Changes in the Blood Flow of the Optic Nerve Head Induced by Different Concentrations of Epinephrine in Intravitreal Infusion During Vitreous Surgery

Ubuka, Makoto; Sugiyama, Tetsuya; Onoda, Yasutaka; Shiba, Tomoaki; Hori, Yuichi; Maeno, Takatoshi

doi:10.1167/iovs.13-13801

Cited by 30 publications

(17 citation statements)

References 21 publications

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“…Noma et al reported that blood flow velocity in the perifoveal capillaries was lower in hypertensive patients [29]. Recent studies showed that optic nerve head blood flow significantly decreased during PPV in response to epinephrine in the infusion solution and an elevated infusion pressure [30,31]. Therefore, hypertensive patients may have more compromised blood flow in the optic nerve head during PPV, resulting in exacerbation of VF damage.…”

Section: Discussionmentioning

confidence: 99%

Visual field changes after vitrectomy with internal limiting membrane peeling for epiretinal membrane or macular hole in glaucomatous eyes

2017

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PurposeTo investigate visual field changes after vitrectomy for macular diseases in glaucomatous eyes.MethodsA retrospective review of 54 eyes from 54 patients with glaucoma, who underwent vitrectomy for epiretinal membrane (ERM; 42 eyes) or macular hole (MH; 12 eyes). Standard automated perimetry (Humphrey visual field 24–2 program) was performed and analyzed preoperatively and twice postoperatively (1st and 2nd sessions; 4.7 ± 2.5, 10.3 ± 3.7 months after surgery, respectively). Postoperative visual field sensitivity at each test point was compared with the preoperative value. Longitudinal changes in mean visual field sensitivity (MVFS) of the 12 test points within 10° eccentricity (center) and the remaining test points (periphery), best-corrected visual acuity (BCVA), intraocular pressure (IOP), and ganglion cell complex (GCC) thickness, and the association of factors with changes in central or peripheral MVFS over time were analyzed using linear mixed-effects models. In addition, 45 eyes from 45 patients without glaucoma who underwent vitrectomy for epiretinal membrane (ERM; 34 eyes) or macular hole (MH; 11 eyes) were similarly examined and statistically analyzed (control group).ResultsIn glaucomatous eyes, visual field test points changed significantly and reproducibly; two points deteriorated only at the center and twelve points improved only at the periphery. Central MVFS decreased (p = 0.03), whereas peripheral MVFS increased postoperatively (p = 0.010). In the control group, no visual field test points showed deterioration, and central MVFS did not change significantly after vitrectomy. BCVA improved, GCC thickness decreased, and IOP did not change postoperatively in both groups. The linear mixed-effects models identified older age, systemic hypertension, longer axial length, and preoperative medication scores of ≥2 as risk factors for central MVFS deterioration in glaucomatous eyes.ConclusionsVisual field sensitivity within 10° eccentricity may deteriorate after vitrectomy for ERM or MH in glaucomatous eyes.

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Section: Discussionmentioning

confidence: 99%

Visual field changes after vitrectomy with internal limiting membrane peeling for epiretinal membrane or macular hole in glaucomatous eyes

2017

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“…We calculated the three parameters of the MBR in the ONH described below by using the LSFG Analyzer software (v.3.0.47, Softcare). After we had identified the margin of the ONH by hand using a round band (Figure 1(a)), the software separated out the vessels using the automated definitive threshold (Figure 1(b)) and then analyzed the means of the MBRs in the vessels of the ONH (MBR-V), in the ONH tissue (MBR-T), and throughout the ONH (MBR-A) [21, 22, 26]. The eye studied was the same side as that used for the FA evaluation.…”

Section: Methodsmentioning

confidence: 99%

Relationships among Ocular Blood Flow Shown by Laser Speckle Flowgraphy, Retinal Arteriosclerotic Change, and Chorioretinal Circulation Time Obtained by Fluorescein Angiography

Osamura

Shiba

Itokawa

et al. 2017

Journal of Ophthalmology

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Purpose. To determine the correlations among the mean blur rate (MBR) in the optic nerve head (ONH) shown by laser speckle flowgraphy (LSFG), retinal arteriosclerosis, and the circulation time obtained by fluorescein angiography (FA). Method. We evaluated 118 patients and assessed their time of choroidal flush, arm-to-retina time, and early and late phases of retinal circulation time (RT: sec) obtained by FA. The severity of retinal arteriosclerosis was classified according to the Scheie classification. The MBR values throughout the ONH (MBR-A), in the tissue (MBR-T), and in the vessels (MBR-V) were analyzed. Results. Patients with retinal vein occlusion (RVO) showed prolonged early and late phases of RT compared to other ocular diseases. Single and multiple regression analyses showed that the MBR-V and Scheie classification were significantly associated with both the choroidal flush and arm-to-retina times. The incidences of RVO and MVR-V were significantly associated with the early phase of RT, and the incidences of RVO, MBR-V, Scheie classification, and gender were revealed to be factors independently contributing to the late phase of RT. Conclusion. MBR-V in the ONH and retinal arteriosclerosis are important contributing factors for the circulation time of each stage obtained by FA.

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“…42 Moreover, intravitreal infusion solutions containing epinephrine were also found to decrease ONH blood flow during vitrectomy. 46 These findings suggest that LSFG may be able to provide valuable intraoperative information on ocular circulation, revealing cases in which surgeons should pay careful attention to the effects of infusion pressure and the intravitreal infusion of epinephrine on blood flow during vitrectomy, particularly for preoperative MBR-decreased eyes.…”

Section: Laser Speckle Flowgraphy Evaluations In Vitreoretinal Surgerymentioning

confidence: 87%

Recent Clinical Applications of Laser Speckle Flowgraphy in Eyes with Retinal Disease

Kunikata¹,

Nakazawa²

2016

Asia-Pacific Journal of Ophthalmology

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Retinal diseases related to ischemia, such as diabetic retinopathy, are the main cause of blindness worldwide. However, the pathogenesis of these diseases remains unclear, as does the time course of associated changes in ocular blood flow. Laser speckle flowgraphy (LSFG), which uses the laser speckle phenomenon to detect and quantify ocular circulation, is a promising candidate for a noninvasive method to measure ocular blood flow in living eyes. A recently developed LSFG measurement parameter, mean blur rate (MBR), can serve as a quantitative and reproducible index of retinal blood cell velocity. Mean blur rate can be used in the study of retinal diseases to evaluate microcirculation in the retinal vessels, choroid, and optic nerve head. In addition to overall MBR (MA), LSFG measurements of optic nerve head microcirculation can be divided into vessel-area MBR (MV) and tissue-area MBR (MT). Absolute values for MT have been shown to be linearly correlated with capillary blood flow, regardless of fundus pigmentation. Recently, there has been an increasing number of reports on the clinical applications of LSFG in retinal disease.

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Changes in the Blood Flow of the Optic Nerve Head Induced by Different Concentrations of Epinephrine in Intravitreal Infusion During Vitreous Surgery

Cited by 30 publications

References 21 publications

Visual field changes after vitrectomy with internal limiting membrane peeling for epiretinal membrane or macular hole in glaucomatous eyes

Visual field changes after vitrectomy with internal limiting membrane peeling for epiretinal membrane or macular hole in glaucomatous eyes

Relationships among Ocular Blood Flow Shown by Laser Speckle Flowgraphy, Retinal Arteriosclerotic Change, and Chorioretinal Circulation Time Obtained by Fluorescein Angiography

Recent Clinical Applications of Laser Speckle Flowgraphy in Eyes with Retinal Disease

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