Ophthalmic Artery

To compare the ophthalmic artery (OA) perfusion of pregnant smokers and nonsmokers by Doppler indexes. Correlate these with the interval of last cigarette, cigarettes per day, years smoking and carbon monoxide expired (COex). Transversal study involving 70 pregnant smokers divided into 33 pregnant who smoked until 2 h: A group (AG) and B group (BG): 37, who smoked between 2 and 24 h before test. Control group (CG) was composed of 51 pregnant nonsmokers. Doppler indexes were assessed: PSV (Peak Systolic Velocity), EDV (End Diastolic Velocity), PI (Pulsatility Index), RI (Resistance Index) and PR (Peak Ratio). Groups were compared using ANOVA, Kruskal-Wallis test, Student's t test, Mann-Whitney and Pearson's correlation coefficient, whereas p < 0.05. RI and PI were higher (p < 0.01) and PSV and EDV were lower (p < 0.05) in B group compared to other groups. A group presented higher PR (p < 0.01) compared to control. AG presented years of smoking, cigarettes per day, COex greater than BG and lower interval of last cigarette than BG. The OA in pregnant smokers shows a biphasic pattern of perfusion correlated with the time of consumption of the last cigarette. There are signs of vasoconstriction and hypoperfusion to tobacco exposure between 2 and 24 and hyperperfusion in A Group compared to B Group.

BACKGROUND: Superselective delivery of chemotherapy through the ophthalmic artery, i.e. ophthalmic artery chemosurgery, has been used for the treatment of advanced intraocular retinoblastoma. Herein, we evaluate the efficacy of ophthalmic artery chemosurgery for retinoblastoma associated with >50% retinal detachment. PROCEDURE: Retrospective review of 37 eyes of 34 retinoblastoma patients who had extensive (>50%) bullous non-rhegmatogenous retinal detachments and received ophthalmic artery chemosurgery either as primary treatment or as "salvage" treatment after failed multi-cycle intravenous chemotherapy and/or external beam radiation (mean follow-up, 21 months). Data on patient and ocular survival, complications of ophthalmic artery chemosurgery treatments, time course of retinal reattachment, and serial electroretinograms (ERG) were collected. RESULTS: A total of 134 ophthalmic artery chemosurgery injections were performed. All children survive. Five eyes (5/37; 14...

Intracranial dissecting and giant serpentine aneurysms are rare vascular anomalies. Their precise cause has not yet been completely clarified, and the radiological appearance of such lesions can be different in each case according to the effect of hemodynamic stress on a pathologic vessel wall. For berry aneurysms, available evidence overwhelmingly favors their causation by hemodynamically induced degenerative vascular disease and there is an obvious need to determine the hemodynamic parameters most likely to induce the precursor atrophic lesions. In this study, a case of a giant dissecting aneurysm angiographically mimicking serpentine aneurysm of the right ophthalmic artery is reported and the relevant literature is reviewed to investigate the pathological characteristics and pathogenesis of this lesion. In the present case, radiological investigation of the lesion suggested a serpentine aneurysm, but the diagnosis was corrected to dissecting aneurysm subsequent to the pathological examination of the resected aneurysm. A giant dissecting aneurysm angiographically mimicking serpentine aneurysm and developing as the result of a circumferential dissection located between the internal elastic lamina and media is of particular interest when the etiology of these aneurysms is considered. To our knowledge this is the first report on intracranial dissecting aneurysm mimicking serpentine aneurysm angiographically. Our case illustrates the importance of careful serial section studies for a better understanding of the vascular pathology underlying the processes involved in intracranial serpentine aneurysms. We conclude that serpentine, dissecting and berry aneurysms may all arise by way of similar pathophysiological mechanisms.

Purpose To assess ocular hemodynamic response to intravitreal triamcinolone in patients with macular edema due to diabetes or retinal vein occlusion. Methods Forty-three patients that were injected by intravitreal triamcinolone acetonide (0.1 cc 4 mg) for unilateral macular edema due to diabetes mellitus (n = 17) and occlusion of retinal vein (n = 26) underwent ocular hemodynamic evaluation by color Doppler imaging (CDI) before and one, two and three months after injection. Non-injected fellow eyes as well as 16 healthy volunteers were also evaluated. Results In patients with diabetic macular edema, there was no hemodynamic difference between eyes to be injected and non-injected at baseline (P > 0.23). Compared to controls, a significant difference existed in the ophthalmic artery resistant index (P = 0.001) and end-diastolic velocity (P < 0.001) in diabetics. At one month, compared to fellow eyes, change in end diastolic velocity from baseline in treated eyes was significantly decreased in posterior ciliary arteries (0.68 ± 0.34 cm/s [mean ± SEM] vs. −1.04 ± 0.81 cm/s, P = 0.012). Throughout the study period, no significant alteration from baseline in the resistant index of any artery was noted in treated diabetic eyes (P > 0.05). In eyes with retinal vein occlusion, baseline CDI evaluation demonstrated reduced posterior ciliary arteries systolic flow velocity compared to fellow and control eyes (13.24 ± 1.04 cm/s, 16.37 ± 0.76 cm/s and 14.33 ± 1.41 cm/s, respectively, P = 0.007). Increased peak systolic velocity in the posterior ciliary arteries at one week (P = 0.02), one month (P = 0.005) and two months (P  = 0.04), and increase in central retinal artery resistant index at one month was noted (P = 0.05). Conclusion Intravitreal triamcinolone temporarily changed central retinal artery blood flow and posterior ciliary arteries' peak systolic blood velocity in eyes with retinal vein occlusion whilst no response of blood flow to triamcinolone injection but only transiently altered end diastolic blood velocity in posterior ciliary arteries was observed in diabetic eyes.

Context: Color Doppler imaging (CDI) allows non invasive assessment of ocular blood flow allowing the assessment of
vascular component of glaucoma etiopathogenesis.
Aims: To evaluate changes in pulsatile ocular blood flow in different types of glaucoma.
Settings and Design: Prospective case control study.
Methods and Material: Color Doppler imaging was used to determine ocular blood flow parameters – peak systolic
velocity ( Vmax), end diastolic velocity (Vd), time average mean of maximum velocity (TAmax), pulsatility index (PI), resistive
index (RI) and systolic/diastolic ratio (S/D) in ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary
artery (SPCA) in primary open angle glaucoma (POAG), primary angle closure glaucoma (PACG) and normal tension
glaucoma (NTG). A comparison of the three groups was made with the normal subjects.
Statistical analysis used: Unpaired Student’s t-test, p value ≤ 0.05 considered significant.
Results: In the POAG group Vmax was decreased in the OA, CRA and SPCA when compared to normals but results were
significant only in the CRA. Vd was significantly decreased in all the three vessels. PI and RI were signifantly increased in all
three vessels except for the RI in OA which was increased insignificantly. S/D ratio was also significantly increased in CRA
and SPCA as compared to normals. In the PACG group Vmax was decreased in all the three vessels as compared to normals but not significantly. Vd was significantly decreased in CRA and SPCA. PI and RI were significantly increased in CRA and SPCA. S/D ratio was significantly increased only in the SPCA.
In the NTG group Vmax was decreased in all the three vessels when compared to normals but not significantly. Vd was
significantly decreased in OA and CRA. The PI and RI were increased significantly in all the three vessels. S/D ratio was
increased significantly in the OA and CRA.
Conclusions: This study confirms that CDI provides an effective way of measuring part of the vascular component of
glaucoma. We found decreased blood flow velocity and increased resistive indices in the ocular vasculature in the different
types of primary glaucoma as compared to normal subjects.
Keywords: Glaucoma; Ophthalmic Artery; Central Retinal Artery; Short Posterior Ciliary Artery; Peak Systolic Velocity;
End Diastolic Velocity; Pulsatility Index; Resistive Index.

To characterize the role of the endothelin system in the blood flow control of the optic nerve head and of the choroid in humans. Two studies were performed in healthy subjects. Study 1 was a randomized, placebo-controlled, double-masked, balanced, two-way crossover design and study 2 a three way-way crossover design. In study 1 twelve healthy male subjects received endothelin (ET)-1 in stepwise increasing doses of 1.25, 2.5, and 5 ng/kg x min (each infusion step occurred over 20 minutes) coinfused with BQ123 (60 microg/kg x min) or placebo on two different study days. In study 2 twelve healthy male subjects received two doses of BQ123 (60 or 120 microg/kg x min over 60 minutes) or placebo on three different study days. Measurements of optic nerve head blood flow (ONHBF) and choroidal blood flow (ChBF) were performed with laser Doppler flowmetry in both studies. In study 2 mean flow velocity (MFV) of the ophthalmic artery was assessed with Doppler sonography. In study 1, ET-1 signif...

To study the correlation between the choroidal thickness (CT) measured by spectral-domain optical coherence tomography (SD-OCT) and retrobulbar blood flow measured by color Doppler flowmetry (CD) in normal subjects. Healthy subjects underwent enhanced-depth imaging SD-OCT and CD using a linear 6 MHz to 18 MHz transducer. The maximal peak systolic velocity and resistance index (RI) were obtained for the ophthalmic artery (OA), short posterior ciliary artery (SPCA), and central retinal artery (CRA) and correlated with the subfoveal CT measured by SD-OCT. Twenty-seven eyes of 27 healthy patients were enrolled (mean age: 40.6 ± 12.4 years; range: 27-68 years). An inverse proportional relationship (P = .0496) was identified between the RI of the SPCA (mean, 0.6117 ± 0.07911) and the subfoveal CT (319.9 µm ± 83.79 µm) but not between the RI and the OA (mean: 0.7019 µm ± 0.07317 µm) or the CRA (mean: 0.68843 µm ± 0.08994 µm). The results of this study suggested there is an inverse proporti...

The purpose of this study was to investigate the effects of glaucoma surgery on retrobulbar hemodynamics and corneal surface temperature (CST). A total of 22 primary open-angle glaucoma eyes underwent deep sclerectomy, and 19 trabeculectomy. The follow-up was of 3 months. The peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistivity index (RI) were evaluated in the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (SPCAs) by color Doppler imaging (CDI). CST was measured using infrared thermography. At 3 months, EDV was increased in OA (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001 in deep sclerectomy, P=0.005 in trabeculectomy), CRA (P=0.044 and P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001), and SPCAs (P=0.011 and P=0.003), and RI decreased in OA, CRA, and SPCAs (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001 in both groups). CST values were augmented (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001 in both groups). A negative correlation between the postoperative changes in RI-OA and CST was found (P=0.023 and P=0.032, respectively). Deep sclerectomy and trabeculectomy seem to be equally effective in improving retrobulbar hemodynamics. Color Doppler imaging and infrared thermography might be useful to evaluate the vascular outcome of glaucoma surgery.

Purpose To assess ocular hemodynamic response to intravitreal triamcinolone in patients with macular edema due to diabetes or retinal vein occlusion. Methods Forty-three patients that were injected by intravitreal triamcinolone acetonide (0.1 cc 4 mg) for unilateral macular edema due to diabetes mellitus (n = 17) and occlusion of retinal vein (n = 26) underwent ocular hemodynamic evaluation by color Doppler imaging (CDI) before and one, two and three months after injection. Non-injected fellow eyes as well as 16 healthy volunteers were also evaluated. Results In patients with diabetic macular edema, there was no hemodynamic difference between eyes to be injected and non-injected at baseline (P > 0.23). Compared to controls, a significant difference existed in the ophthalmic artery resistant index (P = 0.001) and end-diastolic velocity (P < 0.001) in diabetics. At one month, compared to fellow eyes, change in end diastolic velocity from baseline in treated eyes was significantly decreased in posterior ciliary arteries (0.68 ± 0.34 cm/s [mean ± SEM] vs. −1.04 ± 0.81 cm/s, P = 0.012). Throughout the study period, no significant alteration from baseline in the resistant index of any artery was noted in treated diabetic eyes (P > 0.05). In eyes with retinal vein occlusion, baseline CDI evaluation demonstrated reduced posterior ciliary arteries systolic flow velocity compared to fellow and control eyes (13.24 ± 1.04 cm/s, 16.37 ± 0.76 cm/s and 14.33 ± 1.41 cm/s, respectively, P = 0.007). Increased peak systolic velocity in the posterior ciliary arteries at one week (P = 0.02), one month (P = 0.005) and two months (P  = 0.04), and increase in central retinal artery resistant index at one month was noted (P = 0.05). Conclusion Intravitreal triamcinolone temporarily changed central retinal artery blood flow and posterior ciliary arteries' peak systolic blood velocity in eyes with retinal vein occlusion whilst no response of blood flow to triamcinolone injection but only transiently altered end diastolic blood velocity in posterior ciliary arteries was observed in diabetic eyes.

In 516 patients who had endarterectomies for unilateral severe carotid stenoses, arteriography demonstrated no contralateral severe stenoses or occlusions. Pre and postoperative ocular pneumoplethysmography (OPG-Gee) measured simultaneous bilateral ophthalmic systolic pressures (OSP). Immediately after each OPG test a brachial systolic pressure (BSP) was measured with a stethoscope, cuff and manometer. Bilateral ophthalmobrachial systolic pressure (OBSP) indices were calculated from the three pressures measured with the combined testing. Analysis of these OBSP data indicates that the severe stenoses were relatively well compensated in 314 of the 516 patients (61%) whereas there was limited collateral compensation in the remaining 202 patients (39%). The data also suggest that the latter group incurs a greater element of compensatory central hypertension, which is reversed by carotid endarterectomy.

Purpose The effects of anesthetic management on blood flow to the optic nerve have not been well-studied. The ophthalmic artery provides the majority of the blood supply to the optic nerve via several smaller branches. Retinal blood flow has been shown to react to carbon dioxide (CO2) similar to intracranial vessels, but insufficient data exist for the ophthalmic artery. The purpose of this study is to examine the CO2-reactivity of the ophthalmic artery. Methods Eight healthy awake subjects aged 28 to 50 yr were tested for CO2-reactivity in the ophthalmic artery using transcranial Doppler (TCD) insonation of blood flow velocity (Vop), while simultaneously recording the Vop of the middle cerebral artery (Vmca) as an internal control. Vop and Vmca recordings were made under hypocapnic, normocapnic and hypercapnic conditions. Results The CO2-reactivity slope of Vmca was 3.27% per mmHg PaCO2. From normocapnia to hypercapnia, Vop did not change significantly (mean ± SD, 18 ± 4 cm·sec−1 to 18 ± 6 cm·sec−1), (endtidal CO2, et CO2, = 43 ± 5 mmHg to 53 ± 4 mmHg, respectively). In contrast, Vop increased significantly under hypocapnic conditions (etCO2 = 26 ± 4 mmHg) to 25 ± 5 cm·sec−1 (P < 0.05). The CO2-reactivity slope of Vop from normocapnia to hypocapnia was 2.57% per mmHg. Conclusions This study demonstrates that Vop increases with hypocapnia, but is unaffected by hypercapnia. The anastomoses of the ophthalmic artery with the external carotid artery, which displays a relatively fixed resistance, may account for these findings. Objectif Les effets de la démarche anesthésique sur le débit sanguin vers le nerf optique ne sont pas bien connus. L’artère ophtalmique nourrit en grande partie le nerf optique par quelques ramifications plus petites. On a montré que le débit sanguin de la rétine réagit au gaz carbonique (CO2) de façon similaire aux vaisseaux intracrâniens, mais les données manquent sur l’artère ophtalmique. Notre objectif était de vérifier la réactivité au CO2 de l’artère ophtalmique. Méthode Huit sujets sains, éveillés, de 28 à 50 ans, ont été testés pour connaître la réactivité au CO2 de l’artère ophtalmique en utilisant l’enregistrement de la vitesse circulatoire (Vop) avec le Doppler transcrânien (DTC) et, simultanément, la Vop de l’artère cérébrale moyenne. (Vacm) comme témoin interne. Les enregistrements de la Vop et la Vacm ont été faits sous hypocapnie, normocapnie et hypercapnie. Résultats La pente de réactivité au CO2 de la Vacm était de 3,27% par mmHg de PaCO2. De la normocapnie à l’hypercapnie, la Vop n’a pas significativement changé (moyenne ± écart type, 18 ± 4 cm·sec−1 à 18 ± 6 cm·sec−1), (CO2 télé-expiratoire, etCO2, = 43 ± 5 mmHg à 53 ± 4 mmHg, respectivement). Toutefois, la Vop a augmenté de façon significative en hypocapnie (etCO2 = 26 ± 4 mmHg) à 25 ± 5 cm·sec−1 (P < 0,05). La pente de la réactivité au CO2 de la normocapnie à l’hypocapnie est de 2,57 % par mmHg. Conclusion L’étude démontre que la Vop augmente sous hypocapnie, mais n’est pas affectée par l’hypercapnie. Les anastomoses de l’artère ophtalmique avec l’artère carotide externe, qui affiche une résistance relativement fixe, peuvent rendre compte de ces résultats.

In this report, we review the case of a candidal lens abscess in a premature infant girl who was 28 weeks&#39; gestational age at birth. The culture obtained from the lens abscess grew Candida albicans sensitive to amphotericin B but resistant to flucytosine. This case is unique in that the infant developed a fungal lens cataract at 34 weeks&#39; postconceptional age during the last week of a 30-day course of amphotericin B. The embryonic hyaloid artery system, which perfuses the developing lens, regresses between 29 and 32 weeks of gestation; thus, the mechanism for an infection of the lens may be inoculation of the lens by Candida before hyaloid artery system regression, followed by developmental loss of this blood supply, which makes the lens inaccessible to antimicrobial penetration. Candidal endophthalmitis with lens abscess is an uncommon morbidity that requires prompt recognition and surgical intervention for effective management.

Methods. Twenty-five untreated patients with NPG, 23 untreated patients with POAG, and 26 age-matched normal control subjects underwent color Doppler imaging for the measurement of blood flow velocity in the central retinal and ophthalmic arteries. Neither the patients nor the control subjects were using systemic beta-blockers or calcium channel blockers. After log transformation of non-normal data, group differences were compared

Brain death is defined as the &quot;irreversible cessation of all functions of the entire brain, including the brain stem.&quot; The diagnosis can usually be made based on a physical examination. Clinically, there is deep coma. Brain stem reflexes, such as pupillary light, corneal, ...