Is there a role for dynamic retinal vessel analysis in internal medicine?

Abstract

Abstract Purpose Human retinal vessels and their reaction to stimuli change during life and in disease due to physiological, genetic and pathological influences. Using the Dynamic Vessel Analyzer (DVA, Fa. IMEDOS, Jena) it is possible to assess changes in retinal vessel diameters in response to vasoactive stimuli in real time and non‐invasively. Methods Retinal arterial vessel reaction in the natural time course and to the average of 3 consecutive monochromatic flicker stimulations (530‐600 nm, 12,5 Hz, 20 s) with a 80 s observation pause between stimulations was investigated in healthy volunteers of different age groups, obese patients, diabetes type 1 patients, systemic hypertensive patients and patients with lysosomal storage disease. Statistical data analysis of vessel reactions independent from the DVA program was performed. Results There is a statistically significant difference in retinal vascular behaviour in different age groups in a healthy population. The same is true between a healthy population and each of the diseases investigated. Lysosomal storage disease however demonstrated an increase in dilation following flicker stimulation compared to normal persons. Conclusion Flicker stimulation of the retina light evokes a prompt vessel reaction in all healthy subjects. We could demonstrate an age dependence of the retinal arterial reaction in medically healthy persons and in hypertension, diabetes and obese patients. From the increased reaction in lysosomal storage disease further understanding of different factors leading to the vascular reaction to stimuli may be derived. Application of flicker stimulus to retinal vessels represents a method to assess the endothelial function of vessels which is important to understand in systemic disease.