Zusammenfassung
Hintergrund: Der Retinal Vessel Analyzer (RVA) stellt ein neues Online-Messsystem für retinale
Gefäßdurchmesser dar. Ziel dieser Arbeit war es, die Reproduzierbarkeit der mit diesem
System ermittelbaren Werte zu evaluieren und die für den Erhalt von optimalen Resultaten
notwendigen Messbedingungen zu beschreiben. Methode: Bei 20 gesunden Probanden (M : F = 11 : 9; Durchschnittsalter: 33 ± 12 Jahre) wurden
die Durchmesser von retinalen Arterien und Venen mittels RVA bestimmt. Die Messung
wurde nach 2 Stunden und nach 2 Wochen wiederholt, und die erhaltenen Ergebnisse miteinander
verglichen. Ergebnisse: In Bezug auf die retinalen Arterien- bzw. Venendurchmesser war kein signifikanter
Unterschied zwischen den einzelnen Messzeitpunkten nachweisbar. Die Kurzzeitvariabilität
für Arteriendurchmesser betrug 1 %, der Intraklassen-Korrelationskoeffizient κ lag
bei 0,96. Die Langzeitvariabilität betrug 1,8 %, κ erhöhte sich auf 0,98. Bei den
Venendurchmessern ergab sich eine Kurzzeitvariabilität von 1 %, κ betrug 0,97. Die
Langzeitvariabilität betrug 1,5 %, κ erhöhte sich auf 0,98. Schlussfolgerung: Aufgrund der hohen Reproduzierbarkeit der Messwerte stellt das RVA-System eine geeignete
Methode zur retinalen Gefäßanalyse dar.
Abstract
Backgound: To evaluate the reproducibility of measurements with the Retinal Vessel Analyzer
(RVA) in healthy subjects and to describe which measuring conditions should be guaranteed
to obtain optimal results. Methods: The diameter of retinal arteries and veins of 20 healthy subjects (M : F = 11 : 9;
mean age: 33 ± 12 years) were measured with the RVA at baseline, after 2 hours, and
after 2 weeks. Results: No statistically significant differences in the diameter of retinal arteries and
veins between the single measurements were present. Short-term variability of arterial
diameter was 1 %, and the intraclass correlation coefficient κ was 0.96. Long-term
variability was 1.8 %, κ was 0.98. In retinal veins, a short-term variability of 1
% was calculated, with a κ of 0.97. Long-term variability was 1.5 %, with a κ of 0.98.
Conclusion: Due to the high reproducibility of its measurements, the RVA appears to be a useful
device for both analysis and follow-up of retinal vessel diameters.
Schlüsselwörter
Retinal Vessel Analyzer - Reproduzierbarkeit - Messbedingungen
Key words
Retinal Vessel Analyzer - reproducibility - measuring conditions
Literatur
- 1
Delori F C, Fitch K A, Feke G T, Deupree D M, Weiter J J.
Evaluation of micrometric and microdensitometric methods for measuring the width of
retinal vessel images on fundus photographs.
Graefes Arch Clin Exp Ophthalmol.
1988;
226
393-399
- 2
Rassam S M, Patel V, Brinchmann-Hansen O, Engvold O, Kohner E M.
Accurate vessel width measurement from fundus photographs: a new concept.
Br J Ophthalmol.
1994;
78
24-29
- 3
Suzuki Y.
Direct measurement of retinal vessel diameter: comparison with microdensitometric
methods based on fundus photographs.
Surv Ophthalmol.
1995;
39 (Suppl 1)
S57-65
- 4
Stanton A V, Mullaney P, Mee F, O'Brien E T, O'MalIey K.
A method of quantifying retinal microvascular alterations associated with blood pressure
and age.
J Hypertens.
1995;
13
41-48
- 5
Dumskyj M J, Aldington S J, Dore C J, Kohner E M.
The accurate assessment of changes in retinal vessel diameter using multiple frame
electrocardiograph synchronised fundus photography.
Curr Eye Res.
1996;
15
625-632
- 6
Blum M, Bachmann K, Wintzer D, Riemer T, Vilser W, Strobel J.
Noninvasive measurement of the Bayliss effect in retinal autoregulation.
Graefes Arch Clin Exp Ophthalmol.
1999;
237
296-300
- 7
Nagel E, Vilser D, Fuhrmann G, Vilser W, Lang G E.
Dilatation of large retinal vessels after increased intraocular pressure.
Ophthalmologe.
2000;
97
742-747
- 8
Lanzl I M, Witta B, Kotliar K, Vilser W.
Retinal vessel reaction to 100 % O2-breathing-functional imaging using the retinal vessel analyzer with 10 volunteers.
Klin Monatsbl Augenheilkd.
2000;
217
231-235
- 9
Blum M, Scherf C, Bachmann K, Strobel J.
Age-related contractility of retinal arterioles during pure oxygen breathing.
Ophthalmologe.
2001;
98
265-268
- 10
Blum M, Bachmann K, Strobel J.
Age-correlation of blood pressure induced myogenic autoregulation of human retinal
arterioles in 40 volunteers.
Klin Monatsbl Augenheilkd.
2000;
217
225-230
- 11
Blum M, Kubetschka U, Hunger-Dathe W, Bachmann K, Muller U A, Strobel J.
Autoregulation of retinal arterioles in patients with diabetes mellitus and normal
probands.
Klin Monatsbl Augenheilkd.
2000;
216
40-44
- 12
Jandrasits K, Polak K, Luksch A. et al .
Effects of atropine and propranolol on retinal vessel diameters during isometric exercise.
Ophthalmic Res.
2001;
33
185-190
- 13
Fleiss J L.
Measuring agreement between two judges on the presence or absence of a trait.
Biometrics.
1975;
31
651-659
- 14
Kramer M S, Feinstein A R.
Clinical biostatistics. LIV. The biostatistics of concordance.
Clin Pharmacol Ther.
1981;
29
111-123
- 15
Vilser W, Riemer T, Münch K, Strobl J.
Automatic online measurement of retinal vessel diameters.
Invest Ophthalmol Vis Sci.
1996;
37 (Suppl)
226
- 16
Polak K, Dorner G, Kiss B. et al .
Evaluation of the zeiss retinal vessel analyser.
Br J Ophthalmol.
2000;
84
1285-1290
- 17
Pietscher S, Vilser W, Bachmann K. et al .
The circadian relations between online-measured diameter of retinal vessel and blood
pressure.
Invest Ophthalmol Vis Sci.
1997;
38
4889
- 18
Lanzl I M, Kotliar K E, Vilser W.
Can a single drop of phenylephrine 10 % influence retinal vein diameter?.
Invest Ophthalmol Vis Sci.
2001;
42, (Suppl S)
474
- 19
Tobis M F, Lang G E, Vilser W, Tobis K, Lang G K.
Retinal vessel diameters and their reaction to Iight provocation in patients with
retinal vein occlusion.
Invest Ophthalmol Vis Sci.
1999;
40
3737
- 20
Garhofer G, Schmetterer L, Riva C E.
Strong constant light induces a decrease in the diameter of retinal vessels in light
adapted healthy subjects.
Invest Ophthalmol Vis Sci.
2001;
42, Suppl S
482
- 21
Brauer-Burchardt C, Vilser W, Munch K.
Local dependence and variation of retinal branch vessel diameter in normal subjects.
Invest Ophthalmol Vis Sci.
1997;
38
4890
- 22
Pache M, Meyer P, Prünte C, Orgül S, Nuttli I, Flammer J.
Sildenafil induces retinal vasodilatation in healthy subjects.
Br J Ophthalmol.
2002;
86
156-158
Prof. Josef Flammer
Universitäts-Augenklinik Basel
Mittlere Straße 91
4012 Basel · Schweiz
Email: Josef.Flammer@unibas.ch