Kiel J W, Shepherd A P
Department of Physiology, University of Texas Health Science Center, San Antonio 78284.
Invest Ophthalmol Vis Sci. 1992 Jul;33(8):2399-410.
Previous studies show that choroidal blood flow is not autoregulated when intraocular pressure (IOP) is increased to raise venous pressure and lower the perfusion pressure gradient. However, the autoregulatory response to changes in mean arterial pressure (MAP) is unclear. In the current study, the perfusion pressure gradient (MAP-IOP) was altered by (1) decreasing MAP while IOP was held at 5, 15, and 25 mmHg, and (2) increasing the IOP at the prevailing MAP in anesthetized rabbits (n = 8). An occluder on the thoracic vena cava was used to vary MAP; this was monitored through an ear artery catheter. Two catheters were inserted in the vitreous to monitor and control IOP. Choroidal blood flow was measured by laser Doppler flowmetry using a slender stainless-steel probe positioned next to the retinal surface. The efficacy of autoregulation depended on the IOP. When IOP was held constant at 5 mmHg, choroidal blood flow did not fall until the perfusion pressure gradient was less than 40 mmHg. The pressure-flow relationship became progressively more linear (ie, the efficacy of autoregulation decreased) when the IOP was held constant at 15 and 25 mmHg. When IOP was varied and MAP was held constant, the pressure-flow relationship was linear at IOPs greater than 20-25 mmHg. However, choroidal blood flow was pressure independent when the IOP was less than 20-25 mmHg. Simultations using a myogenic mathematic model of the choroid gave results similar to the experimental observations. It was concluded that a myogenic mechanism may be responsible for the autoregulation of choroidal blood flow in the rabbit.
先前的研究表明,当眼内压(IOP)升高以提高静脉压并降低灌注压梯度时,脉络膜血流不受自身调节。然而,对平均动脉压(MAP)变化的自身调节反应尚不清楚。在当前研究中,通过以下两种方式改变灌注压梯度(MAP-IOP):(1)在IOP分别维持在5、15和25 mmHg时降低MAP;(2)在麻醉兔(n = 8)的当前MAP水平上增加IOP。使用胸段腔静脉闭塞器来改变MAP;通过耳动脉导管进行监测。在玻璃体中插入两根导管以监测和控制IOP。使用位于视网膜表面旁边的细长不锈钢探头,通过激光多普勒血流仪测量脉络膜血流。自身调节的效果取决于IOP。当IOP恒定在5 mmHg时,直到灌注压梯度小于40 mmHg时脉络膜血流才下降。当IOP恒定在15和25 mmHg时,压力-血流关系逐渐变得更加线性(即自身调节效果降低)。当改变IOP并保持MAP恒定时,在IOP大于20 - 25 mmHg时压力-血流关系呈线性。然而,当IOP小于20 - 25 mmHg时,脉络膜血流与压力无关。使用脉络膜的肌源性数学模型进行的模拟得出了与实验观察结果相似的结果。得出的结论是,肌源性机制可能是兔脉络膜血流自身调节的原因。