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PubMedDate not supplied

[Perfusion pressure in ocular vessels of patients with open-angle glaucoma].

Perfusion pressure in ophthalmic vessels was measured by computer-aided ophthalmodynamography in health, stenoses of the internal carotid artery, and open-angle glaucoma. A total of 70 subjects were examined. Stenoses of the internal carotid artery are associated with a noticeable reduction of perfusion pressure on the side of stenosis. Some patients develop optic nerve atrophy (without excavation). Secondary neovascular glaucoma was diagnosed in 1 patient. Primary open-angle glaucoma was revealed in none of the patients. Increase of intraocular pressure in patients with open-angle glaucoma was associated with a reduction of perfusion pressure. However, in more than 50% of patients a higher pressure was observed in the orbital artery corresponding to the eye with a higher ophthalmic tone than in the contralateral eye. This was conducive to a certain leveling of perfusion pressure. Such a reaction is regarded as a manifestation of autoregulation of ocular vessels, important for blood delivery to the eyes.

Adult↗
PubMed1994

Testing for carotid atherosclerosis.

BACKGROUND: Optometrists frequently examine patients with the signs and symptoms of carotid artery disease. Referral for appropriate testing is mandatory in such patients. METHODS: A review of the noninvasive tests which an optometrist can perform in the office is presented. The paper also describes the noninvasive tests which are performed in vascular clinics on patients in whom carotid atherosclerosis is to be ruled out. Arteriography, both conventional and digital subtraction studies, is also described. RESULTS: A discussion of the appropriate medical and surgical treatment of patients with carotid atherosclerosis and the ocular manifestations of it is included in the paper. CONCLUSIONS: With the increasing expansion of the scope of practice for optometrists, it is imperative that the signs and symptoms of carotid atherosclerosis be understood and managed appropriately. Preliminary tests for carotid arterial disease can be performed in the office, and referral for more extensive testing is better accomplished when those tests are understood by the referring optometrist.

Arteriosclerosis↗
PubMed1994

[Hypertensive choroid angiography. Initial results].

A new method for the examination of choroidal morphology and hemodynamics by SLO-ICG videoangiography under induced hypertension by ocular ophthalmodynamography is presented. In 17 normal subjects, 32 patients suffering from exudative age-related macular degeneration and 13 patients suffering from subretinal fibrosis, the arterial blood vessels of the choroid were demonstrated in detail angiographically. Perfusion pressures of posterior ciliary arteries at their entry into the eye were also estimated. In the majority of patients in each group the central retinal artery was first filled with dye; in the central 40 degrees field 5-8 posterior ciliary arteries were detected; the arterial branches of the submacular choroid were supplied by a submacular ciliary artery in more than half of the cases; however, dye filling of the submacular choroid occurred later than in the surrounding choroid during reduction of intraocular pressure. ICG fluorescence angiography is compared to other angiographic examination methods of choroidal morphology and hemodynamics.

Adult↗
PubMed1993

[Effect of pterygium operation on preoperative astigmatism. Prospective study].

High-grade corneal astigmatism is considered to be an indication for pterygium surgery. However, no prospective studies have been carried out to determine whether a pterygium operation really reduces preoperative astigmatism. Therefore, we prospectively examined 23 patients who were operated on for pterygia at the University Eye Clinic in Freiburg in 1991. Pre- and postoperative corneal astigmatism was measured by ophthalmometry or retinoscopy. Preoperative astigmatism after pterygium surgery was reduced or unaltered in 19 patients. In 4 patients, the postoperative astigmatism was increased. The mean preoperative astigmatism was 2.41 D in the horizontal meridian, the postoperative astigmatism 1.29 D. The reduction was statistically significant (P < 0.0001, Wilcoxon test). The higher the preoperative astigmatism, the higher the difference between pre- and postoperative astigmatism (r2 = 0.88, P = 0.0001). Our technique of pterygium surgery (free conjunctival transplant after polishing the cornea, limbus, and sclera) reduces preoperative astigmatism. Thus, high-grade astigmatism can be regarded as an indication for pterygium surgery.

Astigmatism↗
PubMed1977

[Ophthalmodynamic findings during cardiac surgery with extracorporeal circulation (author's transl)].

Neurological disturbances were seen in patients who underwent open heart surgery with prolonged extracorporeal circulation. These were found mainly in patients older than 50 years and when episodes of hypotension lower than 50 mm Hg occurred during cardiopulmonary perfusion. A method of recognizing cerebral hypoperfusion would be most helpful to prevent brain damage. According to the experimental and clinical findings of Hager the method of ophthalmodynamography allows some conclusion of analogy in relation to the reaction of the brain vessels. The intraoperative ophthalmodynamogram was recorded in 8 patients undergoing surgery using extracorporeal circulation. The ophthalmodynamograms seen during surgery on the beating heart showed changes associated with surgical manipulation. When the arterial pressure fell the orbital pulsation was decreased. The orbital pulsation stopped when the spontaneous heat beat was replaced by extracorporeal circulation. There was no change attributable to the perfusion pressure produced by the roller pump. Cessation of the orbital oscilogram during extracorporeal circulation does not indicate a cerebral hypoperfusion. No neurological lesion was seen in our patients. We were able to show that amplitude of the ophthalmodynamogram is influenced more by the blood pressure amplitued than the mean arterial pressure.

Adult↗
PubMed1996

Detection of disturbed autoregulation of the peripapillary choroid in primary open angle glaucoma.

BACKGROUND AND OBJECTIVE: This study is concerned with perfusion-pressure videoangiographic investigations, performed by combining oculo-oscillo-dynamography and videoangiography. Perfusion-pressure videoangiography permits an evaluation of local vascular resistance in the choroid relative to ciliary perfusion pressure. PATIENTS AND METHODS: Twelve healthy subjects, 21 patients with primary open angle glaucoma (POAG), and 27 patients with ocular hypertension were examined. RESULTS: Perfusion-pressure videoangiograms revealed that the peripapillary choroid (nasal main ciliary artery) filled at distinctly lower perfusion pressures than the paramacular region (temporal main ciliary artery) in all 12 healthy subjects, with a perfusion pressure difference of 12.5 +/- 4.9 mm Hg. In the 21 patients with POAG, the perfusion pressure difference between the beginning of peripapillary and paramacular perfusion was as small as 3.7 +/- 4.5 mm Hg. In the 27 patients with ocular hypertension, the perfusion pressure difference between the two circulatory regions was almost as high as in the healthy subjects. CONCLUSIONS: These examinations showed that (1) there exists efficient autoregulation in the peripapillary choroids of healthy subjects, (2) autoregulation is diminished or even absent in POAG, and (3) autoregulation is normal, increased, or slightly reduced in ocular hypertension.

Adolescent↗
PubMed1977

[Forms and method of rehabilitation therapy and social-occupational rehabilitation of patients with the sequelae of cerebrovascular diseases].

The authors give some data on restitutional therapy of 516 patients (400 with sequelae following strokes and 116 with transient disorders of cerebral circulation). Treatment of the first group was made in a neurological ward, the second--in a cardiological sanatorium. The programme of restitutional therapy provided the use of psychosocial and biological methods, an appeal to the personality and stage-by-stage accomplishment of rehabilitative measures. Comprehensive restitutional therapy included psychotherapy, medical-activizing regimes, medical gymnastics, massage, occupational therapy, medicinal therapy, etc. The authors elaborated differentiated complexes of rehabilitative treatment for patients with spastic hemiparesis, normal or decreased tone, as well as for patients with transient disorders of cerebral circulation in conditions of a cardiological sanatorium. The indices of effectiveness were the following: an improvement of the condition in patients after brain strokes--97.8%, in patients with transient disorders of cerebral circulation--94%.

Cerebrovascular Disorders↗