Pulsatile ocular blood flow in asymmetric age-related macular degeneration

Abstract

Purpose Ocular perfusion abnormalities have been proposed in the pathogenesis of age-related macular degeneration (AMD) with differences in pulsatile ocular blood flow (POBF) in eyes with asymmetric AMD in Japanese and Taiwanese patients. The purpose of our study was to observe POBF difference in the fellow eyes of Caucasians with asymmetric AMD. Methods This was a cross-sectional study comparing POBF in three groups of patients with asymmetric AMD in the fellow eyes: Group 1 (n ¼ 21) with drusen and active choroidal neovascularisation (CNV); Group 2 (n ¼ 18) with drusen and disciform scar; Group 3 (n ¼ 8) with CNV and disciform scar. The POBF was adjusted for intraocular pressure (IOP), pulse rate (PR), and axial length using multiple regression analysis. Generalised estimation equation model was used to include both eyes in each group. Results The geometric mean (95% confidence interval) POBF values were as follows: Group 1 with drusen 1097.9 ll/min (957.0, 1259.7) in one eye and the fellow eye with CNV 1090.1 ll/min (932.3, 1274.7); Group 2 with drusen 946.0 ll/min (794.2, 1126.7) and disciform scar 966.2 ll/min (780.3, 1196.4); Group 3 with CNV 877.1 ll/min (628.3, 1224.6) and disciform scar 767.2 ll/min (530.5, 1109.7). Adjusting for differences in axial length, pulse rate and intraocular pressure, no statistically significant difference in POBF was found between fellow eyes in the same subject. Conclusions POBF is not different between fellow eyes of Caucasian patients with asymmetric AMD. Eye (2007) 21, 506-511.

Ocular pulse amplitude and retinal vessel caliber changes after intravitreal ranibizumab

“…In this study, we performed monthly ranibizumab injections consecutively three times. It was reported that optimal timing for ranibizumab injections for wet-type AMD is the first 3 months, and it was suggested to inject ranibizumab There are some reports about the ocular blood flow in wet-type AMD in the literature [17][18][19]. Chen et al reported that the pulsatile ocular blood flow (POBF) was significantly higher in eyes with CNV than the contralateral eyes with drusen, but Mori et al found the opposite [7,17].…”

“…Chen et al reported that the pulsatile ocular blood flow (POBF) was significantly higher in eyes with CNV than the contralateral eyes with drusen, but Mori et al found the opposite [7,17]. On the other hand, Sandhu et al revealed that POBF was not different between fellow eyes of patients with asymmetric AMD [18]. But it seems more logical that the reduced blood flow in the choroid is associated with the development and progression of wet-type AMD [19].…”

Ocular blood flow in diabetes and age-related macular degeneration

“…[94][95][96] On the other hand, no difference was found between POBF levels in the 2 eyes of patients with asymmetric AMD in a Caucasian population. 97 Using laser interferometric measurement of fundus pulsation amplitude, we have shown that the heartbeat-related distance change between the cornea and retina is selectively reduced at the membrane in patients with CNV. 98 In recent years, some studies have also investigated retinal blood flow in AMD.…”

Ophthalmic imaging of ocular circulation for detecting disease

“…107,108 A few studies have indicated that POBF is reduced in patients with AMD compared to healthy controls; [109][110] however, no difference was found in POBF between the two eyes of Caucasian patients with asymmetric AMD. 111 Studies have also investigated retinal blood fl ow in AMD. Applying the laser Doppler technique to retinal arteries, pulsatility was found to increase with severity of AMD; however, despite an increase in pulsatility, retinal blood fl ow remained constant, indicating reduced vascular compliance proximal to the eye.…”