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Biomedical subjects

P Titze

Publications and source records attributed to P Titze.

3 recordsLinked to original sources

Autoregulation of human optic nerve head blood flow in response to acute changes in ocular perfusion pressure.

BACKGROUND: Studies in animals have demonstrated that optic nerve head (ONH) blood flow (F(onh)) is autoregulated, but there is a lack of evidence for such a process in humans. Therefore, we investigated the relationship between F(onh) and mean ocular perfusion pressure (PPm) in normal volunteers when PPm is decreased through elevation of the intraocular pressure (IOP). METHODS: Laser Doppler flowmetry (LDF) was used to measure relative mean velocity (Velohn), volume (Volonh) and F(onh) of blood at sites of the ONH away from visible vessels, while PPm was decreased in two ways: (1) rapidly, by IOP increments of 15 s duration, and (2) slowly, by IOP increments of 2 min duration, both by scleral suction cup in one eye of each of nine subjects. RESULTS: A rapid and large decrease of PPm of more than 100% induced a decrease of more than 80% in F(onh). With the slower decrease in PPm, F(onh) remained constant down to a PPm of approximately 22 mm Hg (IOP = 40 mm Hg) and then decreased, predominantly due to a decrease in Velohn. Immediately after removal of the suction cup, F(onh) increased transiently by 44% above baseline. CONCLUSIONS: This study demonstrates efficient blood flow autoregulation in the OHN, which is probably brought about by an increase in vascular capacitance. The magnitude of the reactive hyperaemia agrees with the compensatory decrease in ONH vascular resistance during IOP elevation. The time scale of the autoregulatory process and the dependence of the hyperaemia upon duration of IOP elevation suggest a metabolic mechanism of autoregulation.

Adult↗

Effect of acute decreases of perfusion pressure on choroidal blood flow in humans.

PURPOSE: To investigate the relationship between choroidal blood velocity (ChBVel), blood volume (ChBVol) and blood flow (ChBF) in the foveal region of the human ocular fundus and ocular perfusion pressure and to determine whether the choroidal circulation has some autoregulatory capacity. METHODS: Measurements of ChBVel, ChBVol and ChBF were obtained by laser Doppler flowmetry in healthy subjects (age range, 21 to 57 years) with normal eye examination results. Measurements were performed at normal intraocular pressure (IOP) and during successive step increases in IOP induced by scleral suction. In experiment 1, in six eyes (five subjects), the IOP was increased rapidly, in steps of 50 to 100 mm Hg of suction pressure, which each lasted approximately 10 seconds to a level above diastolic ophthalmic artery blood pressure (IOP = approximately 72 mm Hg). In experiment 2, in 14 eyes (seven subjects), the IOP was increased slowly in four successive steps at 2-minute intervals to a level of approximately 42 mm Hg. We also determined the pulsatility of the flow parameters during the heart cycle, pulsatility = 1 - diast value/syst value. RESULTS: For both rates of suction cup increase, the relationship between ChBFm (mean ChBF over the heart cycle) and mean perfusion pressure was not linear. At high pressure, ChBFm was less affected by decreases in the pressure than expected from a passive vascular system. In some cases, no change in ChBFm was detectable, although significant changes in PChBF occurred. Further decreases in perfusion pressure resulted in a proportional decrease in ChBFm. On release of suction, a significant increase in ChBFm over baseline value was detectable in experiment 1. CONCLUSIONS: The relationship between ChBFm and ocular mean perfusion pressure appears to be bilinear and reveals some autoregulation for moderate step decreases in perfusion pressure. The temporal characteristics of the ChBFm-response suggest a neural or passive hemodynamical process rather than a myogenic or metabolic compensatory mechanism.

Adult↗

Choroidal blood flow during isometric exercises.

PURPOSE: To investigate the response of choroidal blood flow in the foveal region of the human eye to increases in mean perfusion pressure (PPm = mean ophthalmic artery pressure - intraocular pressure; IOP) induced by isometric exercises. METHODS: Using laser-Doppler flowmetry, changes in velocity (ChBVel), number (ChBVol), and flux (ChBF) of red blood cells in the choroidal vascular system in the foveal region of the fundus were measured in both eyes of 11 normal subjects (ages 18 to 57 years) during isometric exercises. RESULTS: During 90 seconds of squatting, PPm increased by an average of 67%, from 46 to 77 mm Hg. This resulted in a significant increase of 12% in ChBFm (the mean of ChBF during the heart cycle), mainly caused by an increase in ChBVelm. A further increase in PPm to a value approximately 85% above baseline resulted in a 40% increase in ChBFm. A significant negative correlation was found between the changes in ChBVelm and ChBVolm, during squatting. CONCLUSIONS: Previous studies have demonstrated that during isometric exercise, blood pressures in the ophthalmic and brachial arteries rise in parallel. These observations and the current results indicate that an increase in PPm up to 67% induces an increase in choroidal vascular resistance that limits the increase in choroidal blood flow to approximately 12%. This regulatory process fails when PPm is further increased.

Adolescent↗