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Retinal hemodynamics during increased intraocular pressure

K Schulte1, S Wolf, O Arend

  • 1Augenklinik der Medizinischen Fakultät der RWTH Aachen, Germany.

German Journal of Ophthalmology
|January 1, 1996
PubMed
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Even healthy individuals show impaired retinal autoregulation with elevated intraocular pressure (IOP). This suggests that IOP levels of 30 mmHg or higher may harm retinal perfusion, impacting glaucoma patients.

Area of Science:

  • Ophthalmology
  • Physiology
  • Medical Research

Background:

  • The exact cause of primary chronic open-angle glaucoma (POAG) is unknown.
  • POAG may involve insufficient retinal hemodynamic autoregulation and poor retinal perfusion.
  • Visual field loss in POAG might be linked to compromised retinal blood flow.

Purpose of the Study:

  • To assess the ability of retinal autoregulation to maintain constant retinal circulation during a sudden increase in intraocular pressure (IOP).

Main Methods:

  • 22 healthy subjects were studied.
  • Retinal hemodynamics were measured using digital video fluorescein angiograms with a scanning laser ophthalmoscope.
  • Intraocular pressure was increased using suction cups to 33.8 +/- 3.4 mmHg from a baseline of 13.8 +/- 1.5 mmHg.

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  • Arm-retina time (ART) and arteriovenous passage time (AVP) were evaluated.

    • Main Results:

    • Elevated IOP significantly increased ART from 9.4 +/- 1.8 s to 11.8 +/- 2.2 s (P < 0.05).
    • Elevated IOP significantly prolonged AVP from 1.6 +/- 0.4 s to 3.0 +/- 0.8 s (P < 0.01).
    • These changes indicate insufficient retinal autoregulation even in healthy individuals.

    Conclusions:

    • An acute rise in IOP to 33.8 mmHg impairs retinal hemodynamics in healthy subjects.
    • IOP values of 30 mmHg or higher may negatively affect retinal perfusion.
    • This finding is relevant for understanding POAG, where retinal perfusion may already be compromised.