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Frieder Meier, Michael Haustein, Eberhard Spörl, Lutz E. Pillunat; Variations in Ocular Microcirculation during the Menstrual Cycle in Glaucomatous and Age-matched Eyes. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5642.
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Our aim was to access the changes in ocular microcirculation during various phases of the menstrual cycle (MC) in glaucomatous and age matched healthy eyes.
In this prospective study the corneal parameters of 15 female glaucoma patients (43 ± 5.5 years) of reproductive age were compared with these of age matched healthy women. Retinal vessel diameters (VD) were measured by dynamic-vessel-analyzer (DVA). A definite flicker provocation (530-600nm; 12.5Hz; 20s, 3 times) was applied to evoke retinal vasodilation. Papillary blood flow was determined by laser Doppler flowmeter (LDF) in the neuroretinal rim. Additionally, dynamic contour tonometer (DCT) was used to register ocular pulse amplitude (OPA). Measurements were completed by determinations of heart frequency (HF) and blood pressure (BP). All measurements were taken at 3 time points in their menstrual cycle, day 1 to 3, at ovulation (approximately day 15) and at day 25 to 28. Ovulation was determined with a test that records the peak of luteinizing hormone in the urine.
Systemic perfusion parameters (HF and BP) showed no significant changes. The arterial and venous VD measured by DVA dilated statistically significantly at all times (P<0.002). The largest increase was observed at ovulation (VDa= +4.98%, P=0.031, the VDv= +5.25%; P=0.017). Also there were no significant differences between glaucoma and age-matched control group. Papillary blood flow does not differ significantly during the MC. It was significantly lower in glaucoma as in the control group (P=0.002). Pulse amplitude (P=0.491) and ocular blood flow (P=0.274) showed no significant changes during the MC but glaucoma patients showed a reduced PA and OBF (P=0.045).
During the menstrual cycle ocular microcirculation changes in healthy subjects and also in glaucoma. Ocular microcirculation is reduced in glaucoma. Retinal vessels show the largest reaction on flicker stimulation at the middle of the menstrual cycle. The physiological estrogen level is in this period of MC at the top.
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