Aging Increases Areas of Low Capillary Blood Flow in the Peripapillary Retinal Circulation of Normal Individuals

Abstract

Abstract: : Purpose: To study the factors associated with the capillary perfusion of the peripapillary retina in a random sample of older individuals. Methods: Blood flow measurements were performed in both eyes of 457 subjects from a sample of 551 consecutive subjects (age 57-88 years, mean 71 years) participating in a population-based study. 17 subjects with glaucoma, 18 on glaucoma medications, 46 with medications for diabetes and 21 with ARMD were excluded form the analysis. Heidelberg retina flowmeter was used to record capillary perfusion in the superotemporal ST and inferotemporal IT peripapillary region in both eyes. Pixel by pixel analysis was done in an area adjacent to the optic disc, with minimum of 1600 pixels. The percentage of pixels with no flow (0 pixels) was calculated. Regression models were used to identify correlations of age, gender, IOP, diastolic (Ppdias), systolic (Ppsys) and mean (PP) perfusion pressure with the percentage of 0 flow pixels.. Results: Gender, IOP, PPdias, Ppsys, PP, were not significantly correlated with the percentage of 0 flow pixels in any of the measurement areas. There was statistically significant positive correlation between age and percentage of 0 flow pixels in the IT measurement areas of both eyes (RE p=0.0001, LE p=0.0434). Age was also significantly positively correlated with 0 flow pixels of the ST area of the right eye (p=0.0002). Conclusions: In normal individuals increased age is associated with increase in the areas of low perfusion of the peripapillary retina. This finding which is comparable to alterations seen in patients with age related macular degeneration and glaucoma suggests that vascular changes may contribute to increased risk for these diseases in older age.

Keywords: blood supply • aging • imaging/image analysis: clinical