Abstract
To investigate changes in retinal vessel density in optic nerve head (ONH) and macula after acute intraocular pressure (IOP) elevation, we conducted a prospective observational study. Eyes with IOP rise ≥5 mmHg after 2-hour dark room prone provocative test (DRPPT) were included. Vasculature of ONH and macula was examined by optical coherence tomography angiography (OCTA) at baseline and after DRPPT. Among the 65 eyes of 42 individuals, 40 eyes with qualified images were enrolled. Mean IOP rise was 9.6 ± 4.2 mmHg (5.0–23.3 mmHg) after DRPPT. Retinal vessel density did not differ after IOP rise for either the papillary region (optic nerve head and radial peripapillary capillary layer) or the macula region (superficial, deep and outer retinal layer) (P > 0.05). Vessel density in each subregion did not change either. If only enrolled eyes with IOP rise ≥10 mmHg, similar results were obtained in condition of IOP increase by 15.0 ± 3.6 mmHg. To conclude, eyes with an acute IOP elevation by 10 or 15 mmHg for two hours, while the blood pressure remained constant, the vessel density in both ONH and macula region examined by OCTA did not show significant changes. The observations fit with an IOP-related autoregulation in retinal blood flow for a moderate elevation of IOP.
Highlights
First time the retinal blood circulation system at different levels of the retina and ONH22
The study included 65 eyes of 42 individuals suspect for occludable angles with otherwise normal eyes, who showed an intraocular pressure (IOP) rise ≥5 mmHg after the dark room prone provocative test (DRPPT)
The IOP increased from 17.2 ± 2.9 mmHg at baseline to 26.4 ± 5.6 mmHg at the end of DRPPT, with a mean rise of 9.6 ± 4.2 mmHg
Summary
First time the retinal blood circulation system at different levels of the retina and ONH22. In view of these new technical possibilities, we conducted the present study to re-assess the relationship between the blood circulation in the retina and optic nerve in eyes at a normal IOP and at an elevated level of IOP. In contrast to previous investigations in which artificial means, such as a suction cup, were applied to increase the IOP, we used the physiological model of IOP elevation by performing a dark room provocative test[23,24,25]
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