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Non-invasive Assessment of Central Retinal Artery Pressure: Age and Posture-dependent Changes.
Kostic, Maja; Gordon, Phillip; Monsalve, Pedro; Jang, Hong; Lam, Byron L; Guy, John; McSoley, John; Vazquez, Luis; Hodapp, Elizabeth; Porciatti, Vittorio.
Afiliación
  • Kostic M; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami, FL, USA.
  • Gordon P; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami, FL, USA.
  • Monsalve P; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami, FL, USA.
  • Jang H; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami, FL, USA.
  • Lam BL; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami, FL, USA.
  • Guy J; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami, FL, USA.
  • McSoley J; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami, FL, USA.
  • Vazquez L; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami, FL, USA.
  • Hodapp E; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami, FL, USA.
  • Porciatti V; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami, FL, USA.
Curr Eye Res ; 46(1): 135-139, 2021 01.
Article en En | MEDLINE | ID: mdl-32441142
Purpose: Assessment of Ocular Perfusion Pressure (OPP) requires estimation of the Mean Central Retinal Artery Pressure (MCRAP) [OPP = MCRAP-IOP]. In a seated position, MCRAP is currently estimated as 2/3 of the Mean Arterial Pressure (MAP) to account for the hydrostatic reduction of MAP at eye level. We tested a surrogate method for direct MCRAP assessment by measuring MAP with Arm-Up and cuff at eye level (AUMAP) at different postures and ages. Methods: MAP and AUMAP were assessed in a mixed population of 136 subjects (mean age 44 ± 17.39 years) including healthy participants (N = 30) and patients with optic neuropathies (Glaucoma suspects, N = 14; Open-Angle Glaucoma, N = 26, LHON, N = 19; MS, N = 47) not expected to alter systemic blood pressure. None of the subjects had history of carotid stenosis or pharmacological treatment to regulate blood pressure. AUMAP was also tested in two subgroups in supine (N = 42) and -10° Head Down body Tilt position (HDT, N = 46). Results: In the seated position, both 2/3MAP and AUMAP increased with increasing age, however with steeper (2x) slope for AUMAP (P < .0001). With decreasing angle of body tilt, AUMAP increased while MAP decreased. The mean AUMAP/MAP ratio (posture coefficient) was, seated, 0.73 (SE 0.003); supine, 0.90 (SE 0.005); HDT, 0.97 (SE 0.005). In the seated position only, the AUMAP/MAP ratio significantly increased with age (P < .0001). Mean posture coefficients obtained with AUMAP were in the range of those based on either direct ophthalmodynamometric measurements or hydrostatic estimations. Conclusions: Surrogate measurement of MCRAP in individual subjects is feasible using the simple AUMAP approach that provides a straightforward estimation of OPP (OPP = AUMAP - IOP) at different body postures. The standard method OPP = 2/3*MAP-IOP in the seated posture underestimates OPP at older ages. Clinical estimation of OPP would benefit from the use of AUMAP, in particular for head-down postures.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Postura / Arteria Retiniana / Glaucoma de Ángulo Abierto / Presión Arterial Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Curr Eye Res Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Postura / Arteria Retiniana / Glaucoma de Ángulo Abierto / Presión Arterial Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Curr Eye Res Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido