Mojtaba Golzan S, Leaney John, Cordina Rachael, Avolio Alberto, Celermajer David S, Graham Stuart L
Australian School of Advanced Medicine, Macquarie University, Sydney, Australia.
Heart Vessels. 2012 Nov;27(6):618-23. doi: 10.1007/s00380-011-0201-x. Epub 2011 Nov 17.
Spontaneous retinal venous pulsations (SRVP) are assessed as a clinical marker for patients with ophthalmic or neurological disorders. The pulsations are influenced by intraocular pressure (IOP), cerebrospinal fluid pressure (CSFp), and retinal venous pressure (RVP). However, little is known about the effect of cyanosis with polycythemia, a common finding in adults with complex congenital heart disease (CHD), on SRVP. This study investigated 11 subjects with long-standing cyanosis secondary to CHD and 11 control subjects to determine if there were measurable differences in resting pulsatility for a given IOP level. Intraocular pressure was measured using Goldman tonometry, and dynamic SRVP was recorded noninvasively using a retinal vessel imaging system. Peak amplitude of SRVP at each cardiac cycle was measured and compared with IOP. Heart rate was also monitored during the tests. Results show that for a similar baseline IOP, SRVP amplitudes are significantly lower in cyanotic patients compared with normal subjects (P < 0.0001). This may be explained by an increased RVP or high CSFp in these patients. Mean venous diameter is also significantly higher in cyanotic patients (P < 0.01), but no significant relationship was found between SRVP or diameter with blood parameters.
自发性视网膜静脉搏动（SRVP）被用作眼科或神经疾病患者的一项临床标志物进行评估。这些搏动受眼内压（IOP）、脑脊液压力（CSFp）和视网膜静脉压（RVP）影响。然而，对于患有多血症的发绀（这在患有复杂先天性心脏病（CHD）的成人中很常见）对SRVP的影响却知之甚少。本研究调查了11名继发于CHD的长期发绀患者和11名对照受试者，以确定在给定的IOP水平下静息搏动性是否存在可测量的差异。使用戈德曼眼压计测量眼内压，并使用视网膜血管成像系统无创记录动态SRVP。测量每个心动周期的SRVP峰值幅度，并与IOP进行比较。测试期间还监测心率。结果表明，对于相似的基线IOP，发绀患者的SRVP幅度明显低于正常受试者（P < 0.0001）。这可能是由于这些患者的RVP升高或CSFp升高所致。发绀患者的平均静脉直径也显著更高（P < 0.01），但未发现SRVP或直径与血液参数之间存在显著关系。
