Response of choroidal blood flow to carbogen breathing in smokers and non-smokers

Wimpissinger, Barbara; Resch, Hemma; Berisha, Fatmire; Weigert, Günther; Schmetterer, Leopold; Polak, Kaija

doi:10.1136/bjo.2003.031773

Cited by 47 publications

(30 citation statements)

References 27 publications

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“…40,44,45 Human studies indicate abnormal choroidal vascular reactivity to carbogen (high oxygen) inhalation in chronic smokers. 30 Substances in cigarette smoke have additionally been demonstrated to induce direct oxidative damage to endothelium. 46,47 We hypothesize that chronic cigarette smoke exposure contributes to specific structural changes to the choroid which might manifest as an overall thinner than average appearance on EDI.…”

Section: Discussionmentioning

confidence: 99%

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Smoking and choroidal thickness in patients over 65 with early-atrophic age-related macular degeneration and normals

Sigler

Randolph

Calzada

et al. 2014

Eye

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Objective To compare macular choroidal thickness between cigarette smokers, those with a history of smoking, and nonsmokers in patients over 65 years of age with earlyatrophic age-related macular degeneration (AMD) and normals. Methods Prospective, consecutive, observational case series. Enhanced depth imaging spectral domain optical coherence tomography 12-line radial scans were performed and choroidal thickness manually quantified at 84 points in the central 3 mm of the macula. Data of normals, soft drusen alone, and soft drusen with additional features of early AMD were compared. A multivariate analysis of variance (MANOVA) model, controlling for age, was constructed to evaluate the effect of smoking history and AMD features on choroidal thickness. Results A history of smoking was significantly associated with a thinner choroid across all patients via logistic regression (P ¼ 0.004; O.R. ¼ 12.4). Mean macular choroidal thickness was thinner for smokers (148±63 mm) than for nonsmokers (181±65 mm) among all diagnosis categories (P ¼ 0.003). Subgroup analysis of patients with AMD features revealed a similar decreased choroidal thickness in smokers (121 ± 41 mm) compared with nonsmokers (146 ± 46 mm, P ¼ 0.006). Bivariate analysis revealed an association between increased pack-years of smoking and a thin choroid across all patients (Po0.001) and among patients with features of early AMD (Po0.001). Both the presence of features of macular degeneration (Po0.001) and a history of smoking (P ¼ 0.024) were associated with decreased choroidal thickness in a MANOVA model. ConclusionChronic cigarette smoke exposure may be associated with decreased choroidal thickness. There may be an anatomic sequelae to chronic tobacco smoke exposure that underlies previously reported AMD risk.

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Section: Discussionmentioning

confidence: 99%

“…28 Cigarette smoking has been linked to many vascular alterations, including experimental evidence of altered retinal 29 and choroidal 30,31 blood flow, and endothelial reactivity. Smokers may also be at higher risk for the development and severity of choroidal neovascularization.…”

Section: Introductionmentioning

confidence: 99%

Smoking and choroidal thickness in patients over 65 with early-atrophic age-related macular degeneration and normals

Sigler

Randolph

Calzada

et al. 2014

Eye

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“…During changes in ocular perfusion pressure (OPP) some regulatory capacity has been observed during an increase and decrease in OPP. [5][6][7][8][9][10][11][12][13][14][15][16] Alterations of the response in ChBF have been observed in smokers 17 and vasospastics, 18 as was well as in patients with diabetic retinopathy, 19 central serous chorioretinopathy, 20 agerelated macular degeneration, 21 and glaucoma. 22 By contrast only few studies have investigated optic nerve head blood flow (ONHBF) during changes in OPP.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Choroidal and Optic Nerve Head Blood Flow Regulation during Changes in Ocular Perfusion Pressure

Schmidl¹,

Boltz

Kaya³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. We compared the response of choroidal and optic nerve head blood flow (ChBF, ONHBF) in response to an increase in ocular perfusion pressure (OPP) during isometric exercise and during a decrease in OPP during an artificial increase in intraocular pressure (IOP). METHODS.We included 96 healthy subjects in our study. In 48 subjects OPP was increased by 6 minutes of squatting, and either ONHBF (n ¼ 24) or ChBF (n ¼ 24) was measured continuously. In 48 other healthy subjects either ONHBF (n ¼ 24) or ChBF (n ¼ 24) was measured continuously during a period of artificial increase in IOP using a suction cup. All blood flow measurements were done using laser Doppler flowmetry. RESULTS.During all experiments the response in blood flow was less pronounced than the response in OPP, indicating for flow regulation. During isometric exercise ChBF regulated better than ONHBF (P ¼ 0.023). During artificial IOP increase ONHBF regulated better than ChBF (P ¼ 0.001). Interindividual variability in blood flow responses was high. During squatting ONHBF decreased considerably below baseline ONHBF when OPP fluctuated in 3 subjects, although OPP still was much higher than at baseline. This phenomenon was not observed in the choroid. CONCLUSIONS.Our data indicate that regulation of ChBF and ONHBF during changes in OPP is different and complex. In some subjects performing squatting, considerable ONHBF reductions were observed during OPP fluctuations, although OPP still was high. Whether this predisposes to ocular disease remains unclear. (Invest Ophthalmol Vis Sci. 2012;53:4337-4346)

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“…In addition, choroidal thickness grading was only performed by one examiner, and we were not able to determine the smoking habits of the patients. Furthermore, OSAHS duration, which has been shown to influence vascular autoregulation ability (31) , was unknown. Another limitation was that our control group was not symptom-free, so they were required to undergo a standard overnight polysomnography.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of choroidal thickness in patients with obstructive sleep apnea/hypopnea syndrome

Kara¹,

Özçimen²,

Bekçi³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Obstructive sleep apnea/hypopnea syndrome (OSAHS) is characterized by transient upper airway resistance caused by a recurrent reduction or cessation of airflow, due to partial or complete occlusion of the upper airway during sleep. It is associated with sleep fragmentation, arousals, bradycardia, tachycardia, and inadequate oxygen saturation despite an increased respiratory effort (1) . Major clinical consequences of the disorder include excessive daytime sleepiness, neurocognitive dysfunction, cardiovascular diseases (hypertension, ABSTRACTPurpose: To compare the subfoveal choroidal thickness (SFCT) of patients with different severities of obstructive sleep apnea/hypopnea syndrome (OSAHS) and normal controls via enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: In this retrospective, case-control study, 49 eyes from 49 patients that had undergone polysomnography were included. SFCT of the horizontal and vertical line scans were manually measured for all eyes based on EDI-OCT images. Two separate analyses were performed according to different apnea/hypopnea index (AHI) groupings. Initial testing was conducted using non-OSAHS, mild OSAHS (5≤AHI<15), moderate OSAHS (15≤AHI<30), and severe OSAHS (AHI≥30) patient groupings, while secondary testing used non-OSAHS, mild OSAHS (5≤AHI<15), and moderate/severe OSAHS (AHI≥15) patient groupings. Results: The mean SFCT was 314.5 µm in the non-OSAHS patients (n=14), 324.5 µm in the mild OSAHS patients (n=15), 269.3 µm in the moderate OSAHS patients (n=11), and 264.3 µm in the severe OSAHS patients (n=9). SFCT between the four groups revealed no significant differences despite a trend towards slight thinning in the severe group (P=0.08). When the moderate and severe groups were merged and compared with the mild OASHS and non-OSAHS groups, SFCT of the moderate/severe group was found to be significantly thinner than that of the mild group (P=0.016). A negative significant correlation was found between SFCT and AHI in OSAHS patients (r=0.368, P=0.033). Conclusions:In patients with moderate/severe OSAHS, EDI-OCT revealed a thinned SFCT. Other accompanying systemic or ocular diseases may induce perfusion and oxygenation deficiency in eyes of OSAHS patients. Further studies are required in order to determine the exact relationships between ocular pathologies and clinical grades of OSAHS. Keywords

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Response of choroidal blood flow to carbogen breathing in smokers and non-smokers

Cited by 47 publications

References 27 publications

Smoking and choroidal thickness in patients over 65 with early-atrophic age-related macular degeneration and normals

Smoking and choroidal thickness in patients over 65 with early-atrophic age-related macular degeneration and normals

Comparison of Choroidal and Optic Nerve Head Blood Flow Regulation during Changes in Ocular Perfusion Pressure

Evaluation of choroidal thickness in patients with obstructive sleep apnea/hypopnea syndrome

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