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K Steuhl, N Niederdraeing, JM Selbach, S Kremmer; Simultaneous Measurement of Optic Nerve Head and Acral Perfusion During Cold Provocation in NTG and the Effect of Acupuncture . Invest. Ophthalmol. Vis. Sci. 2002;43(13):332.
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Purpose:To investigate changes in peripheral and optic nerve head perfusion induced by cold provocation in patients with NTG and to evaluate the effect of acupuncture therapy on the optic nerve head perfusion. Methods:10 patients with NTG and 10 healthy volunteers were enrolled. Peripheral blood flow (PBF) was measured at the finger tips with laser doppler technique. Optic nerve head blood flow (ONHBF) was measured by means of Heidelberg Retina Flowmetry (HRF). Measurements were performed before cold provocation (control), during 3 min with one foot standing in 3°C cold water and during 3 minutes of recovery at room temperature. To evaluate the effect of acupuncture, one week later the patients were needled at 4 typical eye points of the microsystem ear. 30 minutes after relaxing in an armchair 2 consecutive HRF measurements were performed. 15 minutes and 1 hour after acupuncture measurements were repeated. Results:During cold provocation, the PBF decreased down to 50% (of the initial value) and recovered to 80% at the end of 3 minutes with no significant difference between both groups. In normals, the PBF recovered after 20 sec (100%) and reached supranormal values (110-134%) after 30 sec. In NTG, PBF recovered after 35 sec (100%) without supranormal reaction. In the first 30 sec of recovery there was a significant (p<0,01) difference of PBF between NTG and normals. In normals, ONHBF-values undulated mostly over 100%. In NTG, ONHBF decreased to 80-90 % during provocation and recovery values stayed below 100%. After acupuncture ophthalmological standard examination as well as systemic blood pressure and heart rate remained stable, whereas ONHBF increased (8 - 32 %) significantly (p<0.01) in NTG patients but not in healthy volunteers. Conclusion:In NTG, there was a slower recovery after cold provocation at both optic nerve head and finger tip as compared to normals. An excessive reaction was found at the beginning of the recovery phase in normals but not in NTG. After acupuncture therapy in NTG patients we could observe a marked increase of optic nerve head blood flow.
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