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Klin Monbl Augenheilkd 2020; 237(04): 469-473
DOI: 10.1055/a-1024-3277
Klinische Studie
Georg Thieme Verlag KG Stuttgart · New York

Analysis of Retinal Vessel Pulsation with Electrographic Gating – Pulsation Amplitude and the Influence of Hyperoxia

Analyse der Gefäßpulsationen in der Netzhaut mittels EKG-Verankerung – Pulsationsamplitude und Effekte der Hyperoxie
Yasemin Saruhan
Augenklinik, Augenklinik des Universitätsspitals Basel, Basel, Switzerland
,
Olivia Bollinger
Augenklinik, Augenklinik des Universitätsspitals Basel, Basel, Switzerland
,
Konstantin Gugleta
Augenklinik, Augenklinik des Universitätsspitals Basel, Basel, Switzerland
› Author Affiliations
Further Information

Publication History

received 23 August 2019

accepted 02 October 2019

Publication Date:
22 January 2020 (online)

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Abstract

Purpose To analyse the amplitude of vessel pulsation in the retina and to determine whether constriction of the vessels by oxygen would decrease their pulsation amplitude and could thus be used to quantify the rigidity of the retinal vessels.

Patients and Methods The study included 20 healthy young subjects. With the RVA (retinal vessel analyser), we aimed to quantify vessel pulsations under normal and hyperoxic conditions. Electrocardiographic (ECG)-gated RVA was used for this purpose, with change in vessel pulsation as the primary endpoint and shift in vessel pulsation during the heart cycle as the secondary endpoint. Furthermore, we assessed the correlation between the amplitude of retinal vessel wall pulsation and blood pressure. Descriptive statistics, paired t-tests, and correlation analysis were applied.

Results Retinal veins in proximity to the optic disc demonstrated the highest pulsation amplitude under all conditions. All retinal vessels significantly constricted under hyperoxic conditions. There was no significant change in the amplitude of vessel pulsation nor a significant shift in the pulsation cycle under hyperoxic conditions in the examined cohort. No correlation was found between systemic blood pressure parameters and amplitude of retinal vessel wall pulsation or any change in this.

Conclusion ECG-gated RVA recording is not able to detect any relevant change in vessel pulsation behaviour under oxygen, despite clearly observed vasoconstriction in retinal vessels. New approaches are necessary to reliably quantify the rigidity of the retinal vessels.

Zusammenfassung

Hintergrund Analyse der Gefäßpulsationen in der Netzhaut und des Einflusses der Hyperoxie darauf.

Methoden und Patienten Bei 20 jungen gesunden Probanden wurde eine Untersuchung mit RVA (Retinal Vessel Analyzer) mit EKG-Verankerung unter nativen Bedingungen und beim Atmen des 100 %igen Sauerstoffs durchgeführt. Der primäre analysierte Parameter war die Pulsationsamplitude, der sekundäre deren allfällige Verschiebung während des Herzzyklus als Folge der hyperoxiebedingten Vasokonstriktion. Es wurde ebenfalls die Korrelation zwischen der Pulsamplitude in retinalen Gefäßen und den Pulsamplituden des Blutdrucks ermittelt. Deskriptive Statistik, t-Test und Korrelationstests wurden angewendet.

Ergebnisse Die höchsten Pulsamplituden wurden in den Netzhautvenen in der Nähe der Papille beobachtet. Alle retinalen Gefäße wiesen eine statistisch signifikante Vasokonstriktion unter Beatmung mit 100 %igem Sauerstoff auf, es wurde jedoch weder die Pulsamplitudenänderung noch ein zeitliches Verschieben der Pulsationen in den retinalen Gefäßen während der Hyperoxie beobachtet; es wurde ebenfalls keine Korrelation zwischen den Gefäß- und Blutdruckpulsamplituden gesehen.

Schlussfolgerung Die RVA-Analyse der Gefäßpulsationen mithilfe der EKG-Verankerung konnte keine relevante Veränderung des Pulsationsverhaltens der retinalen Gefäße unter Hyperoxiebedingungen feststellen, obwohl alle Gefäße eine Vasokonstriktion gezeigt haben. Somit eignet sich diese Methode in der aktuellen Form nicht für eine Einschätzung der Gefäßsteifigkeit in der Mikrozirkulation.

Key words

glaucoma - retina - retinal vessel rigidity - vessel pulsation amplitude

Schlüsselwörter

Glaukom - Retinagefäßsteifigkeit - Gefäßpulsationsamplitude - Retina
 

  • References

  • 1 Safar ME, Levy BI, Struijker-Boudier H. Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation 2003; 107: 2864-2869
    CrossrefPubMedGoogle Scholar
  • 2 Boutouyrie P, Tropeano AI, Asmar R. et al. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension 2002; 39: 10-15
    CrossrefPubMedGoogle Scholar
  • 3 Walsh JB. Hypertensive retinopathy. Ophthalmology 1982; 89: 1127-1131
    CrossrefPubMedGoogle Scholar
  • 4 Nichols WW, OʼRourke MF, Avolio AP. et al. Effects of age on ventricular-vascular coupling. Am J Cardiol 1985; 55: 1179-1184
    CrossrefPubMedGoogle Scholar
  • 5 Laurent S, Boutouyrie P, Asmar R. et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001; 37: 1236-1241
    CrossrefPubMedGoogle Scholar
  • 6 Laurent S, Katsahian S, Fassot C. et al. Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke 2003; 34: 1203-1206
    CrossrefPubMedGoogle Scholar
  • 7 Nakazato K, Watanabe H, Kawana K. et al. Evaluation of arterial stiffness in patients with branch retinal vein occlusion. Ophthalmologica 2005; 219: 334-337
    CrossrefPubMedGoogle Scholar
  • 8 Flammer J, Pache M, Resink T. Vasospasm, its role in the pathogenesis of diseases with particular reference to the eye. Prog Retin Eye Res 2001; 20: 319-349
    CrossrefPubMedGoogle Scholar
  • 9 Gugleta K, Kochkorov A, Katamay R. et al. On pulse-wave propagation in the ocular circulation. Invest Ophthalmol Vis Sci 2006; 47: 4019-4025
    CrossrefPubMedGoogle Scholar
  • 10 Kochkorov A, Gugleta K, Kavroulaki D. et al. Rigidity of retinal vessels in patients with multiple sclerosis. Klin Monatsbl Augenheilkd 2009; 226: 276-279
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Oettli A, Gugleta K, Kochkorov A. et al. Rigidity of retinal vessel in untreated eyes of normal tension primary open-angle glaucoma patients. J Glaucoma 2011; 20: 303-306
    CrossrefPubMedGoogle Scholar
  • 12 Levine DN, Bebie H. Phase and amplitude of spontaneous retinal vein pulsations: An extended constant inflow and variable outflow model. Microvasc Res 2016; 106: 67-79
    CrossrefPubMedGoogle Scholar
  • 13 Seifertl BU, Vilser W. Retinal Vessel Analyzer (RVA) – design and function. Biomed Tech (Berl) 2002; 47 (Suppl. 12) 678-681
    CrossrefPubMedGoogle Scholar
  • 14 Vilser W, Nagel E, Lanzl I. Retinal Vessel Analysis – new possibilities. Biomed Tech (Berl) 2002; 47 (Suppl. 12) 682-685
    CrossrefPubMedGoogle Scholar
  • 15 Ghanem M, Gugleta K, Oettli A. et al. [Analysis of retinal vein motion in glaucoma patients]. Klin Monatsbl Augenheilkd 2013; 230: 358-362
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Lanzl IM, Witta B, Kotliar K. et al. [Retinal vessel reaction to 100 % O2-breathing–functional imaging using the retinal vessel analyzer with 10 volunteers]. Klin Monatsbl Augenheilkd 2000; 217: 231-235
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Jean-Louis S, Lovasik JV, Kergoat H. Systemic hyperoxia and retinal vasomotor responses. Invest Ophthalmol Vis Sci 2005; 46: 1714-1720
    CrossrefPubMedGoogle Scholar
  • 18 Golzan SM, Morgan WH, Georgevsky D. et al. Correlation of Retinal Nerve Fibre Layer Thickness and Spontaneous Retinal Venous Pulsations in Glaucoma and Normal Controls. PLoS One 2015; 10: e0128433
    CrossrefPubMedGoogle Scholar