Relationship of intraocular pulse pressure and spontaneous venous pulsations.
OBJECTIVE
To determine the influence of intraocular pulse pressure (IOPP) on the presence of spontaneous venous pulsations (SVP) in patients with normal intracranial pressure.


METHODS
Clinic-based cross-sectional study.


METHODS
Forty-seven patients without signs and symptoms of elevated intracranial pressure were recruited from a general ophthalmology clinic. Patients with glaucoma or retinal vascular disease were excluded from the study. IOP was determined by applanation, and IOPP was measured with the Pascal Dynamic Contour Tonometer (Ziemer Group, Port, Switzerland). SVP were assessed by undilated (direct) and dilated indirect ophthalmoscopy. Other variables assessed included age, cup-to-disc ratio, and refractive error (spherical equivalent). The main outcome measure was the presence of SVPs with normal IOPP.


RESULTS
The incidence of SVPs declined with increasing age in a nonlinear manner. Dilated examinations yielded the greatest sensitivity for detecting SVPs, with 91.5% of subjects having SVPs. However, in subjects with IOPP of 1.2 mm Hg or more in at least one eye, the incidence of SVPs was 100%.


CONCLUSIONS
A significant correlation exists between the amplitude of IOPP and the presence of SVPs, with SVPs detected in one or both eyes of all patients with IOPP of 1.2 mm Hg or more. When IOPP is 1.2 mm Hg or more, absent SVPs may be more predictive of elevated intracranial pressure than previously recognized.
Donnelly
Steven J
SJ
Winn Army Community Hospital, Fort Stewart, Georgia, USA.
Subramanian
Prem S
PS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012169:Retinal Vein / Q000502:physiology*; D014065:Tonometry, Ocular; D014690:Venous Pressure / Q000502:physiology