The relationships between the pulsatile flow form of ocular microcirculation by laser speckle flowgraphy and the left ventricular end-diastolic pressure and mass.

To evaluate the relationships between parameters of the pulsatile flow form in the optic nerve head shown by laser speckle flowgraphy (LSFG) and the left ventricular (LV) end-diastolic pressure and mass obtained by echocardiography. We cross sectional analyzed the cases of 175 subjects who had undergone polysomnography. Standard M-mode two-dimensional color Doppler imaging was performed to evaluate the E/e' ratio (which represents the LV end-diastolic pressure) and LV mass. The pulsatile flow form analysis parameters of the blowout score and acceleration time index were evaluated. The parameters were analyzed separately for the tissue, vessels and throughout the optic nerve head (All). We performed a single regression analysis and a multiple regression analysis to determine whether pulsatile flow form are independent factors for the E/e' ratio and LV mass. The factors contributing independently to the E/e' ratio were blowout time-Tissue (standard regression = - 0.27, t-value = - 2.90, p < 0.0001) and body mass index (BMI) (0.16, 2.05, p = 0.04). The factors that were shown to independently contribute to the LV mass were urinary albumin concentration (0.30, - 2.90, p < 0.0001), BMI (0.28, 4.09, p < 0.0001), differences of gender (men = 1, women = 0: 0.23, 3.28, p = 0.001), acceleration time index-Vessel (- 0.23, - 2.99, p = 0.003) and mean arterial blood pressure (0.17, 2.61, p = 0.01). Our results confirmed that parameters of the pulsatile flow form of ocular microcirculation obtained by LSFG are significantly correlated with the LV end-diastolic pressure ratio and LV mass.

Relationship between glycosylated hemoglobin A1c and ocular circulation by laser speckle flowgraphy in patients with/without diabetes mellitus.

PURPOSE: To determine whether there are significant correlations between the hemodynamics of the optic nerve head (ONH) and choroid as shown by laser speckle flowgraphy (LSFG) and the fasting blood sugar (FBS) and HbA1c level in patients with/without diabetes mellitus (DM). METHODS: We analyzed 196 consecutive patients (151 men, 45 women). The pulse waveform analysis parameters of the mean blur rate (MBR), blowout score (BOS) and blowout time (BOT) in the ONH and choroid were evaluated. We used a multiple regression analysis to determine the independent factors for the LSFG parameters that are significantly correlated with FBS or HbA1c. We evaluated the relationship between the LSFG parameters FBS and HbA1c obtained from the 147 non-DM patients. RESULTS: The multiple regression analysis revealed that hematocrit and HbA1c were factors contributing independently to the choroid MBR. The age, gender, pulse pressure, heart rate, spherical refraction and HbA1c were identified as factors contributing independently to the BOS in the ONH. The multiple regression analysis indicated that age, height, pulse pressure, heart rate and HbA1c were factors contributing independently to the BOS in the choroid. A Pearson's correlation analysis showed that the BOT values in the ONH and choroid were significantly correlated with the HbA1c in the non-DM patients. CONCLUSION: Our results confirmed that HbA1c, even within the normal range, affected the blood flow in the ONH and choroid. LSFG may be a useful method to detect abnormalities of asymptomatic ocular circulation.

Relationships among serum lipoprotein lipase mass, visceral fat, and retinal nerve fiber layer thickness.

PURPOSE: The purpose of the study was to determine whether there were significant correlations among the serum lipoprotein lipase mass, visceral fat, and the retinal nerve fiber layer (RNFL) thickness. METHODS: We studied 118 consecutive subjects. Optical coherence tomography (OCT) was used to measure the RNFL thickness. The Pearson correlation coefficient was used to determine the relationships among lipoprotein lipase (LPL) mass, visceral fat area by computed tomography, OCT, and other parameters. We performed a multiple regression analysis to identify independent factors for the RNFL sectors that were the most strongly correlated with the LPL mass and visceral fat area. RESULTS: The LPL mass was significantly correlated with the nasal RNFL thickness in both eyes (right eye: r = 0.24, p = 0.008, left eye: 0.32, 0.0008) and inferior RNFL thickness in the left eye ( r = 0.23, p = 0.01). The visceral fat area was significantly correlated with the nasal RNFL thickness in both eyes (right eye: r = -0.19, p = 0.04, left eye: -0.30, 0.0008) and the inferior RNFL thickness in the left eye ( r = -0.23, p = 0.01). The subcutaneous fat area was not significantly correlated with any OCT parameters. The multiple regression analysis revealed that age, LPL mass, and visceral fat area were independent contributors to the nasal RNFL thickness in the left eye (age, standard regression coefficient = -0.34 , p = 0.0004; LPL mass, 0.26, 2.49, 0.01; visceral fat area, -0.21, 0.03). CONCLUSION: A reduction of lipoprotein lipase and accumulation of visceral fat might produce retinal neurodegenerative disorders that decrease the RNFL thickness, especially on the nasal side.

[Nocturnal dipping of heart rate in patients with proliferative diabetic retinopathy and iris and/or angle neovascularization].

PURPOSE: To evaluate the relationship between nocturnal dipping in heart rates and iris and/or angle neovascularization (NV) in patients with proliferative diabetic retinopathy(PDR). SUBJECTS AND METHOD: One hundred fifty-one patients with PDR who underwent surgery were divided into groups based on either the presence or absence of iris and/or angle NV (NV group, 37; non-NV group, 114 patients). Pulse oximetry was conducted overnight and the heart rates were measured both before and during sleep; the resting and nocturnal heart rates and the resting-nocturnal heart rate dip ratio were calculated. RESULTS: The resting and nocturnal heart rates did not differ significantly between the two groups. The resting-nocturnal heart rate dip ratio was significantly lower in the NV group than in the non-NV group (p = 0.006). In the NV group, the frequency of insulin therapy (p = 0.003) and a history of coronary artery disease were significantly (p = 0.033) higher than in the non-NV group. Pearson's correlation analysis showed that only the NV group was significantly negatively correlated with the resting-nocturnal heart rate dip ratio (r = -0.18, t value = -2.2, p = 0.028). CONCLUSION: In patients with PDR, the non-occurrent of nocturnal dip in heart rate may be a related factor for iris and/or angle neovascularization.