OCULAR HEMODYNAMICS IN NON-EXUDATIVE AGE RELATED MACULAR DEGENERATION

Year 2014, Volume: 16 Issue: 2, 19 - 22, 01.07.2014

Ahmet Taner Gökgöz Talat Bahçebaşı İbrahim Kılıç Murat Tunç

Abstract

Purpose: To explore changes in retrobulbar ocular blood flow dynamics in patients with nonexudative age- related macular degeneration (ARMD). Materials and Methods: 52 patients (M=28, F=24) with ARMD and 45 age-matched healthycontrols (M=23, F=22) were included in our evaluation. Full ophthalmic examination and orbitalcolor Doppler imaging was performed in both eyes. Peak systolic and end-diastolic velocities,resistive and pulsatility indices were considered as Doppler blood flow parameters in ourevaluation. Central retinal, ophthalmic, temporal posterior ciliary and nasal posterior ciliaryarteries measurements were taken. Results: The mean age was 65.90 ± 2.05 in ARMD and 60.95 ± 1.34 in thecontrol group. Pulsatility and resistive indices in ophthalmic arteries of ARMD patients weresignificantly higher than the control group. The peak systolic and end-diastolic velocities innasal and temporal posterior ciliary arteries were significantly lower whereas pulsatility andresistive indices were significantly higher in ARMD compared to the control group. Peak systolicand end-diastolic velocities and resistive indices were significantly higher in ARMD cases,especially in posterior ciliary arteries supplying the choroid. Conclusion: Perfusion defects of the retrobulbar vasculatures were significantly higher inARMD compared to the healthy controls

Keywords

Non-exudative age-related macular degeneration, choroidal perfusion, Dopplerultrasound, ocular hemodynamics

Non-Eksudatif Yaşa Bağlı Makula Dejenerasyonunda Oküler Hemodinami

Abstract

Amaç: Amaç: Non-eksudatif yaşa bağlı makula dejenerasyonu bulunan hastalarda retrobulbaroküler kan akım hemodinamisindeki değişikliklerin değerlendirilmesi (ARMD). Materyal ve Metod: ARMD’si olan 52 hasta (E=28, K=24) ve 45 tane yaşı uyumlu sağlıklıbirey (E=23, K=22) çalışmaya dahil edildi. Her iki grupta, bilateral tam oftalmik muayene veorbital renkli doppler görüntüleme gerçekleştirildi. Doppler kan akım parametreleri olarak piksistolik ve end-diyastolik hızlar, rezistif ve pulsatilite indeksleri belirlendi. Santral retinal,oftalmik, temporal posterior siliyer ve nazal posterior siliyer arterlerde ölçümler yapıldı. Sonuçlar: ARMD’li grupta yaş ortalaması 65.90 ± 2.05 , kontrol grubunda ise 60.95 ±1.34 idi. ARMD hastaların oftalmik arterlerinde, pulsatilite ve resistif indeksleri kontrolgrubuna göre anlamlı yüksek bulundu. ARMD’li grupta kontrol grubuna göre, temporal posteriorsiliyer ve nazal posterior siliyer arterlerde, pik sistolik ve end-diyastolik hızlar anlamlı düşük,pulsatilite ve resistif indeksleri ise anlamlı yüksekti. Pik sistolik, end-diyastolik hızlar ve rezistifindeksler ARMD’li hastalarda, özellikle koroidi besleyen posterior siliyer arterlerde anlamlıyüksek bulundu. Sonuç: Retrobulbar vasküler yapılarda perfüzyon defektleri, ARMD’li grupta kontrol grubunakıyasla anlamlı yüksektir

Keywords

Yaşa bağımlı non-eksudatif makular dejenerasyon, koroidal perfüzyon, doppler ultrason, oküler hemodinami

References

• Edwards MG, Bressler NM, Raja SC. Age- related macular degeneration. In: Yanoff M
• Duker, editors. Opthalmology. London: Mosby, 1999; 8.28. 1-10.
• Klein R, Klein BE, Jensen SC, Meuer SM. The five years incidence and progression of age related maculopathy. The Beaver Dam Eye Study. Ophthalmology 1997; 104: 7-21.
• Hirvela H, Luukinen H, Laara E. Risk factors of age- related maculopathy in a population 70 years of age or older. Ophthalmology 1996; 103: 871-877.
• Stryker WS, Kaplan LA, Stein EA, Stampfer MJ, Sober A, Willett WC. The relation of diet, cigarette smoking, and alcohol consumption to plasma beta carotene and alpha- tocopherol levels. Am J Epidemiol 1988; 127: 283-296.
• Gerster H. Antioxidant protection of the ageing macula. Age Ageing 1991; 20: 60-69.
• Gass JDM. Pathogenesis of disciform detachment of neuroepithelium: 3. senile disciform macular degeneration. Am J Ophthalmol 1967; 63: 617-644.
• Verhoeff FH, Grossman HP. Pathogenesis of disciform degeneration of the macula. Arch Ophthalmol 1987; 18: 561- 585
• Moore KL. Clinically oriented anatomy. 2nd ed. Baltimore: Williams and Wilkinson, 1985; 886-907.
• Grunwald J, Hariprasad S, DuPont J. Foveolar choroidal blood flow in age- related macular degeneration. Invest Ophthalmol Vis Sci 1998;39:385-390.
• Friedman E, Krupsky S, Lane A. Ocular blood flow velocity in age-related macular degeneration. Ophthalmology 1995;102:640-646.
• Dimitrova J,Tamaki Y, Kato S. Retrobulbar circulation in patients with age-related maculopathy. Eye 2002;16:580-586.
• Ciulla T, Harris A, Chung S.H, Danis PR, Kagemann L, Mcnulty L et al. Color Doppler imaging discloses reduced ocular blood flow velocities in nonexudative age-related macular degeneration. Am J Ophthalmol 1999;128:75-80.
• Uretmen O, Akkin C, Erakgun T, Killi R. Color doppler imaging of choroidal circulation in patients with asymmetric age-related macular degeneration. Ophthalmologica 2003;217:137-142.
• Polska E, Kircher K, Ehrlich P, Vecsei PV, Schmetterer L. RI in central retinal artery as assessed by CDI does not correspond to retinal vascular resistance. Am J Physiol Heart Circ Physiol, 2001; 280:H1442-H1447.
• Mori F, Konno S, Hikichi T, Yamaguchi Y, Ishiko S, Yoshida A. Pulsatile ocular blood flow study: decreases in exudative age-related macular degeneration. Br J Ophthalmol 2001;85:531-533.
• Harris A, Haris M, Biller J, Garzozi H, Zarfty D, Ciulla TA, Martin B, et al. Aging affects the retrobulbar circulation differently in women and men. Arch Ophthalmol 2000;118:1076-1080.
• Harris A, Joos K, Kay M, Evans D, Shetty R, Sponsel WE, Martin B. Acute IOP elevation with scleral suction:effects on retrobulbar haemodynamics. Br J Ophthalmol, 1996;80:1055- 1059.
• Sonntag WE, Lynch CD, Cooney PT, Hutchins PM. Decreases in cerebral microvasculature with age are associated with the decline in growth hormone and insulin-like growth factor. Endocrinology 1997; 138:1311-1314.
• McGrath BP, Liang YL, Teede H, Shiel LM, Cameron JD
• Dart A. Age- related deterioration in arterial structure and function in postmenopausal women: impact of hormone replacement therapy. Arterioscler Thromb Vasc Biol. 1998,18:1149-1156.