March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
24-hour Rhythm Of Ocular Perfusion Pressure In Nonarteritic Anterior Ischemic Optic Neuropathy
Author Affiliations & Notes
  • Tiffany Lacharme
    Ophthalmology, Department of Ophthalmology, CHU Grenoble, Grenoble, France
  • Jean Paul Romanet
    Ophthalmology, Department of Ophthalmology, CHU Grenoble, Grenoble, France
  • Ahmed Almanjoumi
    Ophthalmology, Department of Ophthalmology, CHU Grenoble, Grenoble, France
  • Hafid Khayi
    Ophthalmology, Department of Ophthalmology, CHU Grenoble, Grenoble, France
  • Jean Philippe Baguet
    Cardiology, Department of Cardiology, CHU Grenoble, Grenoble, France
  • Jean Louis Pépin
    CHU Grenoble, Lab Hypoxia and Physiopathology, Grenoble, France
  • Christophe Chiquet
    Ophthalmology, Department of Ophthalmology, CHU Grenoble, Grenoble, France
  • Footnotes
    Commercial Relationships  Tiffany Lacharme, None; Jean Paul Romanet, None; Ahmed Almanjoumi, None; Hafid Khayi, None; Jean Philippe Baguet, None; Jean Louis Pépin, None; Christophe Chiquet, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 4890. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Tiffany Lacharme, Jean Paul Romanet, Ahmed Almanjoumi, Hafid Khayi, Jean Philippe Baguet, Jean Louis Pépin, Christophe Chiquet; 24-hour Rhythm Of Ocular Perfusion Pressure In Nonarteritic Anterior Ischemic Optic Neuropathy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4890.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: : Nonarteritic anterior ischemic optic neuropathy (NAAION) is a common of optic neuropathy in the elderly. The blood flow of the optic nerve head (ONH) mainly depends on ocular perfusion pressure (OPP), which is an index for the ocular blood supply estimated from mean blood pressure (MBP) and intraocular pressure (IOP). Circulatory insufficiency and decreased perfusion within the optic nerve have been hypothesized to be related to nocturnal systemic hypotension. The main objective of this prospective study was to investigate the nyctohemeral variations of OPP in NAAION patients.

Methods: : This prospective cohort included 17 consecutive Caucasian patients (eight men and nine women) with NAAION, from October 2009 to July 2011. They had a complete ophthalmological examination and polysomnography. The IOP of both eyes was measured using the Tono-Pen XL ™ electronic tonometer every hour for 24 h. MBP was evaluated over 24 h. Mean OPP was calculated with the following formula: OPP sitting position = (0.74 × MBP) - IOP and OPP lying position = (0.84 x MBP) - IOP. A nonlinear least squares dual harmonic regression analysis approach was used to model the 24-h rhythms of OPP data. After modeling the 24-h OPP curves, the patients were classified as either having a diurnal rhythm (i.e., with a diurnal acrophase), an absence of rhythm, or a nocturnal rhythm.

Results: : On average, a 24-h amplitude of 5.1±2.4 mmHg was found for OPP, but no significant difference was found between nocturnal and diurnal OPP values. After modeling the 24-h OPP curves, the patients were classified as either having a diurnal (12% of the cases) or nocturnal OPP rhythm (47%). Only three patients had a nocturnal reduction of OPP (-18% in average). Obstructive sleep apnea syndrome was diagnosed in 80% of the cases.

Conclusions: : This study of OPP nyctohemeral rhythm demonstrated that the physiological nocturnal rhythm is maintained in 50% of the NAAION patients. The nocturnal variations in OPP seen in 12% of the patients were within the range of OPP where ONH blood flow autoregulation is still fully operative to maintain a normal blood flow. We found no nocturnal ocular hypoperfusion in this population of European patients. Vascular regulation of posterior ciliary arteries and ONH vessels should be further studied.

Keywords: neuro-ophthalmology: optic nerve • ischemia • optic nerve 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×