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Retinal microvascular density modifications during the water drinking test.

Gustavo Rosa Gameiro¹, Giovana Rosa Gameiro^2,3, Michel Eid Farah¹

¹Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo - EPM/UNIFESP, São Paulo, São Paulo, Brazil.

European Journal of Ophthalmology

|June 17, 2021

Summary

The water drinking test (WDT) temporarily increases intraocular pressure (IOP) and affects heart rate (HR) in healthy young adults. It also causes transient changes in the deep retinal vascular plexus, suggesting a link between systemic stress and ocular microcirculation.

Keywords:

Anatomy/biochemistry/physiology diagnostic techniques glaucoma ocular blood flow retina techniques of retinal examination

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Area of Science:

Ophthalmology
Cardiology
Physiology

Background:

The water drinking test (WDT) is a standard method for evaluating intraocular pressure (IOP) response.
Elevated IOP is a risk factor for glaucoma progression.
Understanding ocular microvascular changes during WDT can provide insights into glaucoma pathophysiology.

Purpose of the Study:

To investigate the correlation between changes in the retinal microvascular plexus and the WDT in young, healthy individuals.
To assess the impact of WDT on intraocular pressure, heart rate, and retinal vessel density.

Main Methods:

20 healthy young subjects underwent a WDT protocol involving rapid water ingestion.
Intraocular pressure (IOP), mean arterial pressure (MAP), and heart rate (HR) were measured.
Retinal vessel density of the superficial and deep macular layers was assessed using optical coherence tomography angiography (OCTA) before and after WDT.
OCTA images were analyzed using fractal analysis (box counting).

Main Results:

WDT significantly increased IOP at 30 minutes post-ingestion (18.38 ± 4.53 mmHg) compared to baseline (15.63 ± 3.37 mmHg).
Heart rate (HR) decreased significantly at 15 minutes post-ingestion (64.95 ± 11.37 bpm) compared to baseline (75.74 ± 12.23 bpm).
A significant decrease in deep retinal vessel density was observed at 15 minutes post-ingestion (p=0.040).

Conclusions:

The WDT induces temporary modifications in the deep retinal vascular plexus in healthy young subjects.
These findings suggest a potential link between systemic physiological responses to WDT and ocular microvascular alterations.
Further research may explore the clinical implications of these microvascular changes in glaucoma assessment.