Plange N, Bienert M, Harris A, Remky A, Arend K O
Augenklinik , Universitätsklinikum Aachen, Pauwelsstr. 30, 52057 Aachen.
Ophthalmologe. 2012 Mar;109(3):250-6. doi: 10.1007/s00347-012-2524-0.
The aim of the study was to investigate retrobulbar flow velocities during hypercapnia in patients with normal tension glaucoma (NTG) without systemic vasospasm and jn controls.
A total of 16 NTG patients (mean age 58 ± 14 years) and 16 control subjects (mean age 50 ± 13 years, p = 0.10) were enrolled in this study. Flow velocities, peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistive indices (RI) of the ophthalmic (OA) and central retinal arteries (CRA) were assessed using color Doppler imaging. Blood flow velocities were measured under normocapnic and hypercapnic conditions (increasing the end-tidal pCO(2) by 15%). Blood pressure, ventilation rate and oxygen saturation were monitored simultaneously.
During hypercapnia, velocity responses of the PSV (p = 0.044) and EDV (p = 0.037) of the CRA were significantly different in NTG patients and healthy controls, showing a greater increase of flow velocities in control subjects. Flow velocities of the OA increased significantly in both groups (PSV p = 0.039, EDV p = 0.003) during hypercapnia. Blood pressure, oxygen saturation and intraocular pressure changed similarly in both study groups with carbon dioxide provocation.
Velocity response to hypercapnia was reduced in the CRA of NTG patients compared to controls. This may indicate a faulty vasodilatory response in NTG patients without vasospastic disease.
本研究旨在调查无全身血管痉挛的正常眼压性青光眼（NTG）患者及对照组在高碳酸血症期间的球后血流速度。
本研究共纳入16例NTG患者（平均年龄58±14岁）和16例对照者（平均年龄50±13岁，p = 0.10）。使用彩色多普勒成像评估眼动脉（OA）和视网膜中央动脉（CRA）的血流速度、收缩期峰值速度（PSV）、舒张末期速度（EDV）和阻力指数（RI）。在正常碳酸血症和高碳酸血症条件下（将呼气末pCO₂增加15%）测量血流速度。同时监测血压、通气率和氧饱和度。
在高碳酸血症期间，NTG患者和健康对照者CRA的PSV（p = 0.044）和EDV（p = 0.037）的速度反应存在显著差异，显示对照者的血流速度增加更大。在高碳酸血症期间，两组OA的血流速度均显著增加（PSV p = 0.039，EDV p = 0.003）。在二氧化碳激发试验中，两个研究组的血压、氧饱和度和眼压变化相似。
与对照组相比，NTG患者CRA对高碳酸血症的速度反应降低。这可能表明无血管痉挛性疾病的NTG患者存在血管舒张反应异常。
