J Korean Ophthalmol Soc.  2014 Feb;55(2):237-246. 10.3341/jkos.2014.55.2.237.

Diurnal Fluctuation of Ocular Perfusion Pressure in the Fellow Eyes of Branch Retinal Vein Occlusion

• Park CH
• Park HY
• Yoon JY
• Park CK

• KMID: 2218417
• DOI: http://doi.org/10.3341/jkos.2014.55.2.237

Abstract

PURPOSE
To investigate diurnal change in blood pressure (BP), intraocular pressure (IOP), and ocular perfusion pressure (OPP) in patients with unilateral branch retinal vein occlusion (BRVO) and compare the results with healthy controls.
METHODS
We conducted a prospective case-control study which included 50 patients with unilateral BRVO and 50 age-matched volunteers as controls. Each participant underwent a comprehensive ophthalmic examination including optical coherence tomography (OCT). BP and IOP were evaluated 4 times daily at 8 AM, 10 AM, 2 PM and 6 PM. The mean and fluctuation of BP, IOP, mean arterial pressure (MAP), mean OPP (MOPP), and diastolic OPP (DOPP) were compared between fellow eyes of BRVO patients and normal control eyes.
RESULTS
The average retinal nerve fiber layer (RNFL) thickness was significantly reduced in the fellow eyes of BRVO patients compared to control eyes (p < 0.001). Mean IOP and IOP fluctuation did not differ, but BP fluctuation (systolic BP fluctuation, p = 0.045; diastolic BP fluctuation, p = 0.037) and MAP fluctuation (p = 0.011) were greater in the fellow eyes of BRVO patients compared to normal eyes. The mean MOPP and DOPP did not differ between groups, however, the fluctuation of MOPP (p < 0.001) and DOPP (p < 0.001) were significantly increased in the fellow eyes of BRVO patients. The mean and fluctuation of BP, MAP, MOPP and DOPP were associated with reduced average RNFL thickness in the fellow eyes of BRVO patients.
CONCLUSIONS
These results suggest the fellow eyes of unilateral BRVO patients may be at risk of developing glaucomatous damage.

Keyword

Branch retinal vein occlusion; Diurnal fluctuation; Glaucoma; Ocular perfusion pressure

MeSH Terms

Arterial Pressure
Blood Pressure
Case-Control Studies
Glaucoma
Humans
Intraocular Pressure
Nerve Fibers
Perfusion*
Prospective Studies
Retinal Vein Occlusion*
Retinal Vein*
Retinaldehyde*
Tomography, Optical Coherence
Volunteers
Retinaldehyde

Figure

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  Figure 1. Comparison of optical coherence tomography clock- hour retinal nerve fiber layer (RNFL) thickness profiles between healthy eyes, branched retinal vein occlusion eyes, and unaffected fellow eyes.

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  Figure 2. Fluctuation of intraocular pressure (IOP) and ocular perfusion pressure (OPP) in healthy control eyes and fellow eyes of unilateral branched retinal vein occlusion. The mean diurnal variation of IOP, mean OPP (MOPP) and mean diastolic OPP (DOPP) at different time points are shown (left column). The mean IOP, MOPP, and DOPP shows no significant difference at any time point between groups. The absolute diurnal changes of MOPP and DOPP shows significant difference (*) between the control eyes versus fellow eyes (right column).

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  Figure 3. Representative case 1: 52-year-old man with branched retinal vein occlusion (BRVO) in the left eye. Larger diurnal MOPP, and DOPP fluctuation are observed in the fellow eye of the patient, compared to the mean of control eyes. The localized retinal nerve fiber layer (RNFL) defect is found in the superotemporal area in the fellow eye and superotemporal RNFL is reduced on OCT measurements.

Reference

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