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Zvia Burgansky-Eliash, Shay Gutfreund, Hila Barash, Elena Izkhakov, Ardon Rubinstein; Retinal Blood Flow Velocity in Patients with Metabolic Syndrome Using the RFI. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2135.
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To evaluate differences in retinal blood flow velocities in subjects with metabolic syndrome (MetS) and healthy subjects using the Retinal Function Imager (RFI, Optical Imaging Ltd, Israel) and to compare it to carotid-femoral pulse wave velocity (PWV) that is used as an indicator to atherosclerotic disease.
20 eyes of 20 men with MetS and 21 eyes of 21 healthy men were enrolled. Subjects were diagnosed with MetS based on the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) definition if having 3 of the following criteria: elevated waist circumference (men ≥ 102 cm, women ≥ 88 cm), triglycerides ≥ 150 mg/dL , reduced HDL cholesterol (men ≤ 40 mg/dL, women ≤ 50 mg/dL, blood pressure ≥ 130/85 mm Hg and fasting glucose ≥ 100 mg/dL. All subjects had a detailed ophthalmic evaluation revealing a healthy retina and blood tests for C-reactive protein, fibrinogen, triglycerides, cholesterol and glucose levels. Retinal blood flow velocity measurement with the RFI and carotid femoral PWV were obtained. Differences among groups were assessed by mixed linear models.
The average venous velocity in the MetS patients was 2.7 mm/sec (95% CI 2.6 - 2.8) which was significantly higher than in the healthy subjects (2.5 mm/sec 95% CI 2.4 - 2.6, p=0.003). Similar higher velocity was observed in the arterioles of MetS subjects compared to the healthy group (3.5 mm/sec 95% CI 3.4 - 3.6 vs. 3.3 mm/sec 95% CI 3.2 - 3.4, p=0.021). The PWV values were also higher in the MetS population compared to the healthy one (10.3 mm/sec ± 1.2 vs. 9.3 mm/sec ± 1.5 p=0.005), but there was no correlation between the retinal blood flow velocities and the PWV inside either population. Diastolic blood pressure was correlated with the arterial blood flow velocities in the healthy subjects (r = 0.474 p = 0.030) but such a correlation was not apparent in the MetS group. There was no correlation between any other metabolic syndrome parameters or inflammation markers and the blood flow velocities in either population.
The RFI detected significantly higher retinal blood flow velocities in a population with MetS compared to healthy subjects. This support the notion that abnormalities in microvascular function exist in this population in addition to macrovascular disease as shown with PWV. The RFI provides a non-invasive technique that can serve as an indicator for atherovascular disease.
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