Hessemer V, Schmidt K G
Department of Ophthalmology, Justus Liebig University, Giessen, Germany.
Am J Ophthalmol. 1997 Jun;123(6):748-52. doi: 10.1016/s0002-9394(14)71121-3.
To study the ocular pulsation amplitude (an indicator of choroidal circulation) and systolic ophthalmic artery pressure after panretinal photocoagulation.
Prospectively, in 10 patients with diabetes mellitus (eight with type II and two with type I; mean age, 64 years) and severe, hitherto untreated, bilateral proliferative diabetic retinopathy, we performed intensive, unilateral panretinal photocoagulation with 1,500 argon laser burns (spot size, 500 microm) in two sessions (interval, 3 weeks). Before and (in 3-week intervals) up to 9 weeks after treatment, we recorded ocular pulse curves using oculo-oscillodynamography and determined each patient's ocular pulsation amplitude and systolic ophthalmic artery pressure.
Compared with the untreated contra-lateral eyes, panretinal photocoagulation led to a reduction of ocular pulsation amplitude. Three weeks after the first coagulation, the reduction averaged 20%. Maximum reduction was found 9 weeks after onset of treatment (6 weeks after the second coagulation) and amounted to 29.9%. The differences between photocoagulated and untreated eyes were highly significant on average (P < .01; analysis of variance) as well as for time course (P < .001). Systolic ophthalmic artery pressure was not changed significantly during panretinal photocoagulation follow-up.
Ocular pulsation amplitude is determined by the cardiac cycle-related intraocular volume changes that depend predominantly on choroidal blood flow. The morphologic substrate is probably choriocapillary closure after photocoagulation.
研究全视网膜光凝术后的眼搏动幅度（脉络膜循环的一个指标）和眼动脉收缩压。
前瞻性地，对10例糖尿病患者（8例Ⅱ型和2例Ⅰ型；平均年龄64岁）且患有严重的、此前未经治疗的双侧增殖性糖尿病视网膜病变患者，分两次进行1500次氩激光烧灼（光斑大小500微米）的强化单侧全视网膜光凝（间隔3周）。在治疗前以及治疗后（每隔3周）直至9周，我们使用眼振荡血流动力学记录眼脉搏曲线，并测定每位患者的眼搏动幅度和眼动脉收缩压。
与未治疗的对侧眼相比，全视网膜光凝导致眼搏动幅度降低。首次光凝后3周，降低平均为20%。治疗开始后9周（第二次光凝后6周）发现最大降幅，达29.9%。光凝眼与未治疗眼之间的差异平均而言具有高度显著性（P <.01；方差分析），且在时间进程上也具有显著性（P <.001）。在全视网膜光凝随访期间，眼动脉收缩压无显著变化。
眼搏动幅度由主要依赖脉络膜血流的与心动周期相关的眼内体积变化所决定。其形态学基础可能是光凝后脉络膜毛细血管关闭。
