Abstract

Elevated intraocular pressure (IOP) is an important risk factor for glaucoma. However, the role of IOP in glaucoma progression, as well as retinal physiology in general, remains incompletely understood. We demonstrate the use of visible light optical coherence tomography to measure retinal responses to acute IOP elevation in Brown Norway rats. We monitored retinal responses in reflectivity, angiography, blood flow, oxygen saturation ( ), and oxygen metabolism over a range of IOP from 10 to 100mmHg. As IOP was elevated, nerve fiber layer reflectivity was found to decrease. Vascular perfusion in the three retinal capillary plexuses remained steady until IOP exceeded 70mmHg and arterial flow was noted to reverse periodically at high IOPs. However, a significant drop in total retinal blood flow was observed first at 40mmHg. As IOP increased, the venous demonstrated a gradual decrease despite steady arterial , which is consistent with increased arterial-venous oxygen extraction across the retinal capillary beds. Calculated total retinal oxygen metabolism was steady, reflecting balanced responses of blood flow and oxygen extraction, until IOP exceeded 40mmHg, and fell to 0 at 70 and 80mmHg. Above this, measurements were unattainable. All measurements reverted to baseline when the IOP was returned to 10mmHg, indicating good recovery following acute pressure challenge. These results demonstrate the ability of this system to monitor retinal oxygen metabolism noninvasively and how it can help us understand retinal responses to elevated IOP.

Highlights

  • Elevated intraocular pressure (IOP) is the best-characterized risk factor for glaucoma, the second leading cause of blindness worldwide,[1] and lowering IOP can preserve vision for many glaucoma patients.[2]

  • Measurements by optical coherence tomography angiography (OCTA)[8] indicated that capillary density in the radial peripapillary capillary plexus is highly correlated with nerve fiber layer (NFL) thickness.[9]

  • No systemic blood pressure or heart rate changes were found with IOP elevation

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Summary

Introduction

Elevated intraocular pressure (IOP) is the best-characterized risk factor for glaucoma, the second leading cause of blindness worldwide,[1] and lowering IOP can preserve vision for many glaucoma patients.[2]. The detected densities of vascular plexuses in glaucoma were lower, due to capillary dropout, in both the macular and the optic disc regions compared to that in normal vascular plexuses.[11,12]

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