Dopaminergic vasodilation in the choroidal circulation by d1/d5 receptor activation

PURPOSE: To test whether exogenous dopamine can cause choroidal vasodilation and to identify the mediating receptors in anesthetized rabbits. METHODS: Mean arterial pressure (MAP), intraocular pressure (IOP), and orbital venous pressure (OVP) were measured by direct cannulation of the central ear artery, the vitreous, and the orbital venous sinus, respectively. Laser Doppler flowmetry was used to measure choroidal blood flow (ChorBF) while MAP was manipulated mechanically with occluders on the aorta and vena cava, thus changing perfusion pressure (PP) over a wide range. In the first group of animals (n = 11), pressure-flow (PF) relationships were performed at control and in response to 40 micro g/kg per minute intravenous (IV) dopamine (D40) and D40+SCH-23390 (0.5 mg/kg, bolus injection IV). In the second group of animals (n = 6), PF relationships were recorded at control and during infusion of SKF-38393 (80 micro g/kg per minute). RESULTS: D40 lowered IOP and caused an upward shift in the choroidal PF relationship, which was blocked by the D1/D5 antagonist SCH-23390 suggesting the involvement of the dopamine D1/D5 receptors. Stimulation of the D1/D5 receptors by infusion of the selective agonist SKF-38393 also lowered IOP and caused an upward shift in the PF relationship. Dopamine and SKF-38393 tended to decrease OVP, but the effect was not significant. CONCLUSIONS: Dopamine can cause choroidal vasodilation in anesthetized rabbits. Because SCH-23390 was able to block the response and SKF-38393 caused a similar vasodilation, we conclude that the vasodilation is caused by a D1/D5-receptor-mediated mechanism.     

Retinal autoregulation in open-angle glaucoma

The macular blood flow response to an induced change in intraocular pressure (autoregulation) was studied using the blue field entopic phenomenon in 11 open angle glaucoma patients, eight glaucoma suspects and 13 normal volunteers. A suction cup was used to raise the intraocular pressure (IOP) above its resting state (IOPrest). IOPmax, the highest acutely increased IOP for which blood flow can be maintained constant by autoregulation, was 24.9 +/- 1.5 mmHg (+/- 1 SD) in the glaucoma patients, 30.8 +/- 4.6 mmHg in the glaucoma suspects and 29.9 +/- 3.6 mmHg in the normal subjects. The values for IOPmax - IOPrest were 3.7 +/- 4.3 mmHg, 4.7 +/- 3.3 mmHg, and 14.3 +/- 3.1 mmHg, respectively. After the release of the suction cup, a hyperemic response was observed by 16 of 17 normal eyes, 10 of 14 glaucoma suspect eyes and only 9 of 19 glaucomatous eyes. These results suggest an abnormal autoregulation of macular retinal blood flow in open-angle glaucoma.     

Effects of topical clonidine versus brimonidine on choroidal blood flow and intraocular pressure during squatting

PURPOSE: Clonidine and brimonidine, two alpha-2 agonists, have been shown to reduce intraocular pressure (IOP) in patients with glaucoma. Little is known, however, about the exact role of alpha receptors in the control of ocular blood flow in the posterior pole of the eye. Hence, the study was conducted to investigate the effects of topical clonidine versus topical brimonidine on choroidal blood flow and intraocular pressure during squatting. METHODS: This was a randomized, double-masked, controlled, two-way crossover study. Twelve healthy male nonsmoking volunteers, aged between 19 and 35 years were included in the study. Two drops of clonidine or brimonidine were administered in the subjects' study eyes. Continuous measurement using the compact laser Doppler flowmeter was performed during a 6-minute squatting period, to assess choroidal blood flow regulation during an increase in ocular perfusion pressure. RESULTS: Both substances induced a pronounced but comparable (P = 0.8) decrease in IOP. Squatting increased mean arterial pressure (MAP) and ocular perfusion pressure (P < 0.01). This increase was comparable between the clonidine and the brimonidine study day (P = 0.88). Squatting induced an increase in choroidal blood flow that was less pronounced than the increase in ocular perfusion pressure. Compared with baseline the alpha-2 agonists decreased choroidal blood flow during squatting (P = 0.0026) to a comparable degree (P = 0.86). Vascular resistance increased at baseline and during squatting after administration of the alpha-2 agonists (P < 0.01) in both groups to a comparable degree (P = 0.56). CONCLUSIONS: Topical alpha-2 agonists may induce changes in choroidal blood flow, even after a single administration. Long-term studies are needed to study potential effects of brimonidine and clonidine in the clinical setting.     

Endothelin modulation of choroidal blood flow in the rabbit

Based on the previous finding that locally produced nitric oxide (NO) and endothelin (ET) exert competing effects on choroidal resistance vessels, the present study sought to further characterize the pharmacology of ET in the choroid. The specific goal was to quantify the choroidal blood flow responses to acute changes in perfusion pressure before and after administering endothelin 1 (ET1), a non-selective ET antagonist, and selective antagonists for the endothelin A (ETA) and endothelin B (ETB) receptor subtypes. Anesthetized rabbits were instrumented with an ear artery cannula to measure mean arterial pressure (MAP), occluders on the aorta and vena cava to control MAP, and a vitreous cannula to measure intraocular pressure (IOP). Choroidal blood flow was measured by laser Doppler flowmetry with a vitreous fiber optic probe. The protocol entailed changing the ocular perfusion pressure by varying MAP before and after ET1 (0.9 microg kg(-1), i.v., n = 14), non-selective ET blockade (A-182086, 3 mg kg(-1), i.v., n = 10), selective ETA blockade (FR-139317, 3 mg kg(-1), i.v., n = 12), and selective ETB blockade (A-192621, 3 mg kg(-1), i.v., n = 14). ET1 and ETB blockade shifted the choroidal pressure-flow relation downward, while the non-selective antagonist and the selective ETA antagonist had no effect. The choroid had a biphasic response to exogenous ET1 as seen in other tissues (i.e. initial brief dilation followed by prolonged constriction) that was blocked by the non-selective antagonist whereas the ETA antagonist enhanced the dilation and blocked the constriction, and the ETB antagonist blocked the dilation and enhanced the constriction. These results indicate that ETA and ETB receptors are present and mediate opposing effects on choroidal vascular resistance. The results also suggest that endogenous ET preferentially elicits ETB vasodilation, most likely by stimulating endothelial nitric oxide release.     

Regulation of choroidal blood flow during combined changes in intraocular pressure and arterial blood pressure

PURPOSE: To test the hypothesis that human choroidal blood flow (ChBF) may depend, not only on ocular perfusion pressure (OPP), but also on absolute mean arterial pressure (MAP) and intraocular pressure (IOP). METHODS: There were two study days in an open design. On the first day, OPP was varied by elevating IOP during a squatting-induced increase in MAP (28 subjects). On the second day, only the IOP was increased (17 subjects). IOP was raised in stepwise increments by using the suction cup METHOD: Subfoveal ChBF (laser Doppler flowmetry), MAP, and IOP were assessed, and OPP was calculated as (2/3)(MAP - IOP). For correlation analysis, data from all subjects were pooled according to IOP and MAP, and correlation analyses were performed. RESULTS: When data from study day 1 were grouped according to IOP, no correlation was observed between ChBF and MAP; but ChBFs were lower, the higher the IOP (P < 0.001). When data were grouped according to MAP, a significant correlation was found between ChBF and IOP (P < 0.001), but correlations were independent of MAP. When data of study day 2 were pooled according to IOP, a correlation between ChBF and OPP was seen only at IOP > 40 mm Hg (P < 0.05). CONCLUSIONS: The data confirm previously published observations that the choroid shows some autoregulatory capacity during changes in OPP. In addition, the data indicate that the choroid regulates its blood flow better during exercise-induced changes in MAP than during an experimental increase in IOP.     

Choroidal hemodynamic changes during isometric exercise in patients with inactive central serous chorioretinopathy

PURPOSE: Imaging studies suggest that the choroidal vasculature may be altered in central serous chorioretinopathy. Little is known, however, about the regulation of ocular blood flow in patients with central serous chorioretinopathy (CSC). The hypothesis for the present study was that choroidal blood flow changes during an increase in ocular perfusion pressure induced by isometric exercise may be altered in CSC. METHODS: An observer-masked, two-cohort study was performed in 14 nonsmoking patients with chronic-relapsing but inactive CSC and in 14 healthy nonsmoking volunteers. Both groups were matched for age and sex. Subfoveal choroidal blood flow (CBF) was assessed with laser Doppler flowmetry, and ocular perfusion pressure (OPP) was calculated from mean arterial pressure (MAP) and intraocular pressure (IOP). Changes of CBF during isometric exercise over a period of 6 minutes were measured. RESULTS: Whereas the increase of MAP, the pulse rate, and the OPP were comparable between the two study groups, subfoveal CBF increased significantly more in the group of patients with CSC (P < 0.001). IOP remained unchanged in both groups during isometric exercise. At an 85% increase in OPP, subfoveal CBF was approximately twice as high in the patients with CSC compared with the healthy control group. CONCLUSIONS: The data indicate an abnormal subfoveal CBF regulation in patients with relapsing CSC compared with age-matched, nonsmoking, healthy volunteers during isometric exercise.     

Role of endothelin-1 in choroidal blood flow regulation during isometric exercise in healthy humans

PURPOSE: There is evidence that the choroid has some autoregulatory capacity in response to changes in ocular perfusion pressure (OPP). The mediators of this response are hitherto unidentified. The hypothesis for the current study was that endothelin (ET)-1 and/or angiotensin (ANF)-II may be involved in choroidal vasoconstriction during an increase in OPP. METHODS: To test this hypothesis a randomized, double-masked, placebo-controlled, three way crossover study was performed in 12 healthy male volunteers. Subjects received on different study days intravenous infusions of the specific ET(A) receptor antagonist BQ-123, the angiotensin converting enzyme inhibitor enalapril or placebo. During these infusion periods subjects were asked to squat for 6 minutes. Choroidal blood flow was measured using a confocal laser Doppler flowmeter and ocular perfusion pressure (OPP) was calculated from mean arterial pressure and intraocular pressure. RESULTS: BQ-123 and enalapril had no effect on basal blood pressure, pulse rate, intraocular pressure, or choroidal blood flow. During isometric exercise, a pronounced increase in mean arterial pressure paralleled by an increase in OPP was observed. Although choroidal blood flow slightly increased during squatting, the increase was much less pronounced than the increase in OPP, indicating some regulatory potential of the choroid. Enalapril did not alter the choroidal pressure-flow relationship during isometric exercise, but BQ-123 induced a significant leftward shift of the pressure-flow curve (P < 0.001). CONCLUSIONS: The present data indicate that ET-1, but not ANG II, plays a role in choroidal blood flow regulation during isometric exercise in healthy humans. Hence, impaired choroidal autoregulation in patients with ocular vascular diseases may arise from an altered endothelin system. Further studies in such patients are warranted to verify this hypothesis.     

A rabbit model to study orbital venous pressure,intraocular pressure,and ocular hemodynamics simultaneously

PURPOSE: To measure orbital venous pressure (OVP) and determine the effects of changes in mean arterial pressure (MAP) on OVP, intraocular pressure (IOP), episcleral venous pressure (EVP), and ciliary and choroidal blood flows. METHODS: The experiments were performed in anesthetized rabbits. In all animals, MAP, IOP, and OVP were measured by direct cannulation of the central ear artery, the vitreous, and the orbital venous sinus, respectively. Laser Doppler flowmetry was used to measure choroidal blood flow in one group, and ciliary blood flow in a second group. A servonull micropressure system was used to measure EVP in a third group. The protocol for all three groups entailed varying MAP mechanically with occluders on the aorta and vena cava. RESULTS: The OVP and IOP relationship correlated linearly (r = 0.99) during mechanical manipulation of MAP. EVP also correlated well with OVP (r = 0.9). Resistance calculations based on choroidal and ciliary blood flows and the pressure gradients indicate active adjustment of arterial resistance and passive changes in venous resistance in response to changing MAP in both circulations. CONCLUSIONS: The rabbit orbital venous sinus permits continuous measurements of OVP. The present findings show that OVP is not static and suggest that OVP may play an important role in IOP homeostasis and ocular hemodynamics.     

Autoregulation of human retinal blood flow. An investigation with laser Doppler velocimetry

The effect of acute changes in mean retinal perfusion pressure, P (2/3 of mean brachial artery blood pressure minus IOP), on retinal volumetric blood flow rate, Q, was investigated in normal volunteers. Changes in Q were determined from Q = k X Vmax X D2, where Vmax is the center line red blood cell velocity measured from temporal veins by laser Doppler velocimetry, D is the vessel diameter obtained by monochromatic fundus photography, and k is a constant of proportionality. A suction cup was used to induce step changes in IOP and, consequently, in P. The magnitude of the steps ranged from 10-32 mmHg. During the first 30 sec after a step decrease in P, Vmax and Q were significantly smaller than at rest by an amount proportional to the decrease in P. Thereafter, Vmax and Q increased markedly towards their values at rest, although P changed comparatively little during this period of time. Time constant of the corresponding decrease in vascular resistance, R(t) = P(t)/Q(t), was approximately 45 sec. There was no significant change in D during elevated IOP. Removal of the cup induced an immediate step increase in P, Vmax, D, Q, and R. Thereafter, Vmax, D, Q, and R returned to their values at rest (time constant of the change in R was about 30 sec), while P remained nearly constant. The rapid change in vascular resistance following a step decrease and increase in P can be attributed to an active process that attempts to maintain blood flow close to normal, in spite of changes in perfusion pressure (autoregulation).(ABSTRACT TRUNCATED AT 250 WORDS)     

Relationship between ciliary blood flow and aqueous production in rabbits

PURPOSE: To determine the relationship between ciliary blood flow and aqueous flow by changing the mean arterial pressure (MAP) mechanically under controlled conditions in an animal model. METHODS: In anesthetized rabbits, MAP and intraocular pressure (IOP) were measured by direct cannulation. MAP was controlled with occluders placed on the aorta and vena cava. In group 1 (n = 22), aqueous flow was measured by fluorophotometry. In group 2 (n = 21), ciliary blood flow was measured by laser Doppler flowmetry. In separate subgroups, measurements were made for 60 minutes at the control MAP of 70 mm Hg and for an additional 60 minutes at target MAPs of 80, 55, or 40 mm Hg. RESULTS: The target MAPs achieved perfusion pressures (MAP - IOP) of 33.6 +/- 1.0, 43.5 +/- 0.7, 51.9 +/- 0.6, and 65.2 +/- 0.9 mm Hg. Ciliary blood flow was unaffected by increased perfusion pressure, but decreased progressively as perfusion pressure was lowered. Aqueous flow decreased only at the lowest perfusion pressure. CONCLUSIONS: Under control conditions in anesthetized rabbits, aqueous production is independent of ciliary blood flow until ciliary blood flow declines below 74% of control. At ciliary blood flow below this critical level, aqueous production is blood flow dependent.     

Effects of nitric oxide synthase inhibition on ciliary blood flow, aqueous production and intraocular pressure

A prior study found that inhibition of nitric oxide synthase with L-NAME causes a large, rapid decrease in IOP in anesthetized rabbits. In this follow-up study we sought to determine if this hypotensive effect was due to decreased aqueous production, possibly caused by ciliary vasoconstriction. Two protocols were performed in anesthetized rabbits. In the first protocol, mean arterial pressure (MAP) and IOP were measured by direct cannulation, and aqueous flow was measured by fluorophotometry, before and after L-NAME (5 mg kg(-1), i.v., n = 7). In the second protocol, ciliary blood flow was measured transclerally by laser Doppler flowmetry while MAP was varied mechanically over a wide range before and after L-NAME (5 mg kg(-1), i.v., n = 8). L-NAME caused a significant increase in MAP and decreases in IOP, ciliary blood flow and aqueous flow. L-NAME also caused a significant downward shift in the ciliary pressure-flow relation over the entire pressure range examined. The results indicate that L-NAME causes ciliary vasoconstriction and decreases aqueous production, suggesting that the L-NAME ocular hypotensive effect may be due in part to a blood flow-dependent decrease in aqueous production. However, assuming no uveoscleral outflow and constant episcleral venous pressure and outflow facility, the decrease in aqueous flow accounts for 66% of the drop in IOP, suggesting an additional effect of L-NAME on aqueous outflow.     

眼灌注压对人视乳头微循环的影响

目的 了解眼外负压吸引诱导的眼灌注压改变的条件下，正常人、原发性开角性青光眼(POAG)患者和正常眼压性青光眼患者(NTG)的视乳头微循环的变化，探讨视乳头局部自身调节的幅度。方法正常人8例，POAG患者10例和NTG患者7例，采用眼外负压杯吸引诱导眼压升高，负压增加的幅度为30s50mmHg，同时测量眼压。采用HRF测量视乳头处血流量。将基础状态下视乳头血流值作为基础值，当眼压升高到30mmHg和40mmHg时，分别测量这两点视乳头微循环的血流值，在40mmHg后解除负压吸引，测量负压吸引解除后1min、5min时视乳头微循环的血流值。结果 三组视乳头的基础血流量无明显差异。当眼压升高到30mmHg时，正常组的血流量仍维持稳定，但POAG组和NTG组明显下降，POAG组下降幅度超过25％，NTG组下降幅度超过45％。当眼压升高到40mmHg，正常组视乳头血流量也出现明显下降，其中0NHF下降约30％，POAG组和NTG组下降更明显，POAG组下降幅度超过50％，NTG组下降幅度超过65％。在解除负压吸引后1min，正常组血流量增加的幅度约为31％，POAG组增加约19％，NTG组无明显增加。在负压解除后5min，三组视乳头血流基本恢复到基础状态。结论 正常组视乳头微循环有一定范围的自身调节幅度，可以耐受眼灌注压一定程度的改变，POAG组和NTG组自身调节能力均有不同程度的损害。     

Effects of isometric exercise on subfoveal choroidal blood flow in smokers and nonsmokers

PURPOSE: Little is known about potential effects of smoking on ocular blood flow regulation. In the present study, the hypothesis was that choroidal blood flow (CBF) changes during an increase in ocular perfusion pressure induced by isometric exercise are altered in chronic smokers. METHODS: The study was performed in 24 (12 smokers and 12 nonsmokers) healthy male volunteers in an observer-masked, two-cohort study design. The difference in CBF regulation between smokers and nonsmokers was tested during isometric exercise over a period of 6 minutes. CBF was assessed with laser Doppler flowery (LDF), and ocular perfusion pressure (OPP) was calculated from mean arterial pressure (MAP) and intraocular pressure (IOP). RESULTS: Six minutes of isometric exercise induced a significant increase in MAP, pulse rate (PR), OPP, and CBF in smokers and nonsmokers (each P<0.001). The increase in CBF was significantly higher in the smoking group (P<0.001) than in the healthy control group, whereas a comparable increase in MAP (P=0.18), PR (P=0.18), and OPP (P=0.43) occurred in smokers and nonsmokers. IOP remained unchanged during isometric exercise in both groups. Moreover, in smokers, CBF started to increase at OPPs more than 49% above baseline, whereas CBF in nonsmokers remained stable until an increase in OPP of 74% over baseline. This difference between the two groups was significant (P<0.001). CONCLUSIONS: These data indicate abnormal CBF regulation in chronic smokers compared with age-matched nonsmoking subjects during isometric exercise. The pathways responsible for this abnormal blood flow response remain to be elucidated.     

Choroidal and ciliary body blood flow analysis: application of laser Doppler flowmetry in experimental animals

Laser Doppler flowmetry (LDF) measures the flux of red blood cells in a vascular network embedded in tissue. In the present report, choroidal and ciliary body blood flow was measured continuously using an LDF technique in pentobarbital anesthetized cats. Blood flow measurements were made from the choroid beneath the lateral and superior rectus muscles and from the surface above the ciliary body 2-3 mm posterior to the limbus. In some experiments, the sympathetic nerve to the eye was stimulated; in others, intraocular pressure (IOP) was monitored manometrically with a controlled saline infusion delivered into the anterior chamber to gradually elevate IOP. Norepinephrine (NE) and methacholine (MC) also were tested for their effects on choroidal blood flow when given intravenously and intra-arterially. Transient bilateral carotid artery occlusions produced a significant drop in blood flow, but flow did not decrease to zero probably due to collateral contribution of the vertebral circulation. Sympathetic nerve stimulation produced a frequency-dependent decrease in both choroidal and ciliary body blood flow with the latter exhibiting a lower threshold and a greater magnitude of effect. Gradual elevation of IOP produced a proportional decrease in choroidal blood flow. The level of intraocular pressure required to decrease blood flow was dependent on the existing ocular perfusion pressure. Both intravenous and intra-arterially administered NE produced dose-dependent decreases of choroidal blood flow despite graded increases of systemic arterial blood pressure. In contrast, MC produced dose-dependent increases of choroidal blood flow in conjunction with graded decreases of systemic blood pressure. The results of the present report demonstrate the validity of the LDF technique for performing continuous reading of blood flow changes in the choroid and ciliary body of experimental animals.(ABSTRACT TRUNCATED AT 250 WORDS)     

The complex interaction between ocular perfusion pressure and ocular blood flow – Relevance for glaucoma

Glaucoma is an optic neuropathy of unknown origin. The most important risk factor for the disease is an increased intraocular pressure (IOP). Reducing IOP is associated with reduced progression in glaucoma. Several recent large scale trials have indicated that low ocular perfusion pressure (OPP) is a risk factor for the incidence, prevalence and progression of the disease. This is a strong indicator that vascular factors are involved in the pathogenesis of the disease, a hypothesis that was formulated 150 years ago. The relation between OPP and blood flow to the posterior pole of the eye is, however, complex, because of a phenomenon called autoregulation. Autoregulatory processes attempt to keep blood flow constant despite changes in OPP. Although autoregulation has been observed in many experiments in the ocular vasculature the mechanisms underlying the vasodilator and vasoconstrictor responses in face of changes in OPP remain largely unknown. There is, however, recent evidence that the human choroid regulates its blood flow better during changes in blood pressure induced by isometric exercise than during changes in IOP induced by a suction cup. This may have consequences for our understanding of glaucoma, because it indicates that blood flow regulation is strongly dependent not only on OPP, but also on the level of IOP itself. Indeed there is data indicating that reduction of IOP by pharmacological intervention improves optic nerve head blood flow regulation independently of an ocular vasodilator effect.     

Role of NO in choroidal blood flow regulation during isometric exercise in healthy humans

PURPOSE: Nitric oxide (NO) is an important regulator of basal choroidal blood flow. Animal experiments indicate that NO is also involved in choroidal blood flow regulation during changes in ocular perfusion pressure and inhibition of NO synthase (NOS) has been reported to shift choroidal pressure-flow curves to the right. The hypothesis for the study was that inhibition of NOS may influence choroidal blood flow during isometric exercise. METHODS: To test this hypothesis, a randomized, double-masked, placebo-controlled, three-way crossover study was performed in 12 healthy male volunteers. Subjects received on different study days intravenous infusions of N(G)-monomethyl-L-arginine (L-NMMA), phenylephrine, or placebo. During these infusion periods, subjects were asked to squat for 6 minutes. Choroidal blood flow was assessed with laser Doppler flowmetry, and ocular perfusion pressure (OPP) was calculated from mean arterial pressure and intraocular pressure. RESULTS: L-NMMA and phenylephrine increased resting OPP by 10% and 13%, respectively, but only L-NMMA reduced resting choroidal blood flow (-17%, P < 0.001). The relative increase in OPP during isometric exercise was comparable with all drugs administered. Isometric exercise increased choroidal blood flow during administration of placebo and phenylephrine, but not during administration of L-NMMA (P < 0.001 vs. placebo). CONCLUSIONS: These data indicate that NO plays an important role in the regulation of choroidal blood flow during isometric exercise.     

Effects of body mass index on intraocular pressure and ocular pulse amplitude

AIM: To investigate the effects of body mass index (BMI) on intraocular pressure (IOP) and ocular pulse amplitude (OPA).METHODS: Totally 140 healthy individuals without any systemic diseases were included in the study. BMI (kg/m²) was calculated for every individual. IOP and OPA were measured with Pascal Dynamic contour tonometer (DCT). Blood pressure was also measured along with the DCT. The patients were divided into three groups according to BMI as: Group1, BMI<25; Group2, 25≤BMI<30; Group3, BMI≥30. Mean values of IOP, OPA, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were used in statistical analysis.RESULTS: In Group1, the means of IOP, OPA, were 16.8±2.3mmHg, 2.7±0.7mmHg respectively; and SBP, DBP were 120.0±6.1mmHg, and 77.4±5.6mmHg respectively. In group2, the mean IOP, OPA, SBP, and DBP were found to be 16.6±2.1mmHg, 2.4±0.7mmHg, 121.7±5.3mmHg, and 79.5±4.9mmHg respectively. In group3, the mean IOP, OPA, SBP, and DBP were found to be 17.3±1.7mmHg, 2.1±0.7mmHg, 122.4±5.7mmHg, and 79.7±5.2mmHg respectively. There were no statistically significant difference between groups in terms of IOP, SBP and DBP, while OPA values were significantly lower in group3 (P=0.001).CONCLUSION: Decreased OPA values in individuals with higher BMI may indicate that subjects with higher BMI have lower choroidal perfusion and lower ocular blood flow.     

Pressures in the anterior ciliary arteries, choroidal veins and choriocapillaris.

A micropuncture technique was used to measure the pressure in the anterior ciliary arteries of monkeys as well as the pressures in the choroidal veins and in the choriocapillaris of rabbits. Monkeys were used to measure the pressure in one of the anterior ciliary arteries at three different points, First at a scleral 'well', and then at 2 and 5 mm from the same 'well'. It was found that the pressures recorded increased proportionally to the distance from the scleral 'well'. Afterwards the intraocular pressure (IOP) was increased stepwise and the arterial pressure was measured at each increment (from spontaneous IOP to 50 cmH2O). When compared, it was found that an increase in IOP was not followed by a statistically increased anterior ciliary artery pressure. The pressure in the choroidal veins and the choriocapillaris was measured in rabbits through a scleral window positioned between the two superior veins at about 4 mm from the nearest. The pressure recorded in the choroidal vein was found to be 3.3 +/- 0.4 cmH2O higher than the spontaneous IOP (20.3 +/- 1.6). However, when the IOP was increased stepwise it was found that this difference diminished as the value for the IOP neared the arterial pressure. Thus, the pressure gradient for flow from the intermediate-seized choroidal veins to the intraocular origin of the vortex veins is only a few cmH2O under normal conditions and is reduced at very high intraocular pressures at which the blood flow is markedly reduced or stopped.(ABSTRACT TRUNCATED AT 250 WORDS)     

Time dependent effects of sympathetic denervation on aqueous humor dynamics and choroidal blood flow in rabbits

PURPOSE: This study investigates the time-dependent effects of superior cervical ganglionectomy (SCGx) on aqueous humor dynamics and ocular blood flow in rabbits. METHODS: Measurements were made at various times between 24 hours and 12 months after SCGx. Intraocular pressure (IOP) was measured by pneumatonometry, aqueous flow by fluorophotometry and outflow facility by tonography. Uveoscleral outflow was determined by an intracameral tracer infusion technique and blood flow to the choroid was evaluated with fluorescent microspheres. Values in denervated eyes were compared with the contralateral, normally-innervated eyes using a paired Student's two-tailed t-test. RESULTS: At 24 hours after SCGx, IOP in denervated eyes was less than in normally-innervated eyes (14.6 +/- 0.8 vs 20.1 +/- 1.5 mmHg, 27%, p < 0.002). At one month, IOPs were not different between eyes. Compared with normally-innervated eyes at 10-12 months, IOP in denervated eyes was greater (20.4 +/- 0.7 vs 17.2 +/- 0.9 mmHg, 19%, p < 0.001), outflow facility was less (0.15 +/- 0.02 vs 0.21 +/- 0.01 microl/min/mmHg, 29%, p < 0.01) and blood flow to the choroid was less (12.1 +/- 5.0 vs 16.2 +/- 6.0 ml/min/gm tissue, 25%, p < 0.05). Aqueous humor flow was not significantly altered by SCGx at any time. CONCLUSIONS: The reduction in IOP at 24 hours after SCGx was not due to any change in aqueous flow or uveoscleral outflow (current study) but rather to an increase in outflow facility (previous studies). At 10-12 months, IOP was elevated because outflow facility was significantly reduced. The reduction in choroidal blood flow at 10-12 months may have occurred because of the increased IOP.     

Short-term effect of beta-adrenoreceptor blocking agents on ocular blood flow

PURPOSE: In this study the acute effect of the topically-delivered non-selective beta-blockers timolol and carteolol, and the selective beta-blocker betaxolol, were evaluated with respect to ocular blood flow, intraocular pressure (IOP) and vessel resistance in rabbits' eyes. METHODS: In a double masked randomized design, one eye of each subject (n = 9) received two drops of 0.5 % timolol or 2 % cartelol or 0.5 % betaxolol ophthalmic solution and a separate group of nine rabbits received two drops of placebo consisting of physiological saline in both eyes to serve as control. Using hydrogen clearance method, ciliary body blood flow (CiBF), choroidal blood flow (CBF), and retinal blood flow (RBF) were measured. IOP and systemic mean arterial pressure (MAP) of each subject were measured under same condition before and after the administration of respective drugs to calculate the ocular perfusion pressure (OPP) and vessel resistance. RESULTS: In timolol- and carteolol-treated eyes significant reduction was observed in IOP (p < 0.01), CiBF (p < 0.01), CBF (p < 0.01) and RBF (p < 0.01) compared to control eyes. However, in betaxolol-treated eyes a marginal reduction in IOP was observed accompanied by significant increase in CiBF (p < 0.01) and RBF (p < 0.05). The non-selective beta-blocker-treated eyes tended to have increased vessel resistance, whereas, selective beta-blocker-treated eyes tended to have decreased vessel resistance. CONCLUSIONS: Our current results comparing non-selective and selective beta-blockers suggest that the selective beta-blocker betaxolol may be more appropriate for maintenance of retinal blood flow in situations with low perfusion. Currently the mechanism for regulation of IOP is unclear; however, the findings from this study indicate that decreased CiBF may contribute to reduction in IOP.