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Biomedical subjects

C E Riva

Publications and source records attributed to C E Riva.

At least 19 recordsLinked to original sources

Autonomic denervations influence ocular dimensions and intraocular pressure in chicks.

Choroidal thickness and axial eye length in the chick undergo day/night fluctuations that can also be modulated by visual experience. In the present study, we tested the effect of parasympathetic and sympathetic denervations on both day/night and image dependent changes in ocular dimensions. We also correlated such changes with fluctuations in intraocular pressure. Parasympathectomy influenced choroidal thickness and its day/night fluctuation, but had no effect on vision dependent choroidal thickness modulation. Parasympathectomy also influenced-to a lesser extent-axial length and reduced the axial growth response to form vision deprivation. Sympathectomy had little effect on ocular dimensions, but reduced the day/night differences in intraocular pressure. We conclude that (a) the parasympathetic nervous system influences both choroidal thickness and axial length and participates in the neural control mechanism leading to form deprivation myopia and, (b) the day/night fluctuations of choroidal thickness and axial length are unlikely to be explained by fluctuations in intraocular pressure. For the regulation of choroidal thickness, we hypothesize the existence of two independent mechanisms. One involves the parasympathetic nervous system; it influences the day/night choroidal thickness fluctuation. The other uses a separate pathway and is driven by visual input.

Animals

Blood flow in the human iris measured by laser Doppler flowmetry.

A new instrument based on laser Doppler flowmetry (LDF) has been developed to determine noninvasively the relative flux of red blood cells (RBCs) through the microcirculatory network of the iris of the human eye. The probing laser, photodetector, and target fixation devices required by this method were adapted to a slit lamp. Electronic processing and computer analysis of the Doppler signal allow determination of relative velocity, number, and flux of RBCs in the iris, as well as the pulsatility of these flow parameters during the heart cycle. Based on measurements in one eye of eight normal volunteers, the sensitivity of the technique, i.e., the minimum change detectable at the P < 0.05 level, was 4% for the flux. The decrease in blood flow in response to decreases of the ocular perfusion pressure demonstrates the capability of the technique to detect flow changes and its suitability for investigating the physiology and the pharmacology of iris circulation.

Adolescent

Laser Doppler flowmetry and optic nerve head blood flow.

PURPOSE: Ischemic disorders of the optic nerve head constitute an important cause of visual loss. The optic nerve head is supplied by two main sources of blood flow: the superficial layers by the central retinal artery and the deeper layers by the posterior ciliary arteries. This study was conducted in rhesus monkey eyes to obtain a better understanding of which part of the optic nerve head circulation is measured by laser Doppler flowmetry. METHODS: By means of a fundus camera-based laser Doppler flowmetry technique to measure blood flow in the optic nerve head tissue, laser Doppler flowmetry measurements were taken at baseline and then after experimental occlusion of central retinal artery (12 eyes), posterior ciliary arteries (nine eyes), and combined occlusion of central retinal artery and posterior ciliary arteries (nine eyes). Optic nerve head, choroidal, and retinal circulations were investigated by fluorescein fundus angiography after the various arterial occlusions. RESULTS: Average laser Doppler flowmetry flow during central retinal artery occlusion alone was significantly decreased (P<.001) by 39%+/-21% (mean +/- 95% confidence interval) compared with normal baseline. Combined occlusion of central retinal artery and posterior ciliary arteries reduced laser Doppler flowmetry flow even more markedly by 57%+/-27% (P<.0005), but the difference between this flow reduction and that with central retinal artery occlusion alone was not significant (P>.20). After posterior ciliary artery occlusion alone, however, measurements showed a nonsignificant increase in laser Doppler flowmetry flow of 17%+/-37%. CONCLUSIONS: The findings of this study suggest that the standard laser Doppler flowmetry technique is predominantly sensitive to blood flow changes in the superficial layers of the optic nerve head and less sensitive to those in the prelaminar and deeper regions, and their relative proportions are not known. In this laser Doppler flowmetry technique, the weaker Doppler signal from the deep layers cannot be separated from the dominant signal from the superficial layers to exclusively study the circulation in the deep layers; the latter circulation is of interest in optic nerve head ischemic disorders, including glaucoma. Emerging new optical modalities of the laser Doppler flowmetry technique may help in selectively measuring blood flow in the deeper layers.

Animals

[Measuring choroid blood flow with a new confocal laser Doppler device].

UNLABELLED: A new instrument for the measurement of choroidal blood flow in the fovea is presented. It is based on the laser Doppler method and a confocal optical system with an indirect detection of the Doppler shifted light. METHOD: The intensity of the laser beam (785 nm) at the cornea is 90 microW. Measurements were obtained from a normal population of 21 subjects under resting conditions without dilating the pupil. RESULTS: The reproducibility of the choroidal blood flow, based on 5 measurements of 10 s each in 5 randomly selected subjects, is 9%. The minimum detectable change for a statistical significance of p < or = 0.05, based on a population of 21 subjects and 10 s measurements, is 9%. CONCLUSION: This new compact instrument appears to be suitable for the investigation of the physiology and pharmacology of choroidal blood flow and the effect of age-related macular degeneration.

Adolescent

[Effect of decreased ocular perfusion pressure on iris blood flow measured by laser Doppler flowmetry].

PURPOSE: To determine whether iris blood flow (IBF) is regulated in response to an acute decrease in mean ocular perfusion pressure (PPm = MOAP-IOP, MOAP = mean ophthalmic arterial pressure) induced by increasing the intraocular pressure (IOP). METHODS: Iris blood flow was measured using a slit lamp incorporating a laser Doppler flowmetry (LDF) module. The study was conducted on 12 normal volunteers (14 to 59 years old). IOP was raised using a scleral suction cup. In Exp. #1, the suction pressure was successively raised in steps of 50 to 100 mm Hg, each lasting about 10 sec, until IOP reached the MOAP level. In Exp. #2, the suction was raised to 200 mm Hg in 4 successive steps of 2 min duration. RESULTS: In Exp. #1, no significant change of IBF was observed for small decreases of PPm (< 23%); greater decreases of PPm resulted in a linear IBF decrease (p < 0.01). In Exp. #2, such a IBF versus PPm decrease was also observed (p < 0.001). Immediately after release of suction, a significant, transient IBF increase of 79% above baseline level was observed. CONCLUSION: These results suggest that some IBF regulation occurs for small PPm decreases (< 23%); no IBF compensatory mechanism appears to operate for further decreases of PPm (> 23%).

Adolescent

Ocular axial length and choroidal thickness in newly hatched chicks and one-year-old chickens fluctuate in a diurnal pattern that is influenced by visual experience and intraocular pressure changes.

Low coherence laser Doppler interferometry (LDI) allows high precision measurements of the axial length of the eye and of the thickness of the individual layers of the ocular fundus. Here, we used LDI to monitor diurnal changes in these dimensions in eyes of newly hatched chicks and one-year-old chickens with normal or altered visual input. In chicks and chickens with normal visual experience, axial eye length displays diurnal fluctuations increasing during the light phase. Choroidal thickness also exhibits a diurnal pattern, shrinking during the day and expanding during the night. Retinal thickness does not vary. Based on the pressure compliance of the enucleated chick eye, the diurnal intraocular pressure (IOP) fluctuation could contribute both to the increase in axial length and to daytime choroidal shrinkage. Following deprivation of form vision by unilateral goggle wear, occluded chick eyes demonstrate enhanced axial elongation. Diurnal fluctuations in axial length but not in choroidal thickness are temporarily disrupted. The retina of form deprived eyes thins approximately 10% in five days. In contralateral eyes, the diurnal patterns of both axial length and choroidal thickness fluctuations are also disrupted. Following occluder removal in chicks, choroidal thickness increases for several days during both the light and dark phase, leading to its overall expansion. Retinal thickness returns to baseline. When deprived of form vision for five days, the eyes of year-old chickens do not exhibit measurable axial elongation. Diurnal patterns of fluctuation in axial length and choroidal thickness are however disrupted. After goggle removal, axial length fluctuation is restored to normal, but the diurnal choroidal thickness pattern is inverted. In contralateral eyes, choroidal thickness exhibits normal diurnal fluctuations both during and after form vision deprivation. In conclusion, axial length and choroidal thickness fluctuations are influenced by visual experience in both newborn chicks and one-year-old chickens. In selected instances a binocular interaction regarding axial length and choroidal thickness changes is suggested, the effect weakening with age.

Animals

Blood flow in the human optic nerve head during isometric exercise.

Investigating blood flow autoregulation in the optic nerve is important to understand the physiopathology of various ocular diseases such as glaucoma. This investigation requires that one establishes the relationship between optic nerve blood flow and perfusion pressure. Previous work has documented the effect of lowering the perfusion pressure on optic nerve blood flow. The purpose of the present study was to investigate the effect of elevated perfusion pressure on blood flow in this tissue. Laser Doppler flowmetry was applied to measure relative mean velocity, volume and flux of red blood cells in the tissue of the optic nerve head. These parameters were measured in 13 subjects during isometric exercise consisting of squatting. In the range of perfusion pressures from 56+/-4 to 80+/-5 mmHg (30+/-8%), there was no significant variation of mean velocity, volume and flux of red blood cells, but vascular resistance increased by about 50%. Intraocular pressure was increased significantly above baseline at the end of squatting and decreased during recovery. The results suggest that the maintenance of constant blood flow is achieved by an increase in vascular resistance taking place either at the arterioles feeding or at the veins draining the blood from the ONH or at the ophthalmic artery and/or vessels between this artery and the site of LDF measurements. Combining the results of this study with those of a previous one where perfusion pressure was decreased by increasing the intraocular pressure, we show the entire relationship between perfusion pressure and optic nerve blood flow in man.

Adolescent

Vasomotion and spontaneous low-frequency oscillations in blood flow and nitric oxide in cat optic nerve head.

The purpose of this study was to determine whether spontaneous oscillations in blood flow (relative red blood cell flux) measured by laser Doppler flowmetry (LDF) in the cat optic nerve head were related to fluctuations in nitric oxide (NO) measured with electrochemical sensors (n = 16 cats). Power spectral densities for the magnitude and frequency of LDF and NO fluctuations were determined by discrete Fourier transform analysis. Complex behavior was found for both LDF and NO oscillations with broad spectra containing peaks at multiple frequencies. Most of the power was in the low-frequency range (<10 cycles/min). Spectra were also obtained after administering NO synthase inhibitors (l-nitroarginine, L-NA, n = 6 cats; l-nitroarginine methyl ester, L-NAME, n = 5 cats). Both inhibitors caused a decrease in blood flow, basal NO levels, and amplitude of NO fluctuations. There was little change in amplitude for blood flow oscillations, with some enhancement at the lowest frequencies. We conclude that NO is not required for vasomotion and that spontaneous, low-frequency NO fluctuations observed in the cat optic nerve head are a passive phenomenon caused by natural variations in shear stresses.

Animals

[Flicker stimulation induces retinal vasodilation in man].

BACKGROUND: Previous studies have demonstrated, in the cat, a vasodilatation of retinal vessels in response to neuronal activity induced by diffuse luminance flicker. The aim of this study was to determine whether a similar diameter variation is detectable in humans. MATERIALS AND METHODS: Nine normal subjects were exposed to 1 min of sinusoidally varying diffuse luminance flicker (10 Hz, 30 degrees around optic nerve head). Monochromatic fundus pictures before and after the stimulation were taken. The diameter of retinal arteries and veins was measured on the digitised photographs with the NIH-Image software and an own algorythm. RESULTS: The diameter immediately after flicker was significantly larger than the pre-stimulus diameter by 4.2 +/- 2.2% (p < 0.014) (mean +/- SD) for the retinal arteries and 2.7 +/- 1.7% (p < 0.001) for the retinal veins. Six seconds after cessation of the flicker, arterial diameter was not significantly different from that of pre-flicker value. CONCLUSIONS: Diffuse luminance flicker induces an increase in retinal vessel diameter. This suggest that retinal blood flow is coupled with neuronal activity as previously evidenced by the blue field simulation technique in the macula.

Adolescent

[Blood flow measurement in the optic nerve head during isometric exercise].

PURPOSE: Autoregulation of optic nerve head blood flow (Fonh) in response to decreases in perfusion pressure has been demonstrated in animals and humans. The aim of this study was to determine change in Fonh when systemic blood pressure is increased. METHODS: Blood flow parameters, i.e. relative mean velocity, number, and flux of red blood cells in the ONH tissue (Velonh, Volonh and Fonh, respectively) were measured by laser Doppler flowmetry in one eye of 13 normal subjects (aged 16 to 58 years), at baseline, during, and after isometric exercises consisting of squatting. Brachial artery blood pressure was measured by sphygmomanometry. IOP was measured at baseline and at the end of squatting. RESULTS: During squatting mean arterial pressure increased from 103 +/- 6 mm Hg to 139 +/- 58 mm Hg (average +/- 95% confidence interval), IOP increased from 13 +/- 0.5 to 17 +/- 1 mm Hg. An average increase in PPm from 56 +/- 4 to 80 +/- 7 mm Hg induced no significant (p > 0.05) change in the blood flow parameters. The sensitivity (detection threshold) of the blood flow changes was 8%. CONCLUSION: This study shows for the first time in human autoregulation of Fonh when PPm is increased by increasing the systemic blood pressure.

Adolescent

Noninvasive measurement of oxygen tension in the optic nerve head.

Understanding the pathophysiology of the optic nerve head (ONH) requires precise knowledge of the oxygenation of this tissue. Previous investigations used methods based on oxygen sensitive microelectrodes to measure the partial pressure of oxygen in the ONH tissue. These microelectrodes are inserted into the eye through the pars plana. New methods are now being developed to measure the intravascular PO2 in the ONH. They are based on the quenching of phosphorescence of a porphyrin dye by oxygen. Although these methods require an intravenous injection of this dye, the eye is left untouched. This article reviews these noninvasive methods.

Blood Flow Velocity

Photographic and angiographic characterization of the retina of Kenyan children with severe malaria.

OBJECTIVE: To investigate retinal lesions in children with severe falciparum malaria. METHODS: Color photography and fluorescein angiography were performed in consecutive children admitted to a pediatric high-dependency unit in Kenya during 1 malaria season. The presence and category of retinal lesion was compared with disease severity, clinical outcome, anemia, lactic acidosis, and parasite count. RESULTS: Twenty-six patients with cerebral malaria and 14 patients who were prostrate were studied. Thirty-one of the patients had clinical features of ocular disease, including round, flame-shaped, and white-centered hemorrhages; peripheral and foveal retinal opacification; peripheral vascular occlusion; venous dilation; disc edema with hyperemia; and arterial pulsatility. Of 8 patients with retinal opacification, only 2 showed small, infrequent zones of capillary nonperfusion on fluorescein angiography; the leakage of dye at sites of opacification was not seen. Retinal opacification was significantly associated with a higher parasite count (P < .02). White-centered hemorrhages were significantly associated with a higher parasite count (P < .05), severe disease (p < .05), and severe anemia (P < .02). CONCLUSIONS: The blood-retina barrier and retinal vascular flow remain substantially normal despite widespread pathological features. Retinal features in children with severe malaria are consistent with cellular hypoxia, nutritional deficiency, or both rather than with vascular occlusion; they support the concept of metabolic steal by parasites.

Blood-Retinal Barrier

Autoregulation of human optic nerve head blood flow in response to acute changes in ocular perfusion pressure.

BACKGROUND: Studies in animals have demonstrated that optic nerve head (ONH) blood flow (F(onh)) is autoregulated, but there is a lack of evidence for such a process in humans. Therefore, we investigated the relationship between F(onh) and mean ocular perfusion pressure (PPm) in normal volunteers when PPm is decreased through elevation of the intraocular pressure (IOP). METHODS: Laser Doppler flowmetry (LDF) was used to measure relative mean velocity (Velohn), volume (Volonh) and F(onh) of blood at sites of the ONH away from visible vessels, while PPm was decreased in two ways: (1) rapidly, by IOP increments of 15 s duration, and (2) slowly, by IOP increments of 2 min duration, both by scleral suction cup in one eye of each of nine subjects. RESULTS: A rapid and large decrease of PPm of more than 100% induced a decrease of more than 80% in F(onh). With the slower decrease in PPm, F(onh) remained constant down to a PPm of approximately 22 mm Hg (IOP = 40 mm Hg) and then decreased, predominantly due to a decrease in Velohn. Immediately after removal of the suction cup, F(onh) increased transiently by 44% above baseline. CONCLUSIONS: This study demonstrates efficient blood flow autoregulation in the OHN, which is probably brought about by an increase in vascular capacitance. The magnitude of the reactive hyperaemia agrees with the compensatory decrease in ONH vascular resistance during IOP elevation. The time scale of the autoregulatory process and the dependence of the hyperaemia upon duration of IOP elevation suggest a metabolic mechanism of autoregulation.

Adult

[Measuring leukocyte velocity in macular capillaries using a miniaturized blue field simulator: effect of aperture of the pupil].

BACKGROUND: In this paper we present a miniaturized blue field simulator (BFS) which allows the measurement of the velocity (V) pulsatility (P) and number (D) of leukocytes in the macular retinal capillaries. A study on the effect of the aperture size of the blue light source at the subject's pupil on the measured flow parameters was performed. METHODS: A blue field entoptoscope with a small halogen lamp was used to induce the perception of the "flying corpuscles" and a flat color screen was selected to display a computer simulation of this entoptic phenomenon. The aperture of the blue light source at the pupil was varied by a diaphragm placed at a conjugate pupil plane while the size and retinal irradiance of the blue field stimulus at the fundus was held constant. RESULTS: The results show significant correlations between log pupil area and both V (-18% per log unit) and D (+42% per log unit). When the retinal illuminance is expressed in Log Trolands, V shows no dependency, but D is strongly correlated (+40% per log Troland). CONCLUSIONS: When applying the BFS technique, the size of the blue light stimulus at the pupil, if undilated, must be well controlled to minimize instrument-related variations of the blood flow measurements.

Adult

[Effect of changes in ocular perfusion pressure on choroid ischemia in man].

BACKGROUND: The effect of changes in ocular perfusion pressure (PPm) on the choroidal blood flow (ChBF) in man was studied with the laser Doppler flowmetry (LDF) technique. MATERIALS AND METHODS: We changed the PPm by increasing the intraocular pressure (IOP) or by increasing the blood pressure (BP) with isometric exercises. RESULTS: We observed that a) ChBF was not significantly different from baseline up to an IOP of 27 mm Hg and b) ChBF remained constant even if PPm increased by as much as 72%. CONCLUSION: Our results suggest that ChBF is autoregulated in response to an increase in IOP up to about 27 mm Hg. ChBF remains also constant in spite of an increase in systemic BP, probably due to a vasoconstriction induced by increased sympathetic activity.

Adult

Continuous measurements of intra-vascular pO2 in the pig optic nerve head.

BACKGROUND: The measurement of oxygen concentration in the microvasculature of a tissue is important for the understanding of oxygen delivery. MATERIAL AND METHODS: A technique was developed to measure in a continuous manner the partial pressure of oxygen (pO2) in the optic nerve microvasculature of the minipig. This technique is based on the quenching by oxygen of the phosphorescence emitted by a dye that is injected intravenously. It provides measurements of the intra-vascular pO2 and was applied simultaneously with measurements of the extra-vascular pO2 with microelectrodes and blood flow by laser Doppler flowmetry. RESULTS: We demonstrate for the first that the optic nerve head intra-vascular pO2 increases during dark adaptation. Furthermore no change in extra-vascular pO2 and blood flow could be detected. CONCLUSIONS: Based on Krogh's model, these results suggest that oxygen consumption by the optic nerve head tissue increases during dark adaptation.

Animals

Diffuse luminance flicker increases retinal vessel diameter in humans.

PURPOSE: To determine retinal vessel diameter variations in response to neuronal activity induced by diffuse luminance flicker. METHODS: The diameter of retinal arteries and veins was measured in 9 normal subjects by computer analysis of fundus pictures taken in monochromatic light under normal conditions of illumination and after 1 min of sinusoidally varying diffuse luminance flicker at 10 Hz. RESULTS: The diameter immediately after flicker was significantly larger than the pre-stimulus diameter by 4.2 +/- 2.2% for the retinal arteries and 2.7 +/- 1.7% for the retinal veins (mean +/- SD). Six is after cessation of the flicker, arterial diameter was not significantly different from that of pre-flicker value. CONCLUSIONS: Diffuse luminance flicker induces an increase in retinal vessel diameter. This increase most probably reflects an increase in retinal blood flow previously evidenced in humans by the blue field simulation technique. The technique needs to be optimized in terms of flicker parameters, to determine whether flicker-evoked retinal diameter changes could represent a useful clinical measure of the capability of the retinal vascular system to vasodilate.

Adolescent