Abstract
Purpose To evaluate the use of the Heidelberg retina flowmeter (HRF) in diagnosing retinal ischaemia following macular branch retinal vein occlusion.
Methods Ten patients with ischaemic macular branch retinal vein occlusion, as determined by strict fluorescein angiographic criteria, were examined with the HRF. Blood flow, blood volume and blood velocity characteristics from areas of ischaemic and non-ischaemic retina were recorded and the results between the normal and ischaemic areas of retina compared with paired t-test analysis. Ten healthy volunteers were similarly examined and acted as a control group.
Results Compared with normal retina the HRF recorded a statistically significant reduction in blood flow within the ischaemic retina in 7 of the 10 study patients. In 2 patients the HRF actually recorded a statistically significant increase in blood flow in the area of ischaemic retina; there was no significant difference in the blood flow recorded in the normal and ischaemic retina in the remaining patient. HRF examination of the control group revealed a significant difference in the blood flow between two areas of apparently normal retina in 3 of the 10 volunteers.
Conclusion The HRF is not a reliable tool for diagnosing retinal ischaemia following branch retinal vein occlusion. Our results may suggest that the HRF blood flow recordings are not derived from the retinal circulation alone, but represent the cumulative blood flow through the combined circulations of the retina and choriocapillaris.
Similar content being viewed by others
Article PDF
References
Bonner RF, Nossal R . Principles of laser doppler flowmetry. In: Shepherd AP, Oberg PA, editors. Laser Doppler blood flowmetry. Boston: Kluwer, 1990:17–45.
Marcelo T, Nicolela MD, Nhik P, Drance S . Scanning laser Doppier flowmeter study of retinal and optic disc blood flow in glaucomatous patients. Am J Ophthalmol 1996;122:775–83.
Chung HS, Harris A, Kagemann L, Martin B . Peripapillary retinal blood flow in normal tension glaucoma. Br J Ophthalmol 1999;83:466–9.
Riva CE, Cranstoun JE, Petrig BL . Choroidal blood flow in the foveal region of the human ocular fundus. Invest Ophthalmol Vis Sci 1994;35:4273–81.
Straubhaar M, Orgul S, Gugleta K, Schotzau A, Erb C, Flammer J . Choroidal laser Doppler flowmetry in healthy subjects. Arch Ophthalmol 2000;118:211–5.
Kagemman L, Harris A, Chung HS, Evans D, Buck S, Martin B . Heidelberg retinal flowmetry: factors affecting blood flow measurements. Br J Ophthalmol 1998;82:131–6.
Sullivan P, Cioffi G, Wang L, Johnson C, van Buskirk E, Sherman K, et al. The influence of ocular pulsatility on scanning laser doppler flowmetry. Am J Ophthalmol 1999;128:81–7.
Zambarakji HJ, Evans JE, Amoaku WMK, Vernon SA . Reproducibility of volumetric measurements of normal maculae with the Heidelberg retina tomograph. Br J Ophthalmol 1998;82:884–91.
Michelson G, Schmauss B, Langhans MJ, Harazny J, Groh MJM . Principle, validity and reliability of scanning laser doppler flowmetry. J Glaucoma 1995;5:99–105.
Jalkh AE . Retinal vascular disorders. In: Jalkh AE, Celorio JM, editors. Atlas of fluorescein angiography. Philadelphia: WB Saunders, 1993:165–205.
Avunduk A, Dinc H, Kapicioglu Z, Ugurlu S, Dayanir V, Korkmaz E . Arterial blood flow characteristics in central retinal vein occlusion and effects of panretinal photocoagulation treatment: an investigation by colour Doppler imaging. Br J Ophthalmol 1999;83:50–3.
Fugio N, Feke GT, Ogasawara H, Goger DG, Yoshida A, McMeel W . Quantitative circulatory measurements in branch retinal vessel occlusion. Eye 1994;8:324–8.
Chen H, Gupta A, Weik J, Kohner K . Retinal blood flow in non-ischemic central retinal vein occlusion. Ophthalmology 1998;105:772–5.
Rassam SM, Patel V, Chen HC, Kohner EM . Regional retinal blood flow and vascular autoregulation. Eye 1996;10:331–7.
Sponsel WE, DePaul KL, Zetland SR . Retinal haemodynamic effects of carbon dioxide, hyperoxia and mild hypoxia. Invest Ophthalmol Vis Sci 1992;33:1864–9.
Feke GT, Tagawa H, Deupree DM, Gager DG, Sebag J, Weiter JJ . Blood flow in the normal retina. Invest Ophthalmol Vis Sei 1989;30:58–65.
Hollo G, Greve EL, van den Berg TJ . Evaluation of the peripapillary circulation in healthy and glaucomatous eyes with scanning laser Doppler flowmetry. Int Ophthalmol 1996;20:71–7.
Arend O, Harris A, Martin B, Remky A . Scanning laser ophthalmoscopy-based evaluation of epipapillary velocities: method and physiologic variability. Surv Ophthalmol 1999;44(Suppl 1):S3–9.
Gunwald JE, Hariprasad SM, Dupont J . Effect of aging on foveola choroidal circulation. Arch Ophthalmol 1998;116:150–4.
Heidelberg Retina Flowmeter: scanning laser Doppler flowmetry system for two-dimensional mapping of the perfusion of the retina and optic disc. Heidelberg Engineering, Germany.
Riva CE, Cranstoun JE, Mann RM, Barnes GE . Laser choroidal blood flow in the cat by laser Doppler flowmetry. Invest Ophthalmol Vis Sci 1994;35:608–18.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Squirrell, D., Watts, A., Evans, D. et al. A prospective evaluation of the Heidelberg retina flowmeter in diagnosing ischaemia following branch retinal vein occlusion: A masked, controlled comparison with fluorescein angiography. Eye 15, 261–266 (2001). https://doi.org/10.1038/eye.2001.91
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1038/eye.2001.91
Keywords
This article is cited by
-
The age-dependent decrease in the myogenic response of retinal arterioles as studied with the Retinal Vessel Analyzer
Graefe's Archive for Clinical and Experimental Ophthalmology (2004)
-
Confocal scanning laser Doppler flowmetry in retinovascular disease
Eye (2001)