Purchase this article with an account.
O. Genevois, P. Flaud, M. Benzerroug, A. Larue, M. Muraine, J. Sahel, M. Paques; Arterio-venous Nicking and Dynamic Retinal Microvascular. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5414.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The procedures to quantify the retinal Atherosclerosis are of interest to assess retinal microcirculation. They have been largely improved. In an attempt to better quantify the retinal Atherosclerosis, we hypothesized that arterio-venous nicking has an early impact on venous pulsatility.
The Retinal Vessel Analyzer (RVA, Imedos) allows to measure the variation of retinal vessel’s diameter over time. 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 measures were made on each site, then averaged. The results were compared to the presence or absence of a signs of nicking on retinography from the bottom of the
27 patients were included (13 patients with no sign of nicking and 14 patients with signs of arterio-venous nicking). Among 14 patients with signs of nicking, it is noted a significant decrease (P <0.05) of pulsatility upstream (2.2 ± 0.8 microns) compared to the pulsatility downstream (4.8 ± 1.8 microns). Among the 13 patients with no sign of arterio-venous nicking, only 4 patients (31%) had a symmetrical pulsatility (less than 1µ difference on both sides of the intersection). In 9 patients (5 treated for hypertension), there was a mismatch with a significant decrease (P <0.05) of pulsatility upstream (2.8 ± 0.9 microns) compared to the pulsatility downstream (5.9 ± 2.5 microns ). Among the 23 patients with asymmetric pulsatility, there was generally a diameter of the vein upstream above 10.5% ± 16 with a diameter of the vein downstream.
Comparison of pulsatility of arterio-venous diameters upstream and downstream can detect a nicking’s impact circulatory with great sensitivity. However, the specificity of this measure remains uncertain. 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 measure is correlated to the risk of branch vein occlusion and / or general microvascular complications.
This PDF is available to Subscribers Only