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Klin Monbl Augenheilkd 2014; 231(4): 363-367
DOI: 10.1055/s-0034-1368220
Klinische Studie
Georg Thieme Verlag KG Stuttgart · New York

Ocular Pulse Amplitude Measurement Using Pascal Dynamic Contour Tonometer in Glaucoma Patients

Messung okulärer Pulsamplituden anhand der Pascal-Kontur-Tonometrie bei Glaukompatienten
J. M. Katsimpris
1   Department of Ophthalmology, General Hospital of Patras “Agios Andreas”, Patras, Greece (Chairman: Dr. G. Vassilopoulos)
,
P. E. Theoulakis
2   Department of Ophthalmology, Royal Free London NHS Foundation Trust, London, United Kingdom (Chairman: , S. Althauser)
,
G. E. Papadopoulos
3   Ophthalmology, Surgical Unit, General Hospital of Aigio, Aigio, Greece (Chairman: Dr. G. E. Papadopoulos)
,
A. Katsimpris
1   Department of Ophthalmology, General Hospital of Patras “Agios Andreas”, Patras, Greece (Chairman: Dr. G. Vassilopoulos)
,
J. Lepidas
1   Department of Ophthalmology, General Hospital of Patras “Agios Andreas”, Patras, Greece (Chairman: Dr. G. Vassilopoulos)
,
I. K. Petropoulos
4   Ophthalmological Center of Rive, Geneva, Switzerland (Chairmen: Dr. P. M. Desmangles, Dr. M. A. Matter)
› Author Affiliations
Further Information

Publication History

received 12 September 2013

accepted 01 January 2014

Publication Date:
25 April 2014 (online)

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Abstract

Aim: This study aims to measure and compare the ocular pulse amplitude using Pascal dynamic contour tonometry in normal persons and in glaucoma patients.

Patients and Methods: 20 patients (40 eyes) with primary open angle glaucoma (Group A), 8 patients (16 eyes) with normal tension glaucoma (Group B), and 12 patients (24 eyes) with ocular hypertension (Group C) were included in the study. Control group (Group D) comprised 25 normal volunteers (50 eyes). Intraocular pressure was measured using both Goldmann applanation tonometry in the slit–lamp and Pascal dynamic contour tonometry. Ocular pulse amplitude was evaluated with Pascal dynamic contour tonometry. Statistical evaluation of the differences in ocular pulse amplitude and intraocular pressure among the different groups was performed using Studentʼs t-test.

Results: Mean ocular pulse amplitude values expressed in mmHg were 3.66 ± 1.00, 2.46 ± 0.60, 4.04 ± 1.47, and 2.52 ± 0.52, for Groups A, B, C, and D, respectively. The ocular pulse amplitude was significantly higher in Group A (primary open angle glaucoma) and Group C (ocular hypertension) when compared with Group D (control group) and Group B (normal tension glaucoma). No statistically significant difference was detected between Group D (control group) and Group B (normal tension glaucoma).

Conclusions: Although we can measure the intraocular pressure with Goldmann applanation tonometry, no information can be derived regarding the ocular pulse amplitude. The use of Pascal dynamic contour tonometry in intraocular pressure estimation provides useful clinical information also about the magnitude of the ocular pulse amplitude in different types of glaucoma. Pascal dynamic contour tonometry discloses an elevation of ocular pulse amplitude in primary open angle glaucoma and ocular hypertension patients. On the contrary, the ocular pulse amplitude is within normal limits in normal tension glaucoma patients.

Zusammenfassung

Ziel: Das Ziel dieser Studie war es, die okulären Pulsamplituden bei Glaukompatienten und Normalprobanden anhand der Pascal-Kontur-Tonometrie zu untersuchen und miteinander zu vergleichen. Patienten und Methoden: Zwanzig Patienten (40 Augen) mit primärem Offenwinkelglaukom (Gruppe A), 8 Patienten (16 Augen) mit Normaldruckglaukom (Gruppe B), und 12 Patienten (24 Augen) mit okulärer Hypertension (Gruppe C) wurden eingeschlossen. Die Kontrollgruppe (Gruppe D) bestand aus 25 Normalprobanden (50 Augen). Der Augeninnendruck wurde mit Goldmann-Applanationstonometrie und Pascal-Kontur-Tonometrie gemessen. Die okulären Pulsamplituden wurden mit Pascal-Kontur-Tonometrie evaluiert. Für die statistische Analyse der okulären Pulsamplituden- und Augeninnendruckergebnissen zwischen der verschiedenen Gruppen wurde der Studentʼs t-Test angewendet. Ergebnisse: Der okuläre Pulsamplituden-Mittelwert in mmHg war 3.66 ± 1.00, 2.46 ± 0.60, 4.04 ± 1.47, und 2.52 ± 0.52, für die Gruppen A, B, C und D. Die okulären Pulsamplitudenwerte waren signifikant höher in der Gruppe A und Gruppe C im Vergleich zur Gruppe D und Gruppe B. Es ergaben sich keine statistisch signifikanten Unterschiede zwischen der Gruppe D und der Gruppe B. Schlussfolgerung: Die Goldmann-Applanationstonometrie kann den Augeninnendruck messen, aber sie liefert keine okulären Pulsamplitudenwerte. Anhand der PDCT es ist möglich, nicht nur den Augeninnendruck zu messen, sondern auch die okulären Pulsamplituden zu evaluieren. Die Messung der okulären Pulsamplituden anhand der Pascal-Kontur-Tonometrie zeigte hohe okuläre Pulsamplitudenwerte bei Patienten mit primärem Offenwinkelglaukom oder okulärer Hypertension. Im Gegensatz waren die okulären Pulsamplitudenwerte im Normbereich bei Patienten mit Normaldruckglaukom.

Key words

ocular pulse amplitude - glaucoma - dynamic contour tonometry

Schlüsselwörter

okuläre Pulsamplitude - Glaukom - dynamische Pascal Kontur-Tonometrie
 

  • References

  • 1 Krakau CE. A model for pulsatile and steady ocular blood flow. Graefes Arch Clin Exp Ophthalmol 1995; 233: 112-118
    CrossrefPubMedGoogle Scholar
  • 2 Bynke HG, Schéle B. On the origin of the ocular pressure pulse. Ophthalmologica 1967; 153: 29-36
    CrossrefPubMedGoogle Scholar
  • 3 Perkins ES. The ocular pulse. Curr Eye Res 1981; 1: 19-23
    CrossrefPubMedGoogle Scholar
  • 4 Macri FJ, Brubaker RF. Methodology of eye pressure measurement. Biorheology 1969; 6: 37-45
    PubMedGoogle Scholar
  • 5 Perkins ES. The ocular pulse and introcular pressure as a screening test for carotid artery stenosis. Br J Ophthalmol 1985; 69: 676-680
    CrossrefPubMedGoogle Scholar
  • 6 Perkins FS, Edwards J, Saxena RC. A new recording tonometer. Trans Ophthalmol Soc U K 1997; 97: 679-682
    PubMedGoogle Scholar
  • 7 Krakau CE, Lindberg S, Havelins U. An instrument for recording the ocular pulse wave. Acta Ophthalmol Scand 1995; 73: 472-474
    PubMedGoogle Scholar
  • 8 Langham ME, ToʼMey KF. A clinical procedure for the measurements of the ocular pulse-pressure relationship and the ophthalmic arterial pressure. Exp Eye Res 1978; 27: 17-25
    CrossrefPubMedGoogle Scholar
  • 9 Ulrich WD, Ulrich C. Oculo-oscillo-dynamography: a diagnostic procedure for recording ocular pulses and measuring retinal and ciliary arterial blood pressures. Ophthalmic Res 1985; 17: 308-317
    CrossrefPubMedGoogle Scholar
  • 10 Horven I. Dynamic Tonometry. 3. The corneal indentation pulse in normal and glaucomatous eyes. Acta Ophthalmol (Copenh) 1970; 48: 39-58
    PubMedGoogle Scholar
  • 11 James CB, Smith SE. Pulsatile ocular blood flow in patients with low tension glaucoma. Br J Ophthalmol 1991; 75: 466-470
    CrossrefPubMedGoogle Scholar
  • 12 Perkins ES, Phelps CD. Die okuläre Pulskurve beim Glaukom ohne Hochdruck. Klin Monatsbl Augenheilkd 1984; 184: 303-304
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Bosley TM, Savino PJ, Sergott RC et al. Ocular pneumoplethysmography can help in the diagnosis of giant cell arteritis. Arch Ophthalmol 1989; 107: 379-381
    CrossrefPubMedGoogle Scholar
  • 14 Langham ME, Kramer T. Decreased choroidal blood flow associated with retinitis pigmentosa. Eye 1990; 4: 374-381
    CrossrefPubMedGoogle Scholar
  • 15 Dekker PW, Robert YC, Kanngiesser H et al. Principles of contact lens tonometry. Int Ophthalmol 1998; –1999 22: 105-111
    CrossrefPubMedGoogle Scholar
  • 16 Entenmann B, Robert YC, Pirani P et al. Contact lens tonometry – application in humans. Invest Ophthalmol Vis Sci 1997; 38: 2447-2451
    PubMedGoogle Scholar
  • 17 James CB, Trew DR, Clark K et al. Factors influencing the ocular pulse – axial length. Graefes Arch Clin Exp Ophthalmol 1991; 229: 341-344
    CrossrefPubMedGoogle Scholar
  • 18 Zuckerman JL, Taylor KD, Grassman HJ. Noncontact detection of ocular pulse – correlation with carotid stenosis. Invest Ophthalmol Vis Sci 1997; 11: 1018-1024
    PubMedGoogle Scholar
  • 19 Bill A. Circulation in the Eye. In: Geiger SR, ed. Handbook of Physiology: the cardiovascular System. Vol. 4. Microcirculation, part 2. Bethesda: The American Physiological Society; 1984: 1001-1034
    Google Scholar
  • 20 Langham ME. Ocular Blood Flow and visual Loss in glaucomatous Eyes. In: Krieglstein GK, ed. Glaucoma Update III. Berlin: Springer; 1987: 58-66
    CrossrefGoogle Scholar
  • 21 Alm A, Bill A. The oxygen supply to the retina. II: Effects of high intraocular pressure and of increased arterial carbon dioxide tension on uveal and retinal blood flow in cats. A study with radioactively labelled microspheres including flow determinations in brain and some other tissues. Acta Physiol Scand 1972; 84: 306-319
    CrossrefPubMedGoogle Scholar
  • 22 Törnquist P, Alm A. Retinal and choroidal contribution to retinal metabolism in vivo: A study in pigs. Acta Physiol Scand 1979; 106: 351-357
    CrossrefPubMedGoogle Scholar
  • 23 Alm A. Ocular Circulation. In: Hart WH, ed. Adlerʼs Physiology of the Eye. 9th ed. St Louis: CV Mosby; 1992: 198-227
    Google Scholar
  • 24 Hendrickson P, Robert Y, Stöckli HP. Principles of photometry of the papilla. Arch Ophthalmol 1984; 102: 1704-1707
    CrossrefPubMedGoogle Scholar
  • 25 Drance SM, Douglas GR, Wijsman K et al. Response of blood flow to warm and cold in normal and low-tension glaucoma patients. Am J Ophthalmol 1988; 105: 35-39
    CrossrefPubMedGoogle Scholar
  • 26 Eisenlohr JE, Langham ME, Maumenee AE. Manometric studies of the pressure-volume relationships in living and enucleated eyes of individual human subjects. Br J Ophthalmol 1962; 46: 536-548
    CrossrefPubMedGoogle Scholar
  • 27 Langham ME, Farrell RA, OʼBrien V et al. Blood flow in the human eye. Acta Ophthalmol Suppl 1989; 191: 9-13
    PubMedGoogle Scholar
  • 28 Silver DM, Farrell RA, Langham ME et al. Estimation of pulsatile ocular blood flow from intraocular pressure. Acta Ophthalmol Suppl 1989; 191: 25-29
    PubMedGoogle Scholar
  • 29 Langham ME. Ocular blood flow and vision in healthy and glaucomatous eyes. Surv Ophthalmol 1994; 38 (Suppl.) S161-S168
    CrossrefPubMedGoogle Scholar
  • 30 Schmidt KG, von Rückmann A, Mittag TW. Okuläre Pulsamplitude bei okulärer Hypertension und verschiedenen Glaukomformen. Ophthalmologica 1998; 212: 5-10
    CrossrefPubMedGoogle Scholar
  • 31 Trew DR, James CB, Thomas SH et al. Factors influencing the ocular pulse – the heart rate. Graefes Arch Clin Exp Ophthalmol 1991; 229: 553-556
    CrossrefPubMedGoogle Scholar
  • 32 Cristini G, Gennamo G, Daponte P. Choroidal thickness in primary glaucoma. Ophthalmologica 1991; 202: 81-85
    CrossrefPubMedGoogle Scholar
  • 33 James CB. Pulsatile ocular blood flow. Br J Ophthalmol 1998; 82: 720-721
    CrossrefPubMedGoogle Scholar
  • 34 Schmidt KG, Rückmann A, Mittag TW et al. Reduced ocular pulse amplitude in low tension glaucoma is independent of vasospasm. Eye (Lond) 1997; 11: 485-488
    CrossrefPubMedGoogle Scholar
  • 35 Trew DR, Smith S. Postural studies in pulsatile ocular blood flow: II. Chronic open angle glaucoma. Br J Ophthalmol 1991; 75: 71-75
    CrossrefPubMedGoogle Scholar
  • 36 Cristini G, Meduri R, Gabrini GC et al. A new method for determining the blood quantity in the eye in a unit of time. Albrecht Von Graefes Arch Klin Exp Ophthalmol 1975; 197: 1-11
    CrossrefPubMedGoogle Scholar
  • 37 Lambrou GN, Sindhunata P, van den Berg TJTP et al. Ocular Pulse Measurements in low Tension Glaucoma. In: Lambrou GN, Greve EL, eds. Ocular Blood Flow in Glaucoma. Amsterdam: Kulger & Chedini; 1989: 115-120
    Google Scholar