Impact of systemic blood pressure on the relationship between intraocular pressure and blood flow in the optic nerve head of nonhuman primates.

PURPOSE Studies suggest that reduced ocular perfusion pressure in the optic nerve head (ONH) increases the risk of glaucoma. This study tested a hypothesis that the magnitude of blood flow change in the ONH induced between two same intraocular pressure (IOP) alterations depends on the level of mean systemic blood pressure (BP). METHODS In eight anesthetized rhesus monkeys, systemic BP was maintained at either a high, medium, or low level (n = 6 each, ranging from 51-113 mm Hg); IOP was rapidly altered from 10 to 30 mm Hg and then to 10 mm Hg manometrically. Blood flow in the ONH (BF(ONH)) was repeatedly measured with a laser speckle flow graph for 10 minutes at each IOP level period. The BF(ONH) and relative changes to the baselines at each measured time point were calculated and compared longitudinally among the three BP groups. RESULTS There was no statistically significant difference in mean baseline BF(ONH) across the BP groups. In the high-BP group, BF(ONH) had no significant change during the IOP alterations. However, the same IOP alterations caused a significant BF(ONH) change in the two lower BP groups. The duration of the BF(ONH) changes from baseline to a peak and to a steady state was significantly delayed in the two lower, but not the higher, BP groups. CONCLUSIONS Systemic BP plays an important role in maintaining the normal autoregulation of the ONH, and it became deficient in the lower BP groups. In patients with glaucoma, a normal, sustained BP may be important to prevent worsening glaucoma.

[1]  J. A. Stewart,et al.  Intraocular pressure reduction in normal-tension glaucoma patients in South Korea , 2011, International Ophthalmology.

[2]  P. Tsay,et al.  Glaucoma is associated with peripheral vascular endothelial dysfunction. , 2008, Ophthalmology.

[3]  Lin Wang,et al.  Retinal and choroidal vasoreactivity to altered PaCO2 in rat measured with a modified microsphere technique. , 2008, Experimental eye research.

[4]  L. Pasquale,et al.  Retinal blood flow response to posture change in glaucoma patients compared with healthy subjects. , 2008, Ophthalmology.

[5]  M. C. Leske,et al.  Risk factors for incident open-angle glaucoma: the Barbados Eye Studies. , 2008, Ophthalmology.

[6]  M. C. Leske,et al.  Predictors of long-term progression in the early manifest glaucoma trial. , 2007, Ophthalmology.

[7]  Josef Flammer,et al.  What is the link between vascular dysregulation and glaucoma? , 2007, Survey of ophthalmology.

[8]  S. Orgül Blood flow in glaucoma , 2006, British Journal of Ophthalmology.

[9]  Jaewan Choi,et al.  Circadian fluctuation of mean ocular perfusion pressure is a consistent risk factor for normal-tension glaucoma. , 2007, Investigative ophthalmology & visual science.

[10]  M. C. Leske,et al.  Nine-year changes in intraocular pressure: the Barbados Eye Studies. , 2006, Archives of ophthalmology.

[11]  D. Henrion Pressure and flow-dependent tone in resistance arteries. Role of myogenic tone. , 2005, Archives des maladies du coeur et des vaisseaux.

[12]  Morten la Cour,et al.  Optic nerve oxygenation , 2005, Progress in Retinal and Eye Research.

[13]  L. Schmetterer,et al.  Short-term increase of intraocular pressure does not alter the response of retinal and optic nerve head blood flow to flicker stimulation. , 2005, Investigative ophthalmology & visual science.

[14]  M. Araie,et al.  Time course of changes in optic nerve head circulation after acute reduction in intraocular pressure. , 2005, Investigative ophthalmology & visual science.

[15]  G. Holló,et al.  Carotid Artery Elasticity and Baroreflex Sensitivity in Patients With Glaucoma , 2005, Journal of glaucoma.

[16]  C. Pournaras,et al.  Regulation of Optic Nerve Head Blood flow in Normal Tension Glaucoma Patients , 2004, European journal of ophthalmology.

[17]  J. Wilensky The role of diurnal pressure measurements in the management of open angle glaucoma , 2004, Current opinion in ophthalmology.

[18]  Leopold Schmetterer,et al.  Ocular blood flow and systemic blood pressure in patients with primary open-angle glaucoma and ocular hypertension. , 2004, Investigative ophthalmology & visual science.

[19]  Charles E. Riva,et al.  Autoregulation of human optic nerve head blood flow in response to acute changes in ocular perfusion pressure , 1997, Graefe's Archive for Clinical and Experimental Ophthalmology.

[20]  J. Flammer,et al.  Systemic blood pressure in glaucoma patients , 1993, Graefe's Archive for Clinical and Experimental Ophthalmology.

[21]  K. Kashiwagi,et al.  Association between Nocturnal Blood Pressure Reduction and Progression of Visual Field Defect in Patients with Primary Open-Angle Glaucoma or Normal-Tension Glaucoma , 2004, Japanese Journal of Ophthalmology.

[22]  M. Araie,et al.  Time course of the change in optic nerve head circulation after an acute increase in intraocular pressure. , 2003, Investigative ophthalmology & visual science.

[23]  Motohiro Shirakashi,et al.  Relationship between optic nerve head microcirculation and visual field loss in glaucoma. , 2003, Acta ophthalmologica Scandinavica.

[24]  R. Hughson,et al.  A new two-breath technique for extracting the cerebrovascular response to arterial carbon dioxide. , 2003, American journal of physiology. Regulatory, integrative and comparative physiology.

[25]  S. Wu,et al.  Adler's Physiology of the Eye , 2002 .

[26]  Hitoshi Fujii,et al.  New Laser Speckle Flowgraphy System Using CCD Camera , 2002 .

[27]  Lorri A. Lee,et al.  Cerebral blood flow and vascular physiology. , 2002, Anesthesiology clinics of North America.

[28]  T. Sugiyama,et al.  Long-term effect of topically applied isopropyl unoprostone on microcirculation in the human ocular fundus. , 2002, Japanese journal of ophthalmology.

[29]  M. Araie,et al.  Effect of topical unoprostone on circulation of human optic nerve head and retina. , 2001, Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics.

[30]  G. Cull,et al.  Depth of penetration of scanning laser Doppler flowmetry in the primate optic nerve. , 2001, Archives of ophthalmology.

[31]  J. H. Liu Diurnal measurement of intraocular pressure. , 2001, Journal of glaucoma.

[32]  S. Hayreh Blood Flow in the Optic Nerve Head and Factors that may Influence it , 2001, Progress in Retinal and Eye Research.

[33]  R. Sladen,et al.  Renal blood flow regulation, autoregulation, and vasomotor nephropathy. , 2000, Anesthesiology clinics of North America.

[34]  M. Shirakashi,et al.  Measurement of microcirculation in the optic nerve head by laser speckle flowgraphy and scanning laser Doppler flowmetry. , 2000, American journal of ophthalmology.

[35]  S. Asrani,et al.  Large Diurnal Fluctuations in Intraocular Pressure Are an Independent Risk Factor in Patients With Glaucoma , 2000, Journal of glaucoma.

[36]  T. Sugiyama,et al.  Experimental optic cup enlargement caused by endothelin-1-induced chronic optic nerve head ischemia. , 1999, Survey of ophthalmology.

[37]  D. R. Anderson,et al.  Introductory comments on blood flow autoregulation in the optic nerve head and vascular risk factors in glaucoma. , 1999, Survey of ophthalmology.

[38]  J Flammer,et al.  Vascular dysregulation: a principal risk factor for glaucomatous damage? , 1999, Journal of glaucoma.

[39]  L. Kagemann,et al.  Vascular aspects in the pathophysiology of glaucomatous optic neuropathy. , 1999, Survey of ophthalmology.

[40]  M. Mulvany,et al.  The myogenic response: established facts and attractive hypotheses. , 1999, Clinical science.

[41]  B. Petrig,et al.  Blood flow in the human optic nerve head during isometric exercise. , 1998, Experimental eye research.

[42]  Cioffi Ga Three assumptions: ocular blood flow and glaucoma. , 1998 .

[43]  G. Cioffi Three assumptions: ocular blood flow and glaucoma. , 1998, Journal of glaucoma.

[44]  B. Petrig,et al.  Effect of acute decreases of perfusion pressure on choroidal blood flow in humans. , 1997, Investigative ophthalmology & visual science.

[45]  W. Feuer,et al.  Autoregulation of human optic nerve head circulation in response to increased intraocular pressure. , 1997, Experimental eye research.

[46]  B. Matta,et al.  Impaired cerebral autoregulation after mild brain injury. , 1997, Surgical neurology.

[47]  O Findl,et al.  Effects of changes in intraocular pressure on human ocular haemodynamics. , 1997, Current eye research.

[48]  M Araie,et al.  Real-time measurement of human optic nerve head and choroid circulation, using the laser speckle phenomenon. , 1997, Japanese journal of ophthalmology.

[49]  G. Michelson,et al.  Perfusion of the juxtapapillary retina and optic nerve head in acute ocular hypertension. , 1996, German journal of ophthalmology.

[50]  J. Meyer,et al.  Twenty four hour blood pressure monitoring in normal tension glaucoma. , 1996, The British journal of ophthalmology.

[51]  T. Barth,et al.  Detection of disturbed autoregulation of the peripapillary choroid in primary open angle glaucoma. , 1996, Ophthalmic surgery and lasers.

[52]  D. Heistad,et al.  RECENT INSIGHTS INTO THE REGULATION OF CEREBRAL CIRCULATION , 1996, Clinical and experimental pharmacology & physiology.

[53]  H. Fujii,et al.  Measurement of optic nerve head circulation: comparison of laser speckle and hydrogen clearance methods. , 1996, Japanese journal of ophthalmology.

[54]  B. Lz Impact of intraocular pressure on venous outflow from the globe: a hypothesis regarding IOP-dependent vascular damage in normal-tension and hypertensive glaucoma. , 1996 .

[55]  L. Bito Impact of intraocular pressure on venous outflow from the globe: a hypothesis regarding IOP-dependent vascular damage in normal-tension and hypertensive glaucoma. , 1996, Journal of glaucoma.

[56]  M. Araie,et al.  Non-contact, two-dimensional measurement of tissue circulation in choroid and optic nerve head using laser speckle phenomenon. , 1995, Experimental eye research.

[57]  S. Graham,et al.  Ambulatory blood pressure monitoring in glaucoma. The nocturnal dip. , 1995, Ophthalmology.

[58]  M Araie,et al.  Noncontact, two-dimensional measurement of retinal microcirculation using laser speckle phenomenon. , 1994, Investigative ophthalmology & visual science.

[59]  G. Cioffi,et al.  Microvasculature of the anterior optic nerve. , 1994, Survey of ophthalmology.

[60]  H. Jampel,et al.  Intraocular pressure reduction in normal-tension glaucoma patients. The Normal Tension Glaucoma Study Group. , 1992, Ophthalmology.

[61]  A. P. Shepherd,et al.  Autoregulation of choroidal blood flow in the rabbit. , 1992, Investigative ophthalmology & visual science.

[62]  R. Linden,et al.  The myogenic contribution to coronary autoregulation. , 1991, Bollettino della Societa italiana di biologia sperimentale.

[63]  E. Feigl Coronary autoregulation. , 1989, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[64]  Correlation of asymmetric damage with asymmetric intraocular pressure in normal-tension glaucoma (low-tension glaucoma). , 1988, Archives of ophthalmology.

[65]  H Fujii,et al.  Evaluation of blood flow by laser speckle image sensing. Part 1. , 1987, Applied optics.

[66]  A. Bill Some aspects of the ocular circulation. Friedenwald lecture. , 1985, Investigative ophthalmology & visual science.

[67]  B. Petrig,et al.  Retinal autoregulation in open-angle glaucoma. , 1984, Ophthalmology.

[68]  O B Paulson,et al.  Cerebral autoregulation. , 1984, Stroke.

[69]  R. Duckrow,et al.  Regional optic nerve blood flow and its autoregulation. , 1983, Investigative ophthalmology & visual science.

[70]  D. R. Anderson,et al.  Effect of elevated intraocular pressure on blood flow. Occurrence in cat optic nerve head studied with iodoantipyrine I 125. , 1983, Archives of ophthalmology.

[71]  J. Mcanulty,et al.  CARDIOVASCULAR PHYSIOLOGY , 1981, Clinical obstetrics and gynecology.

[72]  A. Bill,et al.  Effects of raised intraocular pressure on retinal, prelaminar, laminar, and retrolaminar optic nerve blood flow in monkeys. , 1979, Investigative ophthalmology & visual science.

[73]  G. Spaeth Fluorescein angiography: its contributions towards understanding the mechanisms of visual loss in glaucoma. , 1975, Transactions of the American Ophthalmological Society.

[74]  J. T. Ernest,et al.  Autoregulation of optic-disk oxygen tension. , 1974, Investigative ophthalmology.

[75]  A. Alm,et al.  Ocular and optic nerve blood flow at normal and increased intraocular pressures in monkeys (Macaca irus): a study with radioactively labelled microspheres including flow determinations in brain and some other tissues. , 1973, Experimental eye research.

[76]  Angus M'Gillivray,et al.  The Ocular Circulation , 1904, Edinburgh Medical Journal.