Ophthalmodynamometry and ischemic ophthalmopathy.

BACKGROUND

To report on the clinical application of a modified ophthalmodynamometer for the detection of ischemic ophthalmopathy.

METHODS

A 70-year-old patient showed unilateral loss of vision to 1/20, thin retinal arteries, tiny intraretinal hemorrhages, and iris neovascularization. We performed a modified ophthalmodynamometry using a Goldmann contact lens in the holding grip of which a pressure sensor was incorporated.

RESULTS

Ophthalmodynamometry showed that the diastolic central retinal artery pressure was significantly (p<0.001) lower in the affected eye than in the contralateral eye (14.6+/-2.2 arbitrary units versus 45.5+/-5.1 arbitrary units). These ophthalmodynamometric measurements of both eyes were significantly (p<0.05) lower than in a control group (73.8+/-6.2 arbitrary units) consisting of 149 normal eyes. Doppler sonography eventually revealed a marked stenosis of the right internal carotid artery, consistent with the diagnosis of a unilateral ischemic ophthalmopathy.

CONCLUSIONS

Ophthalmodynamometry is a helpful additional tool in the assessment of the oculo-afferent and cerebroafferent vessels in patients with symptomatic ocular ischemia.