Ophthalmodynamometric pressure in eyes with proliferative diabetic retinopathy measured during pars plana vitrectomy

Am J Ophthalmol. 2011 Apr;151(4):624-629.e1. doi: 10.1016/j.ajo.2010.09.025. Epub 2011 Jan 13.

Abstract

Purpose: To measure ophthalmodynamometric pressure (ODP) during vitrectomy in patients with proliferative diabetic retinopathy (PDR).

Design: Prospective, interventional, consecutive case series.

Methods: This study included 75 eyes of 75 patients undergoing vitrectomy for PDR. After core vitrectomy, the intraocular pressure was gradually raised using a vented-gas forced-infusion system (VGFI), and the optic nerve head was continuously monitored through a planoconvex contact lens. When the central retinal artery or its branches on the optic nerve head showed pulsations, the pressure was recorded as ODP. Diastolic blood pressure (DBP) and systolic blood pressure (SBP) were measured at the time of ODP measurement. Multiple regression analysis was performed to investigate the relationship between ODP and various explanatory variables: DBP, SBP, age, gender, body mass index, presence of hypertension, serum hemoglobin A1c, serum total cholesterol, fasting plasma glucose, presence of rubeosis iridis, and severity of PDR.

Results: ODP was 63.6 ± 11.5 mm Hg (range 15.5-84.4 mm Hg). The ODP significantly correlated with DBP (r=0.570, P<.0001) and the mean arterial blood pressure (r=0.522, P<.0001), but not with SBP (r=0.121, P=.303). Multiple regression analysis revealed that ODP had a significant correlation with DBP (P<.0001), presence of rubeosis iridis (P<.0001), and severity of PDR (P=.046).

Conclusions: We measured ODP using VGFI during vitrectomy in patients with PDR. The ODP was significantly associated with DBP. The ODP was lower in patients with rubeosis iridis and severe PDR.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / metabolism
  • Blood Pressure / physiology*
  • Body Mass Index
  • Cholesterol / blood
  • Diabetic Retinopathy / blood
  • Diabetic Retinopathy / physiopathology*
  • Diabetic Retinopathy / surgery
  • Female
  • Fluorescein Angiography
  • Glycated Hemoglobin / metabolism
  • Humans
  • Intraocular Pressure / physiology*
  • Iris / blood supply
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / physiopathology
  • Ophthalmodynamometry*
  • Prospective Studies
  • Retinal Artery / physiology*
  • Vitrectomy*

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human
  • Cholesterol