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  • Title: Autoregulation of Optic Nerve Head Blood Flow Induced by Elevated Intraocular Pressure during Vitreous Surgery.
    Author: Hashimoto R, Sugiyama T, Ubuka M, Maeno T.
    Journal: Curr Eye Res; 2017 Apr; 42(4):625-628. PubMed ID: 27767373.
    Abstract:
    PURPOSE: To investigate optic nerve head (ONH) blood flow changes resulting from intraocular pressure (IOP) elevation in subjects without systemic disorders. MATERIALS AND METHODS: Eighteen eyes of 18 patients who underwent vitrectomy to treat an epiretinal membrane or macular hole at Toho University Sakura Medical Center were included. Following standard 25-gauge microincision vitreous surgery, mean blur rate (MBR) in tissue (MT), an index of ONH blood flow, was measured using laser speckle flowgraphy. Measurements were taken before and 5 and 10 minutes after a 15 mmHg IOP elevation. RESULTS: The ONH blood flow was initially lower than baseline (P = 0.001) after elevating IOP from 14.8 ± 2.8 mmHg to approximately 30 mmHg. Between 5 and 10 minutes after elevating IOP, ONH blood flow partially recovered (P = 0.004), even though ocular perfusion pressure was 20.2% lower than at baseline. CONCLUSIONS: The ONH blood flow in subjects without systemic disorders was initially lower, but began to recover 5-10 minutes after a 15 mmHg elevation in IOP. These results indicate that autoregulatory mechanisms of ONH blood flow may help to minimize the effects of IOP elevations and fluctuations during vitreous surgery.
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