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Can dynamic contour tonometry and ocular pulse amplitude help to detect severe cardiovascular pathologies?
T Bertelmann1, S Langanke1, M Potstawa2
1Department of Ophthalmology, Philipps-University of Marburg, Marburg, Germany.
Insights
Elevated ocular pulse amplitude may indicate severe cardiovascular disease, including arrhythmias and aortic aneurysms. This noninvasive measurement could serve as an affordable screening tool for cardiovascular pathology.
Area of Science:
- Ophthalmology
- Cardiology
- Medical Diagnostics
Background:
- Ocular pulse amplitude (OPA) is a measure of pulsatile ocular blood flow.
- Severe cardiovascular disease can impact ocular hemodynamics.
- The relationship between conspicuous OPA and underlying cardiovascular pathology requires further investigation.
Purpose of the Study:
- To investigate the association between conspicuous ocular pulse amplitude and severe underlying cardiovascular disease.
- To explore the potential of OPA as a noninvasive screening tool for cardiovascular conditions.
Main Methods:
- Case series involving glaucoma patients with conspicuous ocular pulse amplitude.
- Referral for specialized cardiovascular diagnostic procedures.
- Dynamic contour tonometry measurements to assess ocular pulse amplitude.
Main Results:
- Two patients diagnosed with tachyarrhythmia, one treated with cardioversion, the other scheduled for pacemaker implantation.
- A third patient with severe cardiovascular pathology and high OPA underwent surgery for an aortic aneurysm.
- Carotid stenosis was identified based on side differences in OPA.
Conclusions:
- Conspicuous ocular pulse amplitude is closely related to severe cardiovascular disease.
- OPA may serve as a noninvasive, affordable screening tool for detecting severe cardiovascular disease.
- Further prospective studies with larger cohorts are warranted to validate these findings.
Abstract:
We demonstrate the close relationship between a conspicuous ocular pulse amplitude and severe underlying cardiovascular disease. Two otherwise symptom-free glaucoma patients without any previously diagnosed underlying cardiovascular pathology but with a conspicuous ocular pulse amplitude and who underwent routine examinations in our glaucoma department were referred to the appropriate specialty for further diagnostic procedures. In both patients, the diagnosis of a tachyarrhythmia was made as suspected on dynamic contour tonometry measurements. In addition to medical treatment, one patient underwent electric cardioversion and the second patient was scheduled for pacemaker implantation. A third patient with an unexpected high ocular pulse amplitude despite severe cardiovascular pathology underwent major surgery due to an aortic aneurysm. Carotid stenosis was diagnosed due to side differences in ocular pulse amplitude as well. Ocular pulse amplitude might be a noninvasive and affordable screening tool and could be used to detect severe cardiovascular disease. A prospective study including a larger number of patients is needed to prove this hypothesis.
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