Waveform of Ophthalmic Artery Doppler Flow Predicts the Severity of Systemic Atherosclerosis

Abstract

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp oronary artery disease (CAD) is a life-threatening condition that encompasses systemic atherosclerosis. Many basic-research, epidemiological, and clinical studies have been conducted with the aim of combating atherosclerotic disease. Together with aging, the progression of atherosclerosis leads to an increase in stiffening of the aorta, and in turn an increase in pulse pressure (PP) through a reduction in arterial compliance and increased pulse wave velocity. 1 Therefore, increased PP is considered as a sign of increased arterial stiffness. Elevated PP and decreased arterial compliance are also recognized as risk factors for CAD. 1,2Indices of intrarenal vascular resistance calculated from pulsed-wave Doppler velocities, such as pulsatility index (PI) and resistive index (RI), correlate positively with PP and negatively with the carotid hemodynamic pattern in patients with essential hypertension. 3 This pattern was determined by calculating the ratio of diastolic to systolic mean velocity in pulsed Doppler flow recordings of the common carotid artery. The same ratio also showed a significant negative correlation with PP and carotid arterial stiffness. 4 These findings suggest that hemodynamic Doppler flow patterns may reflect not only peripheral vascular resistance but also systemic arterial stiffness.The ophthalmic artery (OA) is the first major branch of the internal carotid artery and divides into many branches in the orbital area. Doppler imaging of the OA was recently made possible by improvements in Doppler equipment. 5 Changes in OA blood flow assessed on pulsed Doppler (OA Doppler) have provided new insights into various vascular disorders including ophthalmic diseases, carotid artery stenosis, and diabetes mellitus. 5 OA Doppler has particular anatomical advantages due to the absence of ultrasonic obstacles and the vertical angle, which differs from the parallel-signaling of carotid artery Doppler to the transducer. Such findings in the ocular fundus are associated closely with systemic atherosclerosis, with previous reports showing that atherosclerotic changes in retinal arteries are potential markers of systemic cardiovascular disease. 6,7 OA Doppler flow patterns may also reflect the severity of diabetes retinopathy. 8,9 Fukuda et al showed that the ratio of systolic to diastolic mean velocity in OA Doppler is closely involved in age and the severity of diabetic retinopathy. 10 There is little information on the relationship between OA Doppler flow and systemic atherosclerosis. We hypothesized Background: Doppler imaging of ophthalmic artery (OA), the first major branch of the internal carotid artery, provides anatomical advantages due to the vertical angle to the body surface and absence of ultrasonic obstacles. It was hypothesized that the Doppler waveform indices of OA correlate with severity of systemic atherosclerosis.

Disturbed correlation between arterial resistance and pulsatility in glaucoma patients

“…For instance, increased ratios between systolic and diastolic MFV in the OA have been reported to reflect systemic atherosclerosis and coronary heart disease (Maruyoshi et al 2010). In OA-NTG, the optimal cutpoint in the nonlinear relationship was detected at RI = 0.82 (p < 0.001).…”

Increased ophthalmic artery resistance index is associated with cognitive impairment in HIV-infected patients

“…17 OARI could have significant advantages with respect to cIMT assessment, namely, the absence of ultrasound obstacles and the vertical angle, which differs from the parallel-signaling of the carotid artery. 11 Finally, other factors associated with cognitive performance were identified in our population. As expected, education emerged as a protective factor against cognitive dysfunction, probably because of a major "cognitive reserve" able to modulate the detrimental effects of HIV and cerebrovascular diseases.…”

“…10 Pathological ophthalmic artery resistance index (OARI) seems to reflect diminished arterial compliance caused by systemic atherosclerosis 9 and hemodynamically significant lesion distal to carotid artery bifurcation. 11 When severe internal carotid artery stenosis occurs in patients with incomplete blood circulation in the circle of Willis, the blood flow in the ophthalmic artery (OA) reverses to supply the ispilateral brain. 12 In addition to being quite specific for severe internal carotid artery disease, OA flow may also provide additional hemodynamic insights e.g.…”

Comparison of intima-media thickness and ophthalmic artery resistance index for assessing subclinical atherosclerosis in HIV-1-infected patients

“…OARI offers important advantages due to the absence of ultrasound obstacles and the vertical angle, which differs from the parallel-signaling of the carotid artery [29]. …”