Skip to main content
SpringerLink
Log in

Pulsatiler okulärer Blutfluss bei Patienten mit Pseudoexfoliation

Pulsatile ocular blood flow in patients with pseudoexfoliation

  • Originalarbeiten
  • Published:
Spektrum der Augenheilkunde Aims and scope Submit manuscript

Zusammenfassung

Das Pseudoexfoliationssyndrom (PEX-Syndrom) zählt heute zu den am häufigsten diagnostizierten Ursachen des Offenwinkelglaukoms, wobei auch eine Assoziation mit einem erhöhten Risiko für Gefäßerkrankungen (z.B. Hypertonie, Angina pectoris, Myokardinfarkt, apoplektischem Insult, retinale Thrombosen) beschrieben worden ist. Ziel dieser Studie war es zu untersuchen, ob mit Hilfe des pulsatilen okulären Blutflusses (POBF) bei diesem Syndrom eine veränderte okuläre Durchblutungssituation zu verifizieren ist.

Augen mit PEX-Syndrom oder Pseudoexfoliationsglaukom (PEG) wurden einer Gruppe von Augen mit normalen Befunden gegenübergestellt. Es erfolgte bei diesen (insgesamt 29 Augen) eine komplette ophthalmologische Untersuchung inklusive Messung des okulären Blutflusses mittels Ocular blood flow Tonometer nach Langham und eine Nervenfaser-dickenmessung mittels Scanning Laser Polarimetrie (GDx™). Die erhobenen Blutflussparameter, wie Pulsamplitude, Pulsvolumen sowie POBF wiesen keine Unterschiede zwischen den Grupppen auf (p>0.004). Ein negativer Zusammenhang ergab sich zwischen dem intraokularen Druck und dem POBF für das Gesamtkollektiv und die Gruppe der Normalaugen. Von den globalen GDx™ Parametern konnte eine positive Korrelation zwischen der „Ellipse Modulation“ und dem POBF festgestellt werden.

Die Messung des pulsatilen okulären Blutflusses dürfte eine weitere wesentliche Information bei der Diagnostik und in der Verlaufskontrolle von Glaukomen liefern. Ein erhöhtes okulär-vaskuläres Risiko bei Patienten mit Pseudoexfoliation ließ sich mit dieser Untersuchungsmethode jedoch nicht nachweisen.

Summary

Pseudoexfoliation syndrome (PEX) is one of the most frequently diagnosed causes of open-angle glaucoma and has been shown to be statistically significantly associated with a high risk of hypertension, angina, myocardial infarction or stroke and retinal vein thrombosis. The aim of this study was to evaluate the pulsatile ocular blood flow (POBF) in pseudoexfoliation syndrome with and without glaucoma.

Eleven eyes with pseudoexfoliation syndrome without glaucoma, 11 with a diagnosis of PEX-glaucoma and seven normal eyes of age-matched controls were enrolled. A complete ophthalmological examination included measuring the POBF with the Langham pneumotonometer as well as the determination of the nerve fiber layer thickness by scanning laser polarimetry (GDx™). There was no difference for the blood flow parameters, pulse amplitude, pulse volume or POBF between the groups (p>0.004). A negative correlation between the intraocular pressure and the POBF was found for all eyes. Out of the GDx™ parameters analysed „ellipse modulation“ was significantly correlated with POBF.

Measurements of the POBF are an additional option for the diagnosis and the follow-up of glaucoma. None of the parameters that are measured by the POBF showed a correlation with the presence of pseudoexfoliation, however.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Literatur

  1. Anton A, Zangwill L, Emdadi A, Weinreb RN (1997) Nerve fiber layer measurements with scanning laser polarimetry in ocular hypertension. Arch Ophthalmol 115: 331–334

    PubMed  CAS  Google Scholar 

  2. Boles Carenini A, Sibour G, Boles Carenini B (1994) Differences in long-term effect of timolol and betaxolol on pulsatile ocular blood flow. Surv Ophthalmol 38: 118–124

    Article  Google Scholar 

  3. Brooks AMV, Gillies WE (1988) The presentation and prognosis of glaucoma in pseudoexfoliation of the lens capsule. Ophthalmology 95: 271–276

    PubMed  CAS  Google Scholar 

  4. Choplin NT, Lundy AC, Dreher AW (1998) Differentiating patients with glaucoma from glaucoma suspects and normal subjects by nerve fiber layer assessment with scanning laser polarimetry. Ophthalmology 105: 2068–2076

    Article  PubMed  CAS  Google Scholar 

  5. Cursiefen C, Händel A, Schönherr U, Naumann GOH (1997) Das Pseudoexfoliationssyndrom bei Patienten mit retinaler Venenast- und Zentralvenenthrombose. Klin Monatsbl Augenheilkd 211: 17–21

    Article  PubMed  CAS  Google Scholar 

  6. Dvorak-Theobald G (1954) Pseudoexfoliation of the lens capsule: Relation to „true“ exfoliation of the lens capsule as reported in the literature and role in its production of glaucoma capsulocuticulare. Am J Ophthalmol 37: 1–12

    PubMed  CAS  Google Scholar 

  7. Freyler H, Radax U (1994) Pseudoexfoliationssyndrom — ein Risikofaktor der modernen Kataraktchirurgie? Klin Monatsbl Augenheilkd 205: 275–279

    Article  PubMed  CAS  Google Scholar 

  8. Helbig H, Schlötzer-Schrehardt U, Noske W, Kellner U, Foerster M, Naumann GOH (1994) Anterior-chamber hypoxia and iris vasculopathy in pseudoexfoliation syndrome. Ger J Ophthalmol 3: 148–153

    PubMed  CAS  Google Scholar 

  9. Hoh ST, Gresnfield DS, Liebmann JM, Hillenkamp J, Ishikawa H, Mistlberger A, Lim ASM, Ritch R (1999) Effect of pupillary dilation on retinal nerve fiber layer thickness as measured by scanning laser polarimetry in eyes with and without cataract. J Glaucoma 8: 159–163

    Article  PubMed  CAS  Google Scholar 

  10. James CB, Smith SE (1991) Pulsatile ocular blood flow in patients with low tension glaucoma. Br J Ophthalmol 75: 466–470

    Article  PubMed  CAS  Google Scholar 

  11. James CB (1994) Effect of trabeculectomy on pulsatile ocular blood flow. Br J Ophthalmol 78: 818–822

    Article  PubMed  CAS  Google Scholar 

  12. Krakau CET (1992) Calculation of the pulsatile ocular blood flow. Invest Ophthalmol Vis Sci 33: 2754–2756

    PubMed  CAS  Google Scholar 

  13. Krakau CET (1995) A model for pulsatile and steady ocular blood flow. Graefe’s Arch Clin Exp Ophthalmol 233: 112–118

    Article  CAS  Google Scholar 

  14. Langham M, To’mey K (1978) A clinical procedure for measuring the ocular pulse. Exp Eye Res 27: 17

    Article  PubMed  CAS  Google Scholar 

  15. Lindberg JG (1989) Clinical investigations on depigmentation of the pupillary border and translucency of the iris. In cases of senile cataract and in normal eyes in elderly persons. Academic Dissertation, Helsinki, 1917. English translation by Tarkkanen A, Forsius H. Acta Ophthal Suppl 190, vol. 66, University Press, Helsinki

  16. Miller J (1981) Simultaneous Statistical Inference, 2nd edn. Springer, New York

    Google Scholar 

  17. Mitchell P, Wang JJ, Smith W (1997) Association of pseudoexfoliation syndrome with increased vascular risk. Am J Ophthalmol 124: 685–687

    PubMed  CAS  Google Scholar 

  18. Naumann GOH, Schlötzer-Schrehardt U, Küchle M (1998) Pseudoexfoliation syndrome for the comprehensive ophthalmologist. Ophthalmology 105: 951–968

    Article  PubMed  CAS  Google Scholar 

  19. Quaranta L, Manni G, Donate F, Bucci MG (1994) The effect of increased intraocular pressure on pulsatile ocular blood flow in low tension glaucoma. Surv Ophthalmol 38: 177–182

    Article  Google Scholar 

  20. Repo LP, Suhonen MT, Teräsvirta ME, Koivisto KJ (1995) Color Doppler imaging of the ophthalmic artery blood flow spectra of patients who have had a transient ischemic attack. Correlations with generalized iris transluminance and pseudoexfoliation syndrome. Ophthalmology 102: 1199–1205

    PubMed  CAS  Google Scholar 

  21. Schlötzer-Schrehardt U, Koca MR, Naumann GOH, Volkholz H (1992) Pseudoexfoliation Syndrome. Ocular manifestation of a systemic disease. Arch Ophthalmol 110: 1752–1756

    PubMed  Google Scholar 

  22. Silver DM, Farrell RA, Langham ME, O’Brien V, Schilder P (1989) Estimation of pulsatile ocular blood flow from intraocular pressure. Acta Ophthalmol [Suppl] 191: 25–28

    CAS  Google Scholar 

  23. StatSoft, Inc (1999) STATISTICA for Windows [Computer program manual]. Tulsa, OK: StatSoft, Inc

    Google Scholar 

  24. Sperduto RD, Hiller R, Chew E, Seigel D, Blair N, Burton TC, Farber MD, Gragoudas ES, Haller J, Seddon JM, Yannuzzi LA (1998) Risk factors for hemiretinal vein occlusion: Comparison with risk factors for central and branch retinal vein occlusion. Ophthalmology 105: 765–771

    Article  PubMed  CAS  Google Scholar 

  25. Tjon-Fo-Sang M, Lemij HG (1997) The sensitivity and specifity of nerve fiber layer measurements in glaucoma as determined with scanning laser polarimetry. Am J Ophthalmol 123: 62–69

    PubMed  CAS  Google Scholar 

  26. Vogt A (1925) Ein neues Spaltlampenbild des Pupillengebietes: hellblauer Pupillensaumfilz mit Häutchenbildung auf der Linsenvorderkapsel. Klin Monatsbl Augenheilkd 75: 1–12

    Google Scholar 

  27. Weinreb RN, Shakiba S, Zangwill L (1995) Scanning laser polarimetry to measure the nerve fiber layer of normal and glaucomatous eyes. Am J Ophthalmol 119: 627–636

    PubMed  CAS  Google Scholar 

  28. Weinreb RN, Zangwill L, Berry CC, Bathija Sample PA (1998) Detection of glaucoma with Scanning laser polarimetry. Arch Ophthalmol 116: 1583–1589

    PubMed  CAS  Google Scholar 

  29. Willianson TH, Harris A (1994) Ocular blood flow measurement. Br J Ophthalmol 78: 939–945

    Article  Google Scholar 

  30. Wollensack J, Becker HU, Seiler T (1992) Pseudoexfoliation syndrome and glaucoma. Does glaucoma capsulare exist? German J Ophthalmol 1: 32–34

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Landesklinik für Augenheilkunde und Optometrie, Sankt Johanns-Spital, Müllner Hauptstraße 48, A-5020, Salzburg

    Andrea Mistlberger, M. Gruchmann, Susanne Sitte & G. Grabner

  2. Büro für Angewandte Statistik, Salzburg

    W. Hitzl

Authors
  1. Andrea Mistlberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Gruchmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W. Hitzl
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Susanne Sitte
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Grabner
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mistlberger, A., Gruchmann, M., Hitzl, W. et al. Pulsatiler okulärer Blutfluss bei Patienten mit Pseudoexfoliation. Spektrum Augeheilkd 14, 14–18 (2000). https://doi.org/10.1007/BF03162856

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03162856

Schlüsselwörter

Key words

Search

Navigation