Pulsatility of parafoveal capillary leukocytes

The use of adaptive optics (AO) in a confocal scanning laser ophthalmoscope (AOSLO) allows for long-term imaging of parafoveal capillary leukocyte movement and measurement of leukocyte velocity without contrast dyes. We applied the AOSLO to investigate the possible role of the cardiac cycle on capillary leukocyte velocity by directly measuring capillary leukocyte pulsatility. The parafoveal regions of 8 eight normal healthy subjects with clear ocular media were imaged with an AOSLO. All subjects were dilated and cyclopleged. The AOSLO field of view was either 1.4x1.5 degrees or 2.35x2.5 degrees, the imaging wavelength was 532 nm and the frame rate was 30fps. A photoplethysmograph was used to record the subject's pulse synchronously with each AOSLO video. Parafoveal capillary leukocyte velocities and pulsatility were determined for two or three capillaries per subject. Leukocyte velocity and pulsatility were determined for all eight subjects. The mean parafoveal capillary leukocyte velocity for all subjects was V(mean)=1.30 mm/s (SD=+/-0.40 mm/s). There was a statistically significant difference between leukocyte velocities, V(max) and V(min), over the pulse cycle for each subject (p<0.05). The mean pulsatility was P(mean)=0.45 (+/-0.09). Parafoveal capillary leukocyte pulsatility can be directly and non-invasively measured without the use of contrast dyes using an AOSLO. A substantial amount of the variation found in leukocyte velocity is due to the pulsatility that is induced by the cardiac cycle. By controlling for the variation in leukocyte velocity caused by the cardiac cycle, we can better detect other changes in retinal leukocyte velocity induced by disease or pharmaceutical agents.