] [Google Scholar]
  14. Spencer J. A., Giussani D. A., Moore P. J., Hanson M. A. In vitro validation of Doppler indices using blood and water. J Ultrasound Med. 1991 Jun;10(6):305–308. doi: 10.7863/jum.1991.10.6.305. [DOI] [PubMed] [Google Scholar]
  15. Stroman G. A., Stewart W. C., Golnik K. C., Curé J. K., Olinger R. E. Magnetic resonance imaging in patients with low-tension glaucoma. Arch Ophthalmol. 1995 Feb;113(2):168–172. doi: 10.1001/archopht.1995.01100020050027. [DOI] [PubMed] [Google Scholar]
  16. Tielsch J. M., Katz J., Sommer A., Quigley H. A., Javitt J. C. Hypertension, perfusion pressure, and primary open-angle glaucoma. A population-based assessment. Arch Ophthalmol. 1995 Feb;113(2):216–221. doi: 10.1001/archopht.1995.01100020100038. [DOI] [PubMed] [Google Scholar]
  17. Trible J. R., Sergott R. C., Spaeth G. L., Wilson R. P., Katz L. J., Moster M. R., Schmidt C. M. Trabeculectomy is associated with retrobulbar hemodynamic changes. A color Doppler analysis. Ophthalmology. 1994 Feb;101(2):340–351. doi: 10.1016/s0161-6420(13)31332-3. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES