Scientific correspondence
Pulsatile ocular blood flow in asymmetric exudative age related
macular degeneration
Shih-Jen Chen, Ching-Yu Cheng, An-Fei Lee, Fenq-Lih Lee, Joe C.K. Chou, Wen-Ming Hsu, Jorn-Hon Liu
Department of
Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan and
National Yang-Ming University School of Medicine, Taipei, Taiwan
Correspondence to: Shih-Jen Chen, MD, Department of Ophthalmology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan sjchen{at}vghtpe.gov.tw
Accepted for publication 21 June 2001
BACKGROUND/AIMS
Decreased
perfusion or increased vascular resistance of the choroidal vessels had
been proposed as the vascular pathogenesis for age related macular
degeneration (AMD). This study planned to answer the question whether
pulsatile ocular blood flow (POBF) was different in patients with
asymmetric exudative AMD between eyes with drusen, choroidal
neovascularisation (CNV), or disciform scar.
METHODS37 patients
with asymmetric exudative AMD were enrolled in this observational case
series study. POBF were measured in both eyes of each subject. Eyes
with high myopia, anisometropia, recent laser treatment, and glaucoma
were excluded.
RESULTSAfter
adjusting for ocular perfusion pressure, intraocular pressure, and
pulse rate, multivariate regression analysis with generalised
estimating equation showed POBF was significantly higher in eyes with
CNV (1217 (SD 476) µl/min) than the contralateral eyes with drusen
(1028 (385) µl/min) (p = 0.024). Eyes with disciform scar had lower
POBF than the contralateral eyes with drusen (999 (262) µl/min and
1278 (341) µl/min, respectively, p<0.001). There was no significant
correlation between the POBF and the lesion size of the CNV.
CONCLUSIONThe POBF in
eyes with drusen was lower than their fellow eyes with CNV, but higher
than their fellow eyes with disciform scar. This finding suggests that
haemodynamic differences between fellow eyes in individuals are
relevant to the development of CNV and the formation of disciform scar.
Further studies on the follow up patients might shed light on the
pathogenesis of exudative AMD.
© 2001 by British Journal of Ophthalmology
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