Changes in central retinal artery blood flow after ocular warming and cooling in healthy subjects

摘要

Context:Retinal perfusion variability impacts ocular disease and physiology.Aim:To evaluate the response of central retinal artery (CRA) blood flow to temperature alterations in 20 healthy volunteers.Setting and Design:Non-interventional experimental human study.Materials and Methods:Baseline data recorded: Ocular surface temperature (OST) in °C (thermo-anemometer), CRA peak systolic velocity (PSV) and end diastolic velocity (EDV) in cm/s using Color Doppler. Ocular laterality and temperature alteration (warming by electric lamp/cooling by ice-gel pack) were randomly assigned. Primary outcomes recorded were: OST and intraocular pressure (IOP) immediately after warming or cooling and ten minutes later; CRA-PSV and EDV at three, six and nine minutes warming or cooling.Statistical Analysis:Repeated measures ANOVA.Results:(n = 20; μ ± SD): Pre-warming values were; OST: 34.5 ± 1.02°C, CRA-PSV: 9.3 ± 2.33 cm/s, CRA-EDV: 4.6 ± 1.27 cm/s. OST significantly increased by 1.96°C (95% CI: 1.54 to 2.37) after warming, but returned to baseline ten minutes later. Only at three minutes, the PSV significantly rose by 1.21 cm/s (95% CI: 0.51to1.91). Pre-cooling values were: OST: 34.5 ± 0.96°C, CRA-PSV: 9.7 ± 2.45 cm/s, CRA-EDV: 4.7 ± 1.12 cm/s. OST significantly decreased by 2.81°C (95% CI: ?2.30 to ?3.37) after cooling, and returned to baseline at ten minutes. There was a significant drop in CRA-PSV by 1.10cm/s (95% CI: ?2.05 to ?0.15) and CRA-EDV by 0.81 (95% CI: ?1.47 to ?0.14) at three minutes. At six minutes both PSV (95% CI: ?1.38 to ?0.03) and EDV (95% CI: ?1.26 to ?0.02) were significantly lower. All values at ten minutes were comparable to baseline. The IOP showed insignificant alteration on warming (95% CI of difference: ?0.17 to 1.57mmHg), but was significantly lower after cooling (95% CI: ?2.95 to ?4.30mmHg). After ten minutes, IOP had returned to baseline.Conclusion:This study confirms that CRA flow significantly increases on warming and decreases on cooling, the latter despite a significant lowering of IOP.