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E. Rechtman, I. Stalmans, J. Glovinsky, A. Leys, J. Moisseiev, J. Van Calster, A. Harris; A Positive Relationship Between Ocular Pulse Amplitude and Systemic Pulse Pressure in Patients With Neovascular Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2009;50(13):949.
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To assess the relationship between ocular pulse amplitude (OPA) and systemic blood pressure measurements in patients with neovascular age-related macular degeneration (AMD).
This assessment is part of a bi-center prospective study (Sheba Medical Center, Israel and University Hospitals Leuven, Belgium), evaluating the effect of intravitreal (IVT) bevacizumab treatment on OPA. After signing an informed consent, all patients have been examined 3 times: At day 0 (prior to IVT bevacizumab), 7(± 3) and 30 (± 3) days post treatment. At each visit, intraocular pressure and OPA were measured, using the Dynamic Contour Tonometer (DCT, Pascal; Swiss Microthecnology AG, Prt, Switzerland). Up to 3 DCT measurements were performed each time, to try to reach a test with good quality. In every visit, systemic blood pressure measurement was taken in a seated position after a five minutes rest. Univariate Pearson correlation was used to evaluate the relationship between OPA and systemic blood pressure (BP) measurements (systemic BP, diastolic BP, mean systemic BP, & systemic pulse pressure (systemic BP minus diastolic BP)).
Thirty seven neovascular AMD patients were recruited for this study and thirty were included in the final analysis (15 patients from each center, 18 females, age 78.8±5.82 years (mean ±SD)). Thirteen patients had treated and controlled systemic hypertension. No relationships between OPA and systemic, diastolic and mean BP were found in any of the three study visits. On the other hand, we found a positive relationship between the treated eye OPA and systemic pulse pressure in all visits (Visit 1:Pearson=0.454, P=0.015; Visit 2: Pearson=0.395, P=0.034; Visit 3: Pearson=0.453, P=0.014).
In neovascular AMD patients, OPA is positively related to systemic pulse pressure. Our results contradict recent findings of no such relationship in young and healthy subjects. This may be due to inadequate regulating mechanisms in the carotid system of elderly population with neovascuar AMD.
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