Abstract
Purpose :
The central retinal vessel trunk was shown to be associated with glaucomatous optic neuropathy previously. In the current study we aim to investigate the changes of the central retinal vein (CRVT) and artery (CRAT) trunk, either in position or caliber, by comparing optic nerve head images before and after acute intraocular pressure (IOP) elevation and investigating their associated parameters.
Methods :
The prospective cohort study included acute primary angle-closure suspects undergoing a dark room prone provocative test (DRPPT) of two hours. Before and at the end of the test, tonometry, swept-source optical coherence tomography with a non-mydriatic fundus camera were performed. The positions and calibers of CRVT and CRAT were marked and assessed on the fundus photos taken at baseline and after DRPPT.
Results :
The study included of 95 eyes from 57 individuals (mean age:54.5±9.4 years; range:30-70 years). IOP increased from 16.2±3.3 mmHg (range:10.3-25.3 mmHg) to 23.4±4.3mmHg (range:15.3-34.3 mmHg). Mean CRVT caliber enlarged (P<0.001) from 99.6±26.0 μm to 106.5±26.1μm, while mean CRAT caliber not change significantly (108.9±24.1 μm versus 108.6±22.0 μm; P=0.58). In multivariate analysis, higher change in CRVT caliber was associated with lower change in IOP (P=0.009; standardized regression coefficient beta=-0.31) and more marked change in CRAT caliber (P=0.01; beta=0.29). Movement of the CRVT (23.3±12.0 μm; range: 0-67.3μm) and CRAT (21.3±13.7μm; range: 0-67.3μm) was positively correlated with the height of IOP-rise (P=0.03; beta=0.22; and P=0.03, beta=0.22, resp.) and vertical disc cup diameter ratio (P=0.02, beta=0.23; and P=0.01, beta=0.25, resp.). The movement of the CRVT and CRAT were directed mainly temporally (27% V.S 28%) and superiorly (28% V.S 27%), following by inferiorly (25% V.S 23%) and nasally (15% V.S 16%), for CRVT and CRAT, respectively.
Conclusions :
After short-term IOP-rise the central vessel trunk changed in position and size. This may be of interest for understanding the impact of IOP change or the trans-lamina cribrosa pressure change to the vessel outflow, or even the pathogenesis of glaucoma.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.