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At least 433 records · Page 24Linked to original sources

[Ocular circulatory changes in halothane-nitrous oxide intubation anesthesia with special reference to arterial CO2 partial pressure. I. Phenomenology of changes].

UNLABELLED: In 20 patients (5 with cataract, 15 with strabismus), general anesthesia was performed using halothane (inspiratory concentration: 0.5 vol.%) and nitrous oxide (65 vol.%); thiopental was employed for induction of anesthesia, vecuronium and succinylcholine were used for neuromuscular blockade prior to intubation. In series 1, the patients were slightly hyperventilated (PCO2 33 mmHg, on average). In series 2, the arterial PCO2 was changed in a range between 20 and 45 mmHg. By means of oculo-oscillo-dynamography, we determined the systolic retinal and ciliary perfusion pressures (PPs,ret and PPs,cil) as well as the respective ocular blood pressures (Ps,ret and Ps,cil), the ocular pulsation volume (PVoc) and the pulsatile ocular blood flow (Fp,oc = PVoc x heart rate). The intraocular pressure (Pio) was measured with the Draeger hand-applanation tonometer. Results of series 1: Measured 5 and 15 min after intubation, PPs,ret was reduced by averages of 12.5 and 20.2 mmHg, respectively, corresponding to decreases of 13.1 and 21.2% compared to the initial values. Ps,ret was decreased by 15.4 mmHg (14.2%) 5 min after intubation and by 27.1 mmHg (25.0%) 15 min after intubation. The ciliary pressures (PPs,cil and Ps,cil) were changed by similar amounts. PVoc was reduced by 0.3 microliters (50.8%) during both time periods after intubation. Fp,oc was lowered by 19.5 microliters/min (41.0%) and by 26.4 microliters/min (55.5%), measured 5 and 15 min after intubation, respectively. Pio was decreased by 1.6 mmHg (11.3%) and by 7.6 mmHg (53.5%), respectively. The systolic brachial artery pressure was reduced by 12.6 mmHg (9.5%) 5 min after intubation and by 29.1 mmHg (21.9%) 15 min after intubation. The diastolic branchial artery pressure showed a slight initial increase, followed by a small decrease. All changes were highly significant (P less than 0.001; 1-factor analysis of variance plus Scheffé test). Results of series 2: In a PCO2 range between 40 and 45 mmHg (normo-until slight hypoventilation; determined 5 min after intubation), PVoc and Fp,oc averaged 0.43 microliter and 42.9 microliters/min, respectively. In a PCO2 range between 30 and 35 mmHg (slight hyperventilation), PVoc and Fp,oc averaged 0.38 microliters and 36.1 microliters/min, respectively; and in a PCO2 range between 20 and 25 mmHg (forced hyperventilation), they averaged 0.21 microliter and 22.8 microliters/min, respectively. All other variables were not dependent on the PCO2 level. CONCLUSIONS: The lowering of PVoc and Fp,oc, observed during halothane-nitrous oxide anesthesia--especially with forced hyperventilation-, may be interpreted as reduced pulsatile choroidal blood flow.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗

[Changes in the circulation of the eye caused by Vörösmarthy preoperative ocular pressure].

Prior to, directly after and 15 minutes after preoperative Vörösmarthy oculopression (30, 40, or 50 mm Hg; 15 min), 30 patients were examined by oculooscillodynamography after Ulrich. Systolic retinal and ciliary perfusion pressures were higher directly after oculopression, whereas the systolic and diastolic ocular blood pressures (intramural pressures) were lower. These changes did not depend significantly on the level of oculopression. Fifteen minutes after oculopression, the ocular perfusion and blood pressures were largely normalized. The hemodynamic changes observed reflect the decrease in intraocular pressure resulting from oculopression. The changes are thought to have a beneficial effect on ocular perfusion (reduction in tissue pressure, decrease in vascular resistance, increase in transmural pressure). The authors' results are consistent with the finding in animal experiments that blood flow to the retina, optic nerve, and uvea increases for a short time after oculopression (Jay et al., Acta Ophthalmol. 1986).

Aged↗

[Ocular circulatory changes caused by retrobulbar anesthesia with and without added adrenaline].

UNLABELLED: In 80 patients, retrobulbar anesthesia (RBA; 5 ml of a lidocaine-bupivacaine mixture with hyaluronidase) with or without addition of adrenaline (after-mixing concentration 1:500,000) was performed preoperatively. In 2 examination series, the acute and medium-term effects of RBA on the following ocular circulatory variables were investigated: ocular pulsation volume (PVoc), systolic ciliary and retinal perfusion pressures or blood pressures, respectively (method: oculo-oscillo-dynamography). RESULTS: RBA with adrenaline: Directly after injection, PVoc was reduced by an average of 49%, the ocular perfusion and blood pressures were lowered by averages of 8.0 and 4.3 mmHg, respectively, and the intraocular pressure (Pio; hand-applanation tonometer) was elevated by 3.5 mmHg. 15 min after injection, PVoc and the ocular perfusion and blood pressures were even slightly more reduced, whereas Pio had reassumed its pre-injection level. RBA without adrenaline: During both time periods after injection, the reduction of PVoc averaged 10% less compared to RBA with adrenaline. The changes in ocular perfusion and blood pressures and in Pio, however, were not significantly different from RBA with adrenaline. CONCLUSIONS: The lowering of PVoc--which variable is determined mainly by the pulsatile choroidal blood flow--in concert with the lowered ciliary perfusion and blood pressures is indicative of a reduced ciliary blood flow during RBA. Because of the decreased retinal perfusion and blood pressures, there is also a higher risk of reduced blood supply to the retina. Only to some degree, the observed inhibitory RBA effects on ocular circulation can be explained by adrenaline, and to an even smaller degree by the only transient Pio elevation.

Adult↗

[Relation of negative pressure difference and artificially elevated intraocular pressure using the suction cup method].

This paper presents regressions and the range of scatter of measured values for current standard ophthalmologic suction cups for the first time. The scatter range is similar to that of blood pressure measurements made by the Riva-Rocci method. Using the regressions presented here it is possible to deduce the increase in pressure from the negative pressure difference in the suction cup; this can be done with sufficient accuracy and the amount of time required is acceptable.

Humans↗

[Ulrich oculo-oscillodynamography in carotid artery stenosis and temporal arteritis].

Oculo-oscillodynamography (OODG) after Ulrich was performed on 21 patients suffering from unilateral hemodynamically relevant carotid stenosis. In ten patients the perfusion pressure was low on the affected side. In the other eleven patients there was no difference between the two sides and these patients were thought to have well-developed collateral anastomoses. In nine patients with temporal arteriitis low perfusion pressure was found by OODG on the side with the lower visual acuity. After systemic therapy with corticosteroids the perfusion pressure normalized on both sides.

Aged↗

[Oculo-oscillodynamography findings in glaucoma without hypertension].

Oculo-oscillodynamography after Ulrich was performed in 27 patients suffering from glaucoma without hypertension (so-called low-tension glaucoma). Patients who had severe systemic disease or were receiving systemic medication which might influence IOP, and patients with narrow angle and an IOP higher than 22 mm Hg were excluded. In 85% of the patients a severe decrease in systolic ciliary perfusion pressure was found, whereas the systolic retinal and diastolic ocular perfusion pressures were significantly lower in almost 30% of the cases. Glaucoma without hypertension appears to be caused by the vascular change at the disk.

Aged↗

[Ocular hemodynamics following suction cup oculopression].

In the study reported here the authors investigated the influence on ocular perfusion pressures of suction-cup oculopression, a procedure which permits oculopression without orbital compression. Patients over 50 years of age were examined before cataract extraction. Ulrich's method of ocular oscillodynamography was used to determine ocular perfusion pressures. A Mikuni and Yoneyama suction-cup dynamometer was applied for suction-cup oculopression. Ocular hypotonia following suction-cup oculopression was adequate and comparable to that achieved by other oculopression methods. After oculopression a significant increase in ocular perfusion pressures (retinal, ciliary, and diastolic) was found. However, ocular blood pressure remains constant after oculopression. Moreover, the increase in ocular perfusion pressure could not be explained by oculocardiac reflexes, because there was no change in systemic arterial blood pressure. It must be assumed, therefore, that the increase in ocular perfusion pressures is caused by a lowering of resistance, i.e., a drop in intraocular pressure.

Blood Pressure↗

[Ocular hemodynamics following local administration of clonidine].

The influence of topically applied clonidine 0.125% on ocular hemodynamics was investigated in ten patients with open-angle glaucoma and ten healthy volunteers, using a new, differentiated method. Ocular perfusion pressures were determined by Ulrich's method of oculo-oscillodynamography. Following monocular application of clonidine 0.125% eye drops a clear decrease in systemic blood pressure and a somewhat less pronounced reduction of ocular perfusion pressure was observed in both groups of patients. The reduction in ocular perfusion pressures was higher in the eye after drop application than in the untreated control eye. It must therefore be assumed that clonidine 0.125% eye drops have a local perfusion pressure-reducing effect in addition to their systemic effect.

Adult↗

[A test of pressure tolerance of the optic nerve head in ocular hypertension].

VER was recorded in 7 patients with ocular hypertension while intraocular pressure was artificially elevated. Four of the patients manifested signs of vascular autoregulation, while in 3 no such signs were observed. This absence of autoregulation was also observed in primary open-angle glaucoma patients. On the basis of these first results it may be expected that the pressure compliance test will identify patients with ocular hypertension in whom damage to the optic disk is likely to occur at a later date.

Adult↗

[Ophthalmodynamography and Doppler ultrasonography of orbital vessels in temporal arteritis].

Twenty-three patients presenting with clinical and angiological signs of temporal arteritis were examined by ODG and DUSG. While the results of ODG were positive in all 23 patients, DUSG failed to furnish diagnostic evidence of temporal arteritis. Findings with DUSG were positive in only 9 out of 23 patients. DUSG is less suitable than ODG as a means of diagnosing temporal arteritis.

Aged↗

[Measurement of coaxial position in lens implants].

Intraocular lens implantation occasionally causes binocular diplopia resistant to prismatic correction. Present methods of examination cannot determine the cause of this incurable diplopia. Therefore, a new method based on keratometry has been invented to allow qualitative and quantitative analysis of biomicroscopically undetectable decentration of intraocular lens implants producing asthenopic complaints. The present study investigates the type and frequency of intraocular lens decentration relative to the visual axis.

Diplopia↗

[Ocular hemodynamics in central and branch artery occlusions].

Ocular oscillodynamograms (OODG) were made in 9 patients with an occlusion of the central artery and 11 patients with an occlusion of one branch artery. While there were no pathologic findings in patients with branch artery occlusions, it was not possible to record any systolic-retinal oscillations of the pulse in patients with an occlusion of the central artery. In three cases the systolic ciliary perfusion pressure was also low owing to carotid stenosis.

Adult↗

[The significance of dynamometric findings for the prognosis of essential hypertension (author's transl)].

Prognoses for patients with hypertonic fundus changes of groups I and II (according to Wagener, Keith) are made on the basis of blood pressure levels and possible known complications. The ophthalmo-dynamometric investigations described here indicate that if the blood pressure in the ophthalmic artery is higher than might be expected from the blood pressure of the hypertonic patient, this is prognostically unfavorable, particularly in patients over 60-years-old.

Age Factors↗

[Ophthalmodynomometry results in central serous retinopathy].

In nine out of 15 eyes with central serous retinopathy verified by fluoroangiography raised Pm. ophth. values were found. The average value of deviations obtained in these 15 eyes was significantly higher than in 30 controls. A possible correlation between central serous retinopathyl and increased peripheral cerebral flow resistance is discussed.

Humans↗

[Amaurosis fungax. Studies on hemodynamics and platelet function].

Thirty-eight patients with amaurosis fugax were examined ophthalmologically. In 12 of these cases carotid occlusion was diagnosed by ophthalmodynamography and Doppler ultrasonography of the orbital vessels. Angiographic substantiation was possible in nine of these patients. The pathognomonic importance of amaurosis fugax for occlusive carotid disease is clearly shown by these findings. The plasma concentration of platelet specific proteins was examined in 32 patients and found to be pathologically increased in 13 cases. Spontaneous aggregation of platelets and circulating platelet aggregates were only found in a few patients. Due to the lack of coincidence between the event of amaurosis fugax and the time when platelet function tests were made no definite conclusions may be drawn from these results. Yet disturbances of platelet function must be taken into consideration in the pathogenesis of amaurosis fugax.

Adult↗

[Biomicroscopic pneumatic ophthalmodynamography (author's transl)].

One hundred volunteers were examined with a new pneumatic dynamometer which permits the use of the slit lamp and the Hruby lens, this is a noncorneal-contact instrument indicating the relationship between diastolic systemic pressure and diastolic ophthalmic pressure; in the latter case, the pressures in the two eyes are compared.

Adolescent↗