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Biomedical subjects

Andrew K C Lam

Publications and source records attributed to Andrew K C Lam.

18 recordsLinked to original sources

Effect of proparacaine on central corneal thickness values: an evaluation using noncontact specular microscopy and pentacam.

PURPOSE: To study the effect of 1 drop of 0.5% proparacaine on central corneal thickness values monitored by nonspecular microscopy and Pentacam, a corneal topographer with rotating Scheimpflug camera. METHODS: Forty subjects were divided into 2 groups with 1 group measured with a noncontact specular microscope and the other group with Pentacam (Oculus, Inc., Wetzlar, Germany). One eye was randomly selected, and corneal thickness values were monitored every 30 seconds for 10 minutes. Baseline corneal thickness values were defined as the average of all measurements taken over 10 minutes. One drop of 0.5% proparacaine was instilled, and the corneal thickness values were monitored by the same instrument every 30 seconds for another 10 minutes after drug instillation. RESULTS: The 2 groups shared similar age range, refractive error, and baseline corneal thickness values. The spontaneous variation of corneal thickness values was within 3 mum for 10 minutes before drug instillation. There was no obvious trend of corneal thickness value change after the instillation of local anesthetics. The variation of corneal thickness values against the baseline was within 5 mum. CONCLUSION: One drop of 0.5% proparacaine does not produce any significant change in central corneal thickness.

Adult↗

The effect of mydriasis from phenylephrine on corneal shape.

PURPOSE: A previous study reported that pharmacologically-dilated pupils changed the corneal shape. Researchers used mydriatic agents with significant cycloplegic effect. The current study investigates the effect of mydriasis on corneal shape using phenylephrine alone, where phenylephrine has minimal effect on the accommodative system and whether corneal topography can be done after pupil dilation. METHODS: Forty-four young healthy subjects with one eye randomly selected for mydriasis were used in this study. Twenty-two received one drop of 2.5% phenylephrine (group 1); the other 22 subjects had one drop of 0.4% benoxinate instilled prior to the application of 2.5% phenylephrine (group 2). They were matched for age and refractive error. Anterior chamber depth, pupil size and corneal parameters were compared before and after mydriasis. The corneal parameters included best-fit sphere (BFS), surface asymmetry index (SAI), surface regularity index (SRI) and the axial and tangential powers in the form of flattest and steepest powers, and in the form of M, J(0), and J(45) vector presentation. RESULTS: Group 1 and group 2 subjects had similar pre-mydriatic baseline ocular parameters. The mean (+/- SD) pupil dilation was 1.24 +/- 0.59 mm for group 1 and 1.80 +/- 0.95 mm for group 2. The dilation was significantly larger in group 2 (unpaired t-tests: t = 2.36, p = 0.02). There were no significant changes in corneal parameters from mydriasis in either group. CONCLUSIONS: Previous investigations used mydriatic agents, which affected not only the pupil size but also accommodation. The current study found that mydriasis from phenylephrine, with minimal effect on accommodation, did not result in significant corneal alteration, and corneal topography can be measured after pupil dilation with phenylephrine.

Adult↗

Pulsatile ocular blood flow in patients with asymmetric internal carotid artery stenosis.

BACKGROUND: The pulsatile ocular blood flow (POBF) of patients with asymmetric internal carotid artery (ICA) stenosis was measured bilaterally. The purpose of this study was to investigate the sensitivity of POBF assessments in screening for ICA stenosis. METHODS: Seventeen subjects with asymmetric ICA stenosis confirmed with carotid duplex ultrasound were recruited. The diagnoses of ICA stenosis were categorised into less than 50 per cent, 50 to 69 per cent and 70 per cent or greater. Their POBF and ocular dimensions were measured after local anaesthesia. Twenty-three normal healthy subjects were recruited as the control. All of the subjects had an inter-ocular axial length difference of less than one millimetre. RESULTS: There were 14 males and three females in the patient group with a median age of 74 years. Fourteen patients had reduced POBF to the eye ipsilateral on the side with greater ICA stenosis. The reduction in POBF ranged from 3.1 to 49.2 per cent. Two patients had reduced POBF contralateral to the side with greater ICA stenosis. One patient had similar POBF between the eyes. The control group included six males and 17 females with a median age of 65 years. The difference in their POBF between the eyes ranged from 0.3 to 13.0 per cent. CONCLUSIONS: Stenosis of the internal carotid artery was found to reduce the POBF ipsilateral to the side with greater stenosis. The overlap in the difference in inter-ocular POBF between the patient and control groups led to a low sensitivity (calculated as 41.2 per cent) for screening ICA stenosis from an assessment of POBF. Therefore, POBF assessment is not a good diagnostic tool for screening for ICA stenosis.

Aged↗

Comparison of near heterophoria tests under varying conditions on an adult sample.

PURPOSE: This study compared the near phoria measurement using the Bernell muscle balance card with and without prism neutralization, using both trial frame and phoropter correction, and compared with the conventional Maddox rod method. METHODS: Forty young normal Chinese adults had their near phoria measured with trial frame correction using the conventional muscle balance card method (method 1). Any deviation was compensated with a prism bar as an alternative approach (method 2). The conventional Maddox rod method (method 3) was also carried out for comparison. These three methods were repeated with phoropter correction and considered as methods 4, 5 and 6. RESULTS: The phorias obtained from these six methods were not significantly different from each other (repeated measures anova, p > 0.05). More than half of the subjects were exophoric. Although the difference in phoria was not significant, phoria measurement using phoropter correction yielded a greater coefficient of variation. CONCLUSIONS: Near phoria measurement using the muscle balance card conducted with trial frame correction was less variable, and was also more natural and similar to a real reading situation. The use of prism for compensation did not affect the phoria results. Exophoria seems to be more common than esophoria in young Chinese adults.

Adult↗

The validity of a digital eyelid tonometer (TGDc-01) and its comparison with Goldmann applanation tonometry - a pilot study.

PURPOSE: To determine the intra- and inter-examiner repeatability of a new eyelid tonometer, and its agreement with Goldmann applanation tonometry (GAT). MATERIALS AND METHODS: Forty normal subjects were recruited and their intraocular pressure was measured by two examiners using the eyelid tonometer. Examiner 1 carried out the first set of measurement, followed by examiner 2, and then examiner 1 again. Finally, a third examiner was responsible for GAT measurement. Five readings were obtained from the eyelid tonometer by each examiner each time and were masked, and three readings were obtained from GAT. The mean readings from the eyelid tonometer and GAT were used for analysis. RESULTS: The intra-examiner repeatability for the eyelid tonometer was better (around +/-5 mmHg 95% of the cases) than the inter-examiner repeatability (around +/-8 mmHg 95% of the cases). The mean difference between the eyelid tonometer and GAT was small from examiner 1 (<0.5 mmHg). However, the limits of agreement were greater than the clinically acceptable level of +/-3 mmHg. Examiner 2 gave an even greater difference from GAT. CONCLUSIONS: Similar to other recent studies, we have found that this eyelid tonometer does not provide good agreement with GAT. Different examiners could position the instrument differently and this eyelid tonometer is suggested for screening purposes only.

Adult↗

Should Orbscan pachometry be performed before or after Goldmann applanation tonometry?

PURPOSE: To compare the Orbscan central corneal thickness (CCT) values before and after intraocular pressure (IOP) measurement with Goldmann applanation tonometry in young normal adults. MATERIALS AND METHODS: Fifty-three eyes of 53 subjects who were free from any ocular problems were studied. The measurements included optical pachometry by the Orbscan II system, followed by Goldmann applanation tonometry, and finally Orbscan optical pachometry again. Standard Goldmann technique was adopted with the application of one drop of 0.4% benoxinate and fluorescein sodium prior to the measurement. The same operator was involved in the Orbscan pachometry before and after Goldmann tonometry. Another investigator was responsible for Goldmann tonometry. Three readings were obtained in each case, and the means were used for analysis. RESULTS: The mean IOP of the sample was 14.6 +/- 2.6 mmHg. There was no significant difference (paired t-test: p = 0.50) in the mean CCT values before and after the Goldmann tonometry (551 +/- 32 and 552 +/- 35 microm respectively). CONCLUSION: Standard Goldmann applanation tonometry does not affect the Orbscan CCT values. Measurement of CCT for the adjustment of true IOP can be carried out either before or after Goldmann tonometry.

Adult↗

Effect of instrument rotation on handheld keratometry.

PURPOSE: To study the effect of instrument rotation on handheld automated keratometry. SETTING: Department of Optometry and Radiography, The Hong Kong Polytechnic University, Hong Kong SAR, China. METHODS: In 33 recruited subjects, corneal curvature in 1 eye (randomly selected) was measured using a Medmont topographic keratometer and a Nidek handheld keratometer. In handheld keratometry, measurements were obtained holding the instrument in the upright position and rotating it anticlockwise 5 degrees, 10 degrees, and 15 degrees and then clockwise 5 degrees, 10 degrees, and 15 degrees. The sequence of measurements was randomly assigned. The steepest and flattest corneal curvatures as well as the axis along the flattest meridian were compared in different conditions. The corneal power was converted to vector representation (M, J0, J45) for a second comparison. RESULTS: There was a significant difference in the steepest and flattest curvatures in different conditions (repeated-measures analysis of variation, P<.05). However, the mean difference between handheld and topographic keratometry was approximately 0.25 diopter (D) for the steepest curvature and 0.05 D for the flattest curvature regardless of the direction and amount of rotation. The intraclass correlation coefficients were nearly 1, which indicated good clinical reliability. The mean difference in axis determination followed the direction and amount of rotation. With vector representation, the difference between the devices increased with the amount of rotation, especially J0 and J45. CONCLUSIONS: Handheld keratometry was in agreement with topographic keratometry. However, practitioners should adjust the axis manually according to the direction and amount of rotation. The difference between handheld and topographic keratometry increased with the rotational effect, which was seen with vector representation. Practitioners are advised to use the handheld keratometer in the upright position.

Adult↗

Effect of posture and artificial tears on corneal power measurements with a handheld automated keratometer.

PURPOSE: To study the effect of posture and artificial tears on handheld automated keratometry. SETTING: Department of Optometry and Radiography, Hong Kong Polytechnic University, Hong Kong, China. METHODS: Thirty-five subjects were recruited to have corneal curvature measurement in 1 eye (randomly selected) by a Medmont topographic keratometer and a Nidek handheld keratometer. In handheld keratometry, the measurements were taken with the subject in a sitting and lying posture (both with and without the use of artificial tears). The sequence of measurements was randomly assigned, but the application of artificial tears was always the last. The steepest and flattest corneal curvatures were compared between the 4 conditions. The corneal power was converted to orthogonal power vector components and rectangular Fourier form (M, J(0), J(45)) for another comparison. RESULTS: There was a significant difference in the steepest and flattest meridians between the 4 conditions (P<.01). However, the mean difference between the handheld keratometer and the topographic keratometer was less than 0.50 diopter, and the intraclass correlation coefficient (ICC) was very high (0.96), indicating good clinical reliability. When analyzed in rectangular Fourier form, the difference was also significant but the ICCs were lower (0.97, 0.89, and 0.64 for M, J(0), and J(45), respectively). The greatest difference was when subjects were in the lying posture and had received artificial tears. CONCLUSIONS: Handheld keratometry provided different results from topographic keratometry. The difference was greatest with the use of artificial tears. Cataract surgeons should take this into consideration, especially when using the handheld keratometry in the operating theater in patients under general anesthesia. Results show that the power vector method is best for studying corneal shape.

Adult↗

Effect of breath-holding on pulsatile ocular blood flow measurement in normal subjects.

BACKGROUND: The Valsalva maneuver is known to affect intraocular pressure (IOP). Simple breath-holding may cause IOP elevation. A recent study demonstrated a decrease in pulsatile ocular blood flow (POBF) during forcible exhalation. This study investigated whether breath-holding could affect POBF measurement. METHODS: Thirty-eight healthy young adults were recruited. Their POBF's were measured with an ocular blood flow pneumatonometer. The first set of measurements was made using normal measurement protocol. Three consecutive readings were obtained, and the mean was used for analysis. The second set of measurements was taken after 5-min rest, and the subjects were required to hold their breath during the acquisition period. RESULTS: As previously reported, POBF reduced with increasing myopia. There was no significant change in IOP, pulse rate, POBF, and pulse amplitude between normal protocol and breath-holding condition. POBF and pulse amplitude demonstrated a greater variation, shown by coefficient of variation, when subjects held their breath. CONCLUSIONS: This study found a greater variation in consecutive POBF measurements during breath-holding condition. There was no significant difference in either POBF or pulse amplitude during breath-holding session, probably because of the use of three consecutive measurements, and averaged results were generated from them. It is advised to measure the POBF by taking consecutive readings, and subjects should not hold their breath.

Adult↗

The validity of a new noncontact tonometer and its comparison with the Goldmann tonometer.

PURPOSE: This study compared a new noncontact tonometer (NCT), the Nidek NT-4000 (Nidek Co., Ltd., Aichi, Japan), with a pulse detection feature; an earlier model, the Nidek NT-2000, without this pulse detection facility; and Goldmann tonometry. METHODS: Thirty-one young subjects had their intraocular pressure (IOP) in one eye randomly measured by two NCT's, followed by a Goldmann tonometer. The pulse detection mode used by the NT-4000 included synchronizing the IOP with the peak of the pulse (P-P), the middle of the pulse (P-M), or the bottom of the pulse (P-B). The order of measurements from these three modes was also random. Three consecutive readings were obtained from each mode/tonometer, and the mean was used for analysis. RESULTS: Goldmann tonometry demonstrated the smallest variation from consecutive measurements (coefficient of variation, <4%), followed by the NT-4000 (coefficient of variation, <5% in various modes) and the NT-2000 (coefficient of variation, >5%). For the NT-4000, the mean IOP decreased from the highest in the P-P mode (16.1 mm Hg) to the lowest in the P-B mode (14.7 mm Hg), with the P-M mode in the middle. A significant difference was found among the IOP readings using the NT-4000 (in various modes), NT-2000, and Goldmann tonometry (repeated-measures analysis of variance, p < 0.01). More than 80% of the results from the NT-4000 were within 3 mm Hg of those from the Goldmann tonometry. CONCLUSIONS: The pulse detection feature from this new NCT could capture and monitor pulse waves, thus reducing the variations in the consecutive measurements. The NT-4000 also performed better than the NT-2000 when compared with the Goldmann tonometry.

Adult↗

The effect of axial length on ocular blood flow assessment in anisometropes.

BACKGROUND: Pulsatile ocular blood flow (POBF) assessment measures the choroidal circulation and therefore provides data with diagnostic value in certain ocular diseases, such as glaucoma. The technique assumes a constant pressure-volume relationship. The current study investigated the effect of axial length on POBF from subjects with axial anisometropia. Ocular blood supply in the ophthalmic artery was also determined using colour Doppler ultrasonography. METHODS: Thirty-one normal, anisometropic subjects were recruited, whose ages ranged from 20 to 34 years. They had axial anisometropia (expressed by spherical equivalent) of at least 2 D. After Goldmann tonometry, the POBF of each eye was measured in a supine posture by one examiner, followed by a measurement of the blood flow velocity in the ophthalmic artery using colour Doppler ultrasonography in the same posture by another examiner. There was a 10 min rest between the two techniques. All the measurements were made at around the same time to eliminate any effect from diurnal variation. RESULTS: The mean anisometropia (expressed by spherical equivalent) was 3.89 +/- 1.96 D and the mean inter-ocular axial length difference was 1.49 +/- 1.00 mm. The anisometropia and axial length were significantly different between the two eyes (paired t-tests: p < 0.001). However, the intra-ocular pressure was similar between the two eyes (paired t-test: p = 0.41). The POBF was significantly lower in the eye with the longer axial length (459.3 microL min-1) than the fellow eye (590.8 microL min-1), paired t-test: p < 0.001. The pulse amplitude was also significantly lower in the eye with the longer axial length (1.61 mmHg) than the fellow eye (1.89 mmHg), paired t-test: p < 0.001. However, the blood flow velocity from colour Doppler ultrasonography did not demonstrate any significant difference between the two eyes (paired t-test: p > 0.05). CONCLUSIONS: The POBF and pulse amplitude were found to be reduced in the eye with the longer axial length but colour Doppler ultrasonography did not show any significant difference. This suggests that a new pressure-volume relation should be considered in deriving POBF. Practitioners should measure the axial length in POBF assessment.

Adult↗

Anterior chamber angle measurement with Anterior Eye Segment analysis system Nidek EAS-1000: improving the repeatability.

Previous studies have reported good intraobserver and interobserver repeatability of anterior chamber angle (ACA) assessment using the Anterior Eye Segment analysis system, EAS-1000. This study investigated the influence of fixation pattern, corneal plotting method and camera position on ACA measurements. A Nidek EAS-1000 system was employed for image acquisition and analysis, to obtain measurements of ACA. Twenty-five young healthy subjects participated. The ACAs were different in different quadrants and using different corneal plotting methods (Repeated measures 3-way anova, p < 0.05). However, the difference was <5 degrees and therefore not clinically significant. Alignment along the visual axis or optical axis did not yield any significant difference. Repeatability was improved by asking the subjects to fixate at the flashing light-emitting diode (LED). Temporal and nasal angles also demonstrated better repeatability than vertical angles. In measuring the vertical angles, the camera can be set at either the temporal or nasal side (Paired t-test, p > 0.05). The Anterior Eye Segment analysis system has good clinical repeatability in measuring ACA. It can be further improved with the use of the flashing LED during image acquisition.

Adult↗

The effect of age on ocular blood supply determined by pulsatile ocular blood flow and color Doppler ultrasonography.

PURPOSE: Pulsatile ocular blood flow (POBF) assessment measures the choroidal circulation and provides diagnostic value to certain ocular diseases such as glaucoma. This technique assumes a constant ocular rigidity and is influenced by axial length, diurnal variation, and age. This study investigated the effect of age on POBF, with consideration of the above factors. Ocular blood supply in the ophthalmic artery was also determined using color Doppler ultrasonography. METHODS: A total of 118 healthy subjects aged 19 to 75 years were recruited. They were divided into five groups (below age 30, 30 to 39, 40 to 49, 50 to 59, and 60 or above) of at least 20 subjects each. Only one eye of each subject, with axial length <24.5 mm, was considered. The subject's supine POBF was determined followed by a measurement of the blood flow velocity in the ophthalmic artery using color Doppler ultrasonography. All the measurements were at around the same time of day to eliminate any effect from diurnal variation. The scleral rigidity was measured using a Schiotz tonometer with 5.5- and 7.5-g weights. RESULTS: Linear regression analysis demonstrated a significant increase of scleral rigidity with age (Pearson correlation coefficient r = 0.26, p < 0.01) and a significant decrease of POBF with age (r = -0.35, p < 0.01). The reduction in peak systolic velocity in the ophthalmic artery with age was significant (r = -0.28, p < 0.01). Both the systolic and diastolic brachial pressure showed significant increase with age (r = 0.55, p < 0.01; r = 0.40, p < 0.01, respectively). Using multiple regression analysis, POBF showed a significant correlation with age (partial correlation r = -0.36, p < 0.01), but not with scleral rigidity or systolic or diastolic brachial pressure. The peak systolic velocity in the ophthalmic artery also showed significant correlation with age (partial correlation r = -0.29, p < 0.01). CONCLUSIONS: The reduction in POBF with age was significant. Although aging affects scleral rigidity and systemic blood pressure, multiple regression analysis indicates that the most influential factor affecting POBF is aging. The peak systolic velocity in the ophthalmic artery also decreased with age, indicating reduced ocular blood supply.

Adult↗

Corneal thickness at different reference points from Orbscan II system.

BACKGROUND: To locate the thinnest region of the cornea and ascertain whether there is a mismatch between the corneal apex and the thinnest part of the cornea, both as defined by the Orbscan II system. METHODS: Ninety-two eyes of 46 normal subjects were investigated with three reference points identified: the fixation point, the corneal apex and the thinnest region of the cornea. These three points were predetermined by the topographic software system and categorised into different quadrants. RESULTS: The thinnest region of the cornea was found to be located in the inferior temporal quadrant for the right eye and inferior for the left eye. There was no significant difference in corneal thickness between the thinnest region of the cornea and the corneal apex. There was a significant difference found in the location of the reference points (p < 0.01). CONCLUSIONS: Differences in the location of the reference points may be of clinical significance, however, our study showed that the corneal thickness at these reference points is not significantly different. Users of the Orbscan II system are free to use any reference points at the central region without reaching any significant difference in corneal thickness.

Adolescent↗

Crossed and uncrossed stereoacuity at distance and the effect from heterophoria.

BACKGROUND: Previous studies have found that crossed disparities give better stereoacuity than uncrossed. When near phoria is considered, exophores had a better crossed stereoacuity and esophores had a better uncrossed stereoacuity. The current study investigated the effect of heterophoria on distant crossed and uncrossed stereoacuity. METHODS: Seventy-two subjects were recruited and their distant heterophoria measured. Heterophoria within two prism dioptres was considered as orthophoric. Esophoric group had esophoria greater than two prism dioptres. Exophoric group had exophoria greater than two prism dioptres. There were 40 orthophores, 23 exophores and nine esophores. Their stereoacuity was measured with a three-rod apparatus at 6 m. RESULTS: The mean crossed stereoacuity was 4.8" and uncrossed stereoacuity was 7.2" (t = -3.03, p < 0.01). The mean stereoacuity for orthophoric subjects was 5.31", 6.02" for exophores and 8.91" for esophores. The distant crossed stereoacuity is better than uncrossed stereoacuity in all three groups but the difference is only significant for the exophores. Exophoric subjects demonstrated a significant difference between crossed (4.10") and uncrossed (7.95") stereoacuity. CONCLUSIONS: Orthophores have the best stereoacuity, followed by exophores and esophores. Exophoric subjects have a better crossed than uncrossed stereoacuity. More esophoric subjects should be recruited to confirm the difference between crossed and uncrossed stereoacuity.

Adolescent↗

Intra-observer and inter-observer repeatability of anterior eye segment analysis system (EAS-1000) in anterior chamber configuration.

BACKGROUND: Anterior chamber configuration can be assessed via optical or ultrasonic techniques. Scheimpflug photography is a non-invasive method measuring the anterior segment. The Anterior Eye Segment analysis system, EAS-1000, utilises the Scheimpflug principle and was found to have good repeatability. Previous repeatability studies, however, have had limitations in their design. The current study investigated the intra-observer and interobserver repeatability of the EAS-1000. METHODS: Twenty-five healthy young subjects were recruited. The anterior chamber angles in different quadrants were measured by two examiners for interobserver analysis. The first examiner repeated the measurement at another session for intra-observer analysis. The 95% limits of agreement and intra-class correlation coefficient (ICC) were calculated. The anterior chamber depth was also measured and compared with ultrasound biometry. RESULTS: The anterior chamber angle assessment demonstrated good intra-observer (ICC ranging from 0.77 to 0.90 for different quadrants) and interobserver (ICC ranging from 0.68 to 0.81 for different quadrants) repeatability. The 95% intra-observer limits of agreement were within +/-5 degrees. The 95% interobserver limits of agreement were within +/-6 degrees. There was no significant difference between male and female subjects or among angles at different quadrants. The anterior chamber depth was found to be repeatable (ICC > 0.90) with 95% limits of agreement +/-0.1 mm. The anterior chamber depth was shallower than that obtained from ultrasound biometry. CONCLUSIONS: The EAS-100 is a non-invasive instrument which is repeatable for measuring the anterior chamber angle and depth. It provides quick results and is good for screening purposes. There is an under-estimation of anterior chamber depth, as previously reported.

Adolescent↗

The performance of four different corneal topographers on normal human corneas and its impact on orthokeratology lens fitting.

PURPOSE: To evaluate the performances of Humphrey Atlas 991, Orbscan II, Dicon CT200, Medmont E300 on young Chinese adults. METHODS: Three sets of corneal topography measurements were obtained from each topographer from 22 subjects-two sets by the same examiner and one set by another examiner on the same day. RESULTS: There were no significant within-examiner and between-examiner differences for any of the parameters tested for each topographer. However, only the repeatability and reproducibility (of apical radius[Ro], eccentricity, and elevation) of the Humphrey and Medmont were good. There was no statistically significant between-topographer difference in R(o), but significant differences in eccentricity and elevation values were found. The number of repeated readings that should be taken for a precision of 2 microm (elevation) were 12 for the Humphrey and 2 for the Medmont. CONCLUSIONS: The performance of both the Humphrey and the Medmont was very good. R(o) and eccentricity values of different topographers cannot be used interchangeably, but the agreement in elevation values was good for these topographers. The number of repeated readings required for maximum precision varies with the topographer used, and they are not interchangeable.

Adult↗

The effect of myopic axial elongation and posture on the pulsatile ocular blood flow in young normal subjects.

PURPOSE: This study investigated the effect of myopic axial elongation on pulsatile ocular blood flow (POBF) in young normal subjects. A regression equation was derived to quantify the effect. The effect of posture in POBF for eyes with different axial lengths was studied to determine if axial myopia, with different ocular volumes, would result in a change in POBF with various postures. METHODS: Seventy-nine normal subjects (38 males and 41 females) with different refractive errors were recruited. The mean age of the subjects was 22 years, and only the right eye was used for analysis. The axial length (AL) was measured, followed by Perkins intraocular pressure (IOP) and POBF with an OBF tonometer (OBF Labs [UK] Ltd) in a sitting posture. An "erected arm" blood pressure (BP) was measured with an automatic sphygmomanometer for the calculation of ocular perfusion pressure (OPP), using the formula: mean BP IOP, where the mean BP was calculated as one third of the systolic blood pressure plus two thirds of the diastolic blood pressure. The measurements of IOP, POBF, and BP were repeated in a supine posture. RESULTS: The POBF was negatively correlated with AL (r = -0.57, p < 0.01). The regression line was in the form of POBF (microl/min) = -78.5 x AL (mm) + 2655.7. There was a significant reduction (17%) in POBF in a supine posture (p < 0.01). The reduction was not significantly correlated with AL. The pulse amplitude also demonstrated a 10% reduction from postural variation (p < 0.01). The OPP increased significantly (33%) in the supine posture (p < 0.01). CONCLUSIONS: The POBF was significantly influenced by AL. Therefore, AL should be measured in determining the POBF, especially in young myopic subjects. The amount of postural variation in POBF was similar to previous studies with young subjects and was not affected by AL.

Adult↗