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Olivier Genevois, marc muraine, Jose A. Sahel, Michel Paques; New Analysis Technique Of Arterio-venous Nicking By Retinal Vessel Analyzer. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3006.
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The procedures to quantify the retinal Atherosclerosis are of interest to assess the microcirculatory. In an attempt to better quantify the retinal Atherosclerosis, we hypothesized that arterio-venous nicking have early an impact on venous pulsatility.
The Retinal Vessel Analyzer (RVA, Imedos) allows you to measure changes over time in the diameter of retinal vessels. We analyzed the retinal venous vascular pulsatility found on both sides of arterio-venous nicking in healthy subjects and patients with signs of nicking proved. Ten measurements were made at each site, then averaged. The results were compared to the presence or absence of a sign from nicking on photographs from the bottom of eye
41 patients were included (19 patients with no sign of nicking and 22 patients with signs of arterio-venous nicking). Among 22 patients with signs of nicking, it is noted a significant decrease (P <0.05) of pulsatility upstream (1.9 ± 1.8 microns) compared to the pulsatility downstream (4.8 ± 1.9 microns). Among the 19 patients with no sign of arterio-venous nicking, only 7 patients (36%) have a symmetrical pulsatility (less than 1µ difference on both sides of the intersection). In 12 patients (7 treated for hypertension), there is a mismatch with a significant decrease (P <0.05) of pulsatility upstream (2.8 ± 1.2 microns) compared to the pulsatility downstream (5.9 ± 2.5 microns ).
Retinal vessel relative pulse, which may reflect the compliance of the vessel wall, is a parameter of potential interest for cardiovascular and eye diseases. In our study the RVA has revealed infraclinical abnormalities of the arterio-venous nicking that can be useful in the follow up of patients cured for high blood pressure.Comparison of pulsatility and artério-venous diameters upstream and downstream can detect an nicking’s impact circulatory with great sensitivity. This new measure should help more quickly assess the degree of retinal Atherosclerosis and perhaps general of a patient. It remains to be seen whether this is correlated to the risk of branch vein occlusion and / or general microvascular complications.
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