Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark.
Invest Ophthalmol Vis Sci. 2021 Mar 1;62(3):11. doi: 10.1167/iovs.62.3.11.
Recent evidence suggests that the smaller retinal vessels are significantly involved in the regulation of retinal blood flow and that this regulation may differ among the macular area and the retinal periphery. An alternative to studying blood flow regulation in smaller retinal vessels that are difficult to resolve is to assess the metabolic consequences of changes in the microcirculation using oximetry.
In 20 normal persons aged (mean ± SD, range) 30.1 ± 3.8 (24-37) years, the oxygen saturation and diameter of retinal arterioles and venules to the macular area and the retinal periphery were studied before and during an increase in the arterial blood pressure induced by isometric exercise.
The isometric exercise increased the mean arterial blood pressure by (mean ± SEM) 10.0 ± 1.1 mm Hg but induced no significant changes in the diameter of the arterioles (P = 0.83). The isometric exercise had no significant effect on the oxygen saturation in the arterioles supplying the macular area and the retinal periphery (P > 0.42 for both comparisons). However, there was a significant increase in the oxygen saturation in venules draining the retinal periphery to reduce the oxygen extraction from (mean ± SEM) 36.0% ± 2.3% to 30.6% ± 2.1% (P = 0.002) but no significant change in the preexisting low oxygen extraction in the macular area that changed from (mean ± SEM) 18.2% ± 3.0% to 16.2% ± 1.9% (P = 0.37).
Minor changes in the arterial blood pressure can induce changes in retinal rheology with significant regional variation. The finding may help explain regional variations in manifestations of retinal vascular disease such as hyperpermeability in the macular area and capillary occlusion in the retinal periphery.
最近的证据表明,较小的视网膜血管在调节视网膜血流方面起着重要作用,而这种调节可能在黄斑区和视网膜周边部之间存在差异。替代研究难以解决的较小视网膜血管的血流调节的方法是使用血氧测定法评估微循环变化的代谢后果。
在 20 名年龄(平均值±标准差,范围)为 30.1±3.8(24-37)岁的正常个体中,在等长运动引起的动脉血压升高之前和期间,研究了黄斑区和视网膜周边部视网膜小动脉和小静脉的氧饱和度和直径。
等长运动使平均动脉血压升高(平均值±SEM,范围)10.0±1.1mmHg,但对小动脉直径无显著影响(P=0.83)。等长运动对供应黄斑区和视网膜周边部的小动脉中的氧饱和度没有显著影响(两者比较的 P>0.42)。然而,视网膜周边部引流小静脉中的氧饱和度显著增加,从(平均值±SEM,范围)36.0%±2.3%降至 30.6%±2.1%(P=0.002),但黄斑区原有的低氧摄取没有显著变化,从(平均值±SEM,范围)18.2%±3.0%降至 16.2%±1.9%(P=0.37)。
动脉血压的微小变化可引起视网膜流变学的变化,且具有显著的区域性差异。这一发现可能有助于解释视网膜血管疾病表现的区域性差异,如黄斑区的高通透性和视网膜周边部的毛细血管阻塞。