Postural effects on spontaneous retinal venous pulsations in healthy individuals.

Abstract

To assess amplitudes of spontaneous retinal venous pulsations (SVP) in three various postures (sitting, supine and lateral decubitus) in healthy individuals. Thirty participants (28±8years, 25 females) were included in the study. Intraocular pressure (IOP), blood pressure (BP) and SVP's were measured at three different postures using a calibrated Tono-Pen applanation tonometer, a digital sphygmomanometer, and a custom-built handheld video ophthalmoscope, respectively. Retinal venous pulsations (SVP) amplitudes were extracted from the retinal videos using a custom written MATLAB algorithm. Mean arterial pressure (MAP=(systolic+2diastolic)/3) and mean ocular perfusion pressure (MOPP=(2/3 MAP)-IOP) were also calculated at each posture. A one-way ANOVA was applied to each parameter to determine any significant difference for the various postural changes. Mean IOP increased (p<0.0001) and mean SVP decreased (p<0.0001) from sitting to supine. The mean IOP (mmHg) and SVP (MU; measuring units) in sitting, supine and lateral decubitus were 16.2±2, 19.4±4, 19.8±2mmHg and 5.8±2, 4.5±2, and 4.7±2 MU, respectively. Mean arterial pressure (MAP) and MOPP also decreased significantly from sitting to supine (p<0.001, p<0.001) and sitting to lateral decubitus (p<0.05, p<0.01). There were no significant differences between IOP, SVP, MAP or MOPP during a postural modification from supine to lateral decubitus. In this study, we showed a significant reduction in SVP amplitudes and a significant increase in IOP from sitting to supine position in a healthy young cohort. This supports the rationale to further study such phenomenon in ocular conditions such as glaucoma to determine whether relative SVP change, for a similar postural change, can reveal early signs of vascular dysfunction.