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C. Pruente, K. Gugleta; Choroidal Vascular Reaction to Hand–grip Stress in Patients With Central Serous Chorioretinopathy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4063.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: The pathogenesis of Central Serous Chorioretinopathy (CSC) is still largely unknown. Recent angiographic studies suggest the possible involvement of choroidal vascular dysregulation in the pathogenesis of CSC. The aim of this study was to investigate choroidal vascular reaction and blood flow response to hand–grip stress in patients with CSC which could explain some of the changes in the choroidal microcirculation in these patients. Method: 17 consecutive patients with acute CSC (mean age 42.8±8.8 yrs) and 34 age– and sexmatched normals without (mean age 45.5±12.5 yrs) and with (mean age 41.8±11.7 yrs) a history of vasospasm underwent a hand grip test while choroidal blood flow was measured by means of Laser Doppler flowmetry (LDF). Blood pressure, heart rate and IOP were monitored. All CSC–patients had acute visual disturbances, localized neurosensory detachment and typical angiographic changes. Results:Mean blood pressure was significantly higher in CSC patients than in normals with or without vasospasm (mean±SD: 97.4±9.2, 87.9±10.7 and 93.3±9.9 respectively). Furthermore, mean blood pressure increase to provocation was significantly different (increase in %: 8.0±0.9, 14.8±1.2 and 12.8±1.3). Comparing results were found for heart rate with lower values for CSC patients. Baseline flow in the LDF was significantly lower in patients and response of choroidal blood flow was significantly different in CSC patients compared to both normal groups with no significant change in the CSC group but significant changes in both normal groups (increase of 15% in non–vasospastic and decrease of 10% in the vasospastic normal group during squeeze). Significant differences were also found during recovery. Conclusions: These findings suggest that choroidal vascular reactivity is altered during the acute phase of CSC. Furthermore, systemic circulation is involved in CSC patients. These results provide a further hint for the possible involvement of microvascular dysregulation in the pathogenesis of CSC.
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