Abstract

Aims: The calculation of impedance for a vascular network is a common method used in circulation studies. Impedance indices (the ratios of the harmonics of pressure to the harmonics of flow) provide the investigator with a measure of the opposition to blood flow in a pulsatile system and are a proven indicator for vasculopathy. Previous studies investigating the eye’s opposition to blood flow have concentrated on simple measures of resistance (the ratio of mean pressure difference to mean flow) which are more appropriate to a steady state or non-pulsatile system. The purpose of this study is to demonstrate a new, non-invasive, method to determine the vascular impedance of the eye during the known physiologic stress of sustained isometric exercise.

Methods: Waveforms of ocular blood flow and carotid arterial blood pressure were measured non-invasively. Ocular blood flow waveforms were calculated using the Langham-Silver method by measuring the small fluctuations in intraocular pressure intraocular pressure over time with a high fidelity pneumatonometer. Carotid arterial blood pressure waveforms were determined using a SphygmoCor electronic tonometer held over the common carotid artery of the neck. Both waveforms were recorded simultaneously in normal volunteers under two conditions: (1) a baseline resting state and (2) during sustained isometric exercise. The components of the two waveforms (the harmonics) were calculated using a Fast Fourier transform and expressed as a ratio in order to determine a set of impedance values for each condition. The first four impedance values were calculated.

Results: 12 volunteers (six male: six female) with a mean age of 27 years (range 22–32 years) were recruited to the study. In comparison to baseline resting conditions, mean carotid blood pressure and heart rate both increased significantly during exercise: baseline mean carotid blood pressure, 82.6±8.2 mm Hg vs exercise mean carotid blood pressure, 93.8±12.8 mm Hg (p<0.001); baseline pulse rate, 64.6±9.1 BP_m vs exercise pulse rate, 71.8±9.7 BP_m (p<0.001). Compared to resting conditions, the first and third impedance values demonstrated significant change during exercise: the first impedance value rose (83.9±25.6 mm Hg-s/μl to 117.1 ± 40.9 mm Hg-s/μl, p = 0.01) and the third impedance value fell (487.9 ± 294.7 mm Hg-s/μl to 248.3±206.8 mm Hg-s/μl, p = 0.01).

Conclusions: The present study demonstrates, for the first time, a practical non-invasive method of calculating an index of impedance moduli for the pulsatile quotient of blood flow to the eye. Furthermore, during controlled isometric exercise, the impedance moduli displayed changes consistent with that known for a vascular system during vasoconstriction. The calculation of impedance moduli for the eye therefore shows promise for future investigations into ocular conditions where vascular obstruction is an aetiological factor.