Neurovascular coupling in the retrobulbar ciliary circulation

Abstract

Abstract Purpose Perfusion of the retina is adapted to the metabolic demand by neurovascular coupling. Neurovascular coupling has shown to be present in the retinal vasculature, but not in vessels supplying the optic nerve.The present study investigated the presence of neurovascular coupling in the anterior part of the optic nerve in healthy and glaucoma subjects. Methods Retrobulbar blood flow velocities were determined by color Doppler imaging (CDI). A Siemens Elegra ultrasound system with a 7.5L40 transducer was used. Peak‐systolic and end‐diastolic velocities (PSV and EDV) in the central retinal artery (CRA) or the short posterior ciliary artery (SPCA) were the primary readout. CDI measurements were performed shortly before, during, immediately after, 60 s after, and 120 s after a 10‐Hz flicker stimulation of the retina. Results Thirty‐five glaucoma patients and 44 healthy control subjects were included in the study. In the SPCA of healthy controls, flicker stimulation led to a rise of PSV from 9.7±0.8 to 12.5±0.8 cm/s (P<0.001; N=24) and of EDV from 2.4±0.3 to 3.6±0.3 cm/s (P<0.001; N=24). This effect was not detectable in glaucoma patients. In the CRA, flicker light led to an increase of EDV from 2.1±0.2 to 3.0±0.3 cm/s (P=0.002; N=20) in healthy volunteers and from 1.3±0.2 to 2.0±0.2 cm/s in glaucoma patients (P=0.004; N=15). PSV was affected by flicker stimulation in neither the healthy volunteers nor glaucoma patients. Conclusion The data indicate the presence of neurovascular coupling in the vascular bed supplied by the paraoptic SPCA. The response pattern to the flicker stimulus differs between healthy and glaucoma subjects.