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Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 11/2014

01.11.2014 | Glaucoma

Investigation of blood flow regulation and oxygen saturation of the retinal vessels in primary open-angle glaucoma

verfasst von: L. Ramm, S. Jentsch, S. Peters, R. Augsten, M. Hammer

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 11/2014

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Abstract

Purpose

To examine the supply of oxygen to the retina in primary open-angle glaucoma (POAG).

Methods

Forty-one patients with primary open-angle glaucoma (mean age 64.1 ± 12.9 years) and 40 healthy subjects (63.6 ± 14.1 years) were included. Fundus images, centered at the optic disc, were taken using the Retinal Vessel Analyzer (RVA). The vessel diameters were calculated as central retinal artery (CRAE) and vein equivalent (CRVE) from diameter measurements in the peripapillary vessels. The oxygen saturation of the arteries and veins was investigated employing a two-wavelengths technique. After the measurement at baseline, the vascular response to flicker light exposure was measured.

Results

In glaucoma patients the mean oxygen saturation of the retinal veins at baseline was higher than in the healthy controls (64.36 ± 7.11 vs. 59.78 ± 8.47, p = 0.01), whereas the mean arteriovenous oxygen saturation difference was lower (33.07 ± 5.24 vs. 37.53 ± 6.95, p = 0.002). The arterial oxygen saturation as well as the arterial and venous diameters showed no difference between the groups. The increase of the CRVE during flicker light stimulation (3.72 ± 3.29 % vs. 5.43 ± 4.04, p = 0.039), as well as the change of the venous oxygen saturation (2.08 ± 3.74 % vs. 4.18 ± 3.88 %, p = 0.016) and the arteriovenous saturation difference (−2.1 ± 3.31 % vs. −4.43 ± 3.6 %, p = 0.003) were smaller in POAG patients than in the healthy group.

Conclusions

The reduction in the arteriovenous difference in oxygen saturation in POAG patients might show a decreased oxygen demand of the retina caused by the glaucomatous loss of neuroretinal tissue. The lower extent of the flicker light-induced change of the diameter of retinal veins and the venous oxygen saturation could indicate an impairment of blood flow regulation.
Literatur
6.
Zurück zum Zitat Nakahara T, Mori A, Kurauchi Y, Sakamoto K, Ishii K (2013) Neurovascular interactions in the retina: physiological and pathological roles. J Pharmacol Sci 123:79–84PubMedCrossRef Nakahara T, Mori A, Kurauchi Y, Sakamoto K, Ishii K (2013) Neurovascular interactions in the retina: physiological and pathological roles. J Pharmacol Sci 123:79–84PubMedCrossRef
8.
Zurück zum Zitat Garhöfer G, Zawinka C, Resch H, Huemer KH, Schmetterer L, Dorner GT (2004) Response of retinal vessel diameters to flicker stimulation in patients with early open angle glaucoma. J Glaucoma 13:340–344PubMedCrossRef Garhöfer G, Zawinka C, Resch H, Huemer KH, Schmetterer L, Dorner GT (2004) Response of retinal vessel diameters to flicker stimulation in patients with early open angle glaucoma. J Glaucoma 13:340–344PubMedCrossRef
9.
Zurück zum Zitat Gugleta K, Waldmann N, Polunina A, Kochkorov A, Katamay R, Flammer J, Orgul S (2013) Retinal neurovascular coupling in patients with glaucoma and ocular hypertension and its association with the level of glaucomatous damage. Graefes Arch Clin Exp Ophthalmol 251:1577–1585. doi:10.1007/s00417-013-2276-9 PubMedCrossRef Gugleta K, Waldmann N, Polunina A, Kochkorov A, Katamay R, Flammer J, Orgul S (2013) Retinal neurovascular coupling in patients with glaucoma and ocular hypertension and its association with the level of glaucomatous damage. Graefes Arch Clin Exp Ophthalmol 251:1577–1585. doi:10.​1007/​s00417-013-2276-9 PubMedCrossRef
11.
Zurück zum Zitat Hammer M, Vilser W, Riemer T, Liemt F, Jentsch S, Dawczynski J, Schweitzer D (2011) Retinal venous oxygen saturation increases by flicker light stimulation. Invest Ophthalmol Vis Sci 52:274–277PubMedCrossRef Hammer M, Vilser W, Riemer T, Liemt F, Jentsch S, Dawczynski J, Schweitzer D (2011) Retinal venous oxygen saturation increases by flicker light stimulation. Invest Ophthalmol Vis Sci 52:274–277PubMedCrossRef
12.
Zurück zum Zitat Riva CE, Grunwald JE, Sinclair SH, Petrig BL (1985) Blood velocity and volumetric flow rate in human retinal vessels. Invest Ophthalmol Vis Sci 26:1124–1132PubMed Riva CE, Grunwald JE, Sinclair SH, Petrig BL (1985) Blood velocity and volumetric flow rate in human retinal vessels. Invest Ophthalmol Vis Sci 26:1124–1132PubMed
13.
Zurück zum Zitat Hubbard LD, Brother RJ, King WN, Clegg LX, Klein R, Cooper LS, Sharrett AR, Davis MD, Cai J (1999) Method for the evaluation of retinal microvascular abnormalities associated with hytertension/sclerosis in the arteriocslerotic risc community study. Ophthalmology 106:2269–2280PubMedCrossRef Hubbard LD, Brother RJ, King WN, Clegg LX, Klein R, Cooper LS, Sharrett AR, Davis MD, Cai J (1999) Method for the evaluation of retinal microvascular abnormalities associated with hytertension/sclerosis in the arteriocslerotic risc community study. Ophthalmology 106:2269–2280PubMedCrossRef
14.
Zurück zum Zitat Parr JC, Spears GFS (1974) General caliber of the retinal arteries expressed as the equivalent width of the central retinal artery. Am J Ophthalmol 77:472–477PubMedCrossRef Parr JC, Spears GFS (1974) General caliber of the retinal arteries expressed as the equivalent width of the central retinal artery. Am J Ophthalmol 77:472–477PubMedCrossRef
15.
Zurück zum Zitat Knudtson MD, Lee KE, Hubbard LD, Wong TY, Klein R, Klein BEK (2003) Revised formulas for summarizing retinal vessel diameters. Curr Eye Res 27:143–149PubMedCrossRef Knudtson MD, Lee KE, Hubbard LD, Wong TY, Klein R, Klein BEK (2003) Revised formulas for summarizing retinal vessel diameters. Curr Eye Res 27:143–149PubMedCrossRef
16.
Zurück zum Zitat Hammer M, Vilser W, Riemer T, Schweitzer D (2008) Retinal vessel oximetry-calibration, compensation for vessel diameter and fundus pigmentation, and reproducibility. J Biomed Opt 13:054015PubMedCrossRef Hammer M, Vilser W, Riemer T, Schweitzer D (2008) Retinal vessel oximetry-calibration, compensation for vessel diameter and fundus pigmentation, and reproducibility. J Biomed Opt 13:054015PubMedCrossRef
17.
Zurück zum Zitat Beach JM, Schwenzer KJ, Srinivas S, Kim D, Tiedeman JS (1999) Oximetry of retinal vessels by dual-wavelength imaging: calibration and influence of pigmentation. J Appl Physiol 86:748–758PubMed Beach JM, Schwenzer KJ, Srinivas S, Kim D, Tiedeman JS (1999) Oximetry of retinal vessels by dual-wavelength imaging: calibration and influence of pigmentation. J Appl Physiol 86:748–758PubMed
18.
Zurück zum Zitat Köhler W, Schachtel G, Voleske P (2007) Biostatistik. Vierte Aufl. Springer, Berlin Köhler W, Schachtel G, Voleske P (2007) Biostatistik. Vierte Aufl. Springer, Berlin
19.
Zurück zum Zitat Gugleta K, Kochkorov A, Waldmann N, Polunina A, Katamay R, Flammer J, Orgul S (2012) Dynamics of retinal vessel response to flicker light in glaucoma patients and ocular hypertensives. Graefes Arch Clin Exp Ophthalmol 250:589–594. doi:10.1007/s00417-011-1842-2 PubMedCrossRef Gugleta K, Kochkorov A, Waldmann N, Polunina A, Katamay R, Flammer J, Orgul S (2012) Dynamics of retinal vessel response to flicker light in glaucoma patients and ocular hypertensives. Graefes Arch Clin Exp Ophthalmol 250:589–594. doi:10.​1007/​s00417-011-1842-2 PubMedCrossRef
20.
Zurück zum Zitat Costa VP, Harris A, Stefánsson E, Flammer J, Krieglstein GK, Orzalesi N, Heijl A, Renard JP, Serra LM (2003) The effects of antiglaucoma and systemic medications on ocular blood flow. Prog Retin Eye Res 22:769–805PubMedCrossRef Costa VP, Harris A, Stefánsson E, Flammer J, Krieglstein GK, Orzalesi N, Heijl A, Renard JP, Serra LM (2003) The effects of antiglaucoma and systemic medications on ocular blood flow. Prog Retin Eye Res 22:769–805PubMedCrossRef
21.
Zurück zum Zitat Siesky B, Harris A, Kagemann L, Stefansson E, McCranor L, Miller B, Bwatwa J, Regev G, Ehrlich R (2010) Ocular blood flow and oxygen delivery to the retina in primary open-angle glaucoma patients: the addition of dorzolamide to timolol monotherapy. Acta Ophthalmol 88:142–149. doi:10.1111/j.1755-3768.2009.01604.x PubMedCrossRef Siesky B, Harris A, Kagemann L, Stefansson E, McCranor L, Miller B, Bwatwa J, Regev G, Ehrlich R (2010) Ocular blood flow and oxygen delivery to the retina in primary open-angle glaucoma patients: the addition of dorzolamide to timolol monotherapy. Acta Ophthalmol 88:142–149. doi:10.​1111/​j.​1755-3768.​2009.​01604.​x PubMedCrossRef
22.
Zurück zum Zitat Jonas JB, Nguyen XN, Naumann GO (1989) Parapapillary retinal vessel diameter in normal and glaucoma eyes. I. Morphometric data. Invest Ophthalmol Vis Sci 30:1599–1603PubMed Jonas JB, Nguyen XN, Naumann GO (1989) Parapapillary retinal vessel diameter in normal and glaucoma eyes. I. Morphometric data. Invest Ophthalmol Vis Sci 30:1599–1603PubMed
24.
Zurück zum Zitat Leung H, Wang JJ, Rochtchina E, Tan AG, Wong TY, Klein R, Hubbard LD, Mitchell P (2003) Relationships between age, blood pressure, and retinal vessel diameters in an older population. Invest Ophthalmol Vis Sci 44:2900–2904PubMedCrossRef Leung H, Wang JJ, Rochtchina E, Tan AG, Wong TY, Klein R, Hubbard LD, Mitchell P (2003) Relationships between age, blood pressure, and retinal vessel diameters in an older population. Invest Ophthalmol Vis Sci 44:2900–2904PubMedCrossRef
26.
Zurück zum Zitat Geirsdottir A, Palsson O, Hardarson SH, Olafsdottir OB, Kristjansdottir JV, Stefánsson E (2012) Retinal vessel oxygen saturation in healthy individuals. Invest Ophthalmol Vis Sci 53:5433–5442PubMedCrossRef Geirsdottir A, Palsson O, Hardarson SH, Olafsdottir OB, Kristjansdottir JV, Stefánsson E (2012) Retinal vessel oxygen saturation in healthy individuals. Invest Ophthalmol Vis Sci 53:5433–5442PubMedCrossRef
28.
Zurück zum Zitat Hammer M, Vilser W, Riemer T, Schweitzer D (2008) Retinal vessel oximetry-calibration, compensation for vessel diameter and fundus pigmentation, and reproducibility. J Biomed Opt 13(5):054015. doi:10.1117/1.2976032, 1–7PubMedCrossRef Hammer M, Vilser W, Riemer T, Schweitzer D (2008) Retinal vessel oximetry-calibration, compensation for vessel diameter and fundus pigmentation, and reproducibility. J Biomed Opt 13(5):054015. doi:10.​1117/​1.​2976032, 1–7PubMedCrossRef
30.
Zurück zum Zitat Lang F, Lang P (2007) Basiswissen Physiologie. Zweite Aufl. Springer Medizin Verlag, Heidelberg Lang F, Lang P (2007) Basiswissen Physiologie. Zweite Aufl. Springer Medizin Verlag, Heidelberg
32.
Zurück zum Zitat Vandewalle E, Abegão Pinto L, Olafsdottir OB, De Clerck E, Stalmans P, Van Calster J, Zeyen T, Stefánsson E, Stalmans I (2013) Oximetry in glaucoma: correlation of metabolic change with structural and functional damage. Acta Ophthalmol. doi:10.1111/aos.12011 Vandewalle E, Abegão Pinto L, Olafsdottir OB, De Clerck E, Stalmans P, Van Calster J, Zeyen T, Stefánsson E, Stalmans I (2013) Oximetry in glaucoma: correlation of metabolic change with structural and functional damage. Acta Ophthalmol. doi:10.​1111/​aos.​12011
33.
Zurück zum Zitat Werne A, Harris A, Moore D, BenZion I, Siesky B (2008) The circadian variations in systemic blood pressure, ocular perfusion pressure, and ocular blood flow: risk factors for glaucoma? Surv Ophthalmol 53:559–567PubMedCrossRef Werne A, Harris A, Moore D, BenZion I, Siesky B (2008) The circadian variations in systemic blood pressure, ocular perfusion pressure, and ocular blood flow: risk factors for glaucoma? Surv Ophthalmol 53:559–567PubMedCrossRef
34.
Zurück zum Zitat Wong TY, Klein R, Klein BEK, Meuer SM, Hubbard LD (2003) Retinal vessel diameters and their associations with age and blood pressure. Invest Ophthalmol Vis Sci 44:4644–4650PubMedCrossRef Wong TY, Klein R, Klein BEK, Meuer SM, Hubbard LD (2003) Retinal vessel diameters and their associations with age and blood pressure. Invest Ophthalmol Vis Sci 44:4644–4650PubMedCrossRef
35.
Zurück zum Zitat Nagel E, Vilser W, Lanzl I (2004) Age, blood pressure, and vessel diameter as factors influencing the arterial retinal flicker response. Invest Ophthalmol Vis Sci 45:1486–1492PubMedCrossRef Nagel E, Vilser W, Lanzl I (2004) Age, blood pressure, and vessel diameter as factors influencing the arterial retinal flicker response. Invest Ophthalmol Vis Sci 45:1486–1492PubMedCrossRef
37.
Zurück zum Zitat Traustason S, Hardarson SH, Gottfredsdottir MS, Eysteinsson T, Karlsson RA, Stefánsson E, Harris A (2009) Dorzolamide-timolol combination and retinal vessel oxygen saturation in patients with glaucoma or ocular hypertension. Br J Ophthalmol 93:1064–1067. doi:10.1136/bjo.2008.148460 PubMedCrossRef Traustason S, Hardarson SH, Gottfredsdottir MS, Eysteinsson T, Karlsson RA, Stefánsson E, Harris A (2009) Dorzolamide-timolol combination and retinal vessel oxygen saturation in patients with glaucoma or ocular hypertension. Br J Ophthalmol 93:1064–1067. doi:10.​1136/​bjo.​2008.​148460 PubMedCrossRef
38.
Zurück zum Zitat Wimpissinger B, Resch H, Berisha F, Weigert G, Schmetterer L, Polak K (2005) Response of retinal blood flow to systemic hyperoxia in smokers and nonsmokers. Graefes Arch Clin Exp Ophthalmol 243:646–652. doi:10.1007/s00417-004-1083-8 PubMedCrossRef Wimpissinger B, Resch H, Berisha F, Weigert G, Schmetterer L, Polak K (2005) Response of retinal blood flow to systemic hyperoxia in smokers and nonsmokers. Graefes Arch Clin Exp Ophthalmol 243:646–652. doi:10.​1007/​s00417-004-1083-8 PubMedCrossRef
39.
Zurück zum Zitat Polak K, Dorner G, Kiss B, Polska E, Findl O, Rainer G, Eichler HG, Schmetterer L (2000) Evaluation of the Zeiss retinal vessel analyser. Br J Ophthalmol 84:1285–1290PubMedCentralPubMedCrossRef Polak K, Dorner G, Kiss B, Polska E, Findl O, Rainer G, Eichler HG, Schmetterer L (2000) Evaluation of the Zeiss retinal vessel analyser. Br J Ophthalmol 84:1285–1290PubMedCentralPubMedCrossRef
40.
Zurück zum Zitat Nagel E, Münch K, Vilser W (2001) Durchmesserbestimmung von Netzhautgefäßabschnitten in digitalen Fundusfotografien–Eine klinische Studie zur Methodik und Reproduzierbarkeit. Klin Monatsbl Augenheilkd 218:616–620PubMedCrossRef Nagel E, Münch K, Vilser W (2001) Durchmesserbestimmung von Netzhautgefäßabschnitten in digitalen Fundusfotografien–Eine klinische Studie zur Methodik und Reproduzierbarkeit. Klin Monatsbl Augenheilkd 218:616–620PubMedCrossRef
41.
Zurück zum Zitat Hardarson SH, Basit S, Jonsdottir TE, Eysteinsson T, Halldorsson GH, Karlsson RA, Beach JM, Benediktsson JA, Stefansson E (2009) Oxygen saturation in human retinal vessels is higher in dark than in light. Invest Ophthalmol Vis Sci 50:2308–2311. doi:10.1167/iovs.08-2576 PubMedCrossRef Hardarson SH, Basit S, Jonsdottir TE, Eysteinsson T, Halldorsson GH, Karlsson RA, Beach JM, Benediktsson JA, Stefansson E (2009) Oxygen saturation in human retinal vessels is higher in dark than in light. Invest Ophthalmol Vis Sci 50:2308–2311. doi:10.​1167/​iovs.​08-2576 PubMedCrossRef
Metadaten
Titel
Investigation of blood flow regulation and oxygen saturation of the retinal vessels in primary open-angle glaucoma
verfasst von
L. Ramm
S. Jentsch
S. Peters
R. Augsten
M. Hammer
Publikationsdatum
01.11.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 11/2014
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-014-2766-4

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