First Author: A.Sengul TURKEY
Co Author(s): R. Rasier O. Artunay 0 0 0 0 0 0 0 0 0
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The reduction of vasodilation is considered an endothelial dysfunction. Blood pressures should be examined in patients with recurrent or persistent subconjunctival hemorrhages (SCH), particularly in older patients. The aim of the present study was to investigate whether flickering light response of retinal vessel is altered in patients with SCH.
Retrospective, case-control study
Twenty patients with SCH and 20 age and sex matched healthy volunteers were included in the study. Patients with SCH were divided into 3 groups. Group 1 consisted of 7 patients who had SCH one time, Group 2 consisted of 6 patients who had SCH twice and Group 3 consisted of 7 patients who had SCH more than 2 times. Retinal vessel diameters were measured continuously with the Imedos Retinal Vessel Analyser (RVA). Changes in vasodilation are expressed as percent change over baseline values.
Retinal vessel diameters, mean arterial pressure and intraocular pressure were comparable between both groups. The retinal arterial diameter change was 3.5 +/- 1.6% in the control group, 2.3 +/- 2.3% in the group 1, 1.6 +/- 2.2% in the group 2, and 1.1+/- 1.9% in group 3. The response of retinal arterioles to diffuse luminance flicker was significantly diminished in patients with SCH compared with healthy volunteers. The vasodilation of retinal arterioles and venules decreased continuously with increasing numbers of SCH.
In patients in whom SCH is recurrent or persistent, further evaluation, including workup for systemic hypertension is warranted. Screening and early diagnosis of sclerotic and hypertensive vessel changes are gaining increasing importance in industrialized countries because of lifestyle factors and increasing life expectancy. In conclusion, retinal vasodilatation caused by stimulation with diffuse luminance flicker appears to be diminished in patients with recurrent SCH. The noninvasive testing of retinal autoregulation with DVA might prove to be of value in early detection of hypertensive vessel pathological changes in recurrent SCH patients.