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Impairment of autoregulation of optic nerve head blood flow during vitreous surgery in patients with hypertension and hyperlipidemia

  • Glaucoma
  • Published:
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Abstract

Purpose

To examine whether hypertension (HTN) and hyperlipidemia (HL) affect autoregulation of optic nerve head (ONH) blood flow during vitrectomy.

Design: Cohort study.

Methods

Seventeen eyes from 17 subjects with HTN and HL and 19 eyes from 19 control subjects without systemic disorders underwent vitrectomy for the treatment of epiretinal membrane or macular hole. Following standard 25-gauge microincision vitrectomy, the mean blur rate (MBR), which is an index of relative ONH blood flow, in the vascular area (vascular MBR) and MBR in the tissue area (tissue MBR) were measured using laser speckle flowgraphy. Measurements were conducted before and 5 and 10 min after an approximately 15-mmHg rise in intraocular pressure (IOP). Both parameters represent relative values of ONH blood flow (%, compared to baseline). The recovery rate of blood flow to the ONH was calculated using the following equation: (MBR at 10 min − MBR at 5 min)/(MBR at baseline − MBR at 5 min).

Results

Ocular perfusion pressure in all subjects was reduced both 5 and 10 min after the increase in IOP. Vascular MBR in subjects with HTN and HL (75.5 ± 14.8) was significantly lower than that in control subjects (86.7 ± 12.1) 10 min after IOP elevation (P = 0.019). The recovery rate of vascular blood flow was significantly lower in the HTN and HL groups than in the control group (P = 0.002).

Conclusions

Our results suggest that HTN and HL impair autoregulation in the vascular component of ONH blood flow during vitrectomy.

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Acknowledgements

We would like to thank Chiaki Nishimura for statistical consultation and Editage Author Services for editing this manuscript.

Design and conduct of study

R.H. and T.M. Data collection: R.H. and T.M. Management, analysis, and interpretation of data: R.H., T.S., U.M., and T.M. Preparation, review, or approval of the manuscript: R.H., T.S., M.U., and T.M.

Funding

No funding was received for this research.

Author information

Author notes

  1. Tetsuya Sugiyama

    Present address: Nakano Eye Clinic of Kyoto Medical Co-operative, Kyoto, Japan

Authors and Affiliations

  1. Department of Ophthalmology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-Shi, Chiba Prefecture, 285-8741, Japan

    Ryuya Hashimoto, Tetsuya Sugiyama, Makoto Ubuka & Takatoshi Maeno

  2. Department of Ophthalmology, Osaka Medical College, 2-7, Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan

    Tetsuya Sugiyama

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  1. Ryuya Hashimoto
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Correspondence to Ryuya Hashimoto.

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All procedures performed in the studies involving human participants were in accordance with the institutional review board of Toho University Sakura Medical Center and with the 1964 Helsinki Declaration.

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Hashimoto, R., Sugiyama, T., Ubuka, M. et al. Impairment of autoregulation of optic nerve head blood flow during vitreous surgery in patients with hypertension and hyperlipidemia. Graefes Arch Clin Exp Ophthalmol 255, 2227–2235 (2017). https://doi.org/10.1007/s00417-017-3788-5

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  • DOI: https://doi.org/10.1007/s00417-017-3788-5

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