Ocular rigidity in living human eyes in health and disease

Abstract

Abstract Purpose It is known that the balance between aqueous humor secretion and outflow rate controls the steady ‐ state average intraocular pressure (IOP). It has been also early identified that blood circulation results to IOP fluctuations practically synchronous to cardiac function. IOP is the primary mechanical load to several ocular structures including the optical nerve head. Methods In‐vivo intraoperative measurement of these quantities as well as secretion/outflow coefficients in humans allowed us to quantify ocular rigidity, IOP and its fluctuations (and pulsatile blood flow) in a series of physiological and pathological eyes. Ocular rigidity, outflow facility and pulsatile ocular blood flow were measured intraoperatively in a cohort of 63 patients undergoing cataract surgery. Measurements were also performed in a series of age related macular degeneration (AMD) patients. Results The eye, is a living structure under a continuously varying mechanical load that is strongly related to ocular haemodynamics. Ocular rigidity ranged from 0.0122 to 0.0343 (mean 0.0208)μl‐1. Outflow facility coefficient (derived from pressure decay curves) was 0.33 (sd 0.15)μl/min/mmHg. Pulsatile ocular blood flow exhibited a strong negative correlation to IOP in all subjects. The ocular rigidity coefficient was higher in wet AMD patients compared to patients with dry AMD and healthy controls. Conclusion There are indications that this mechanical load, associated also to ocular rigidity, can not only inter‐modulate blood flow but also have a long‐term effect on other structures in the eye. Understanding the role of these parameters may contribute to the understanding of ocular disease.