title: Continuous response of optic nerve head blood flow to increase of arterial blood pressure in humans.
abstract: OBJECTIVE
  This study investigates the effect of increased ocular perfusion pressure (OPP) on optic nerve head (ONH) hemodynamics.
  
  
  METHODS
  In 21 healthy subjects, the increase in arterial blood pressure (BP), measured continuously using a pneumatic transcutaneous sensor, was produced by isometric exercise consisting of 2 minutes of hand-gripping. ONH blood flow parameters-namely the velocity (Vel), number (Vol), and flux (F) of red blood cells-were measured using the laser Doppler flowmeter (LDF).
  
  
  RESULTS
  In those 14 healthy subjects who exhibited a similar increase in BP to handgrip superior to 30% of baseline BP, group average increases of BP and OPP amounted to 34% ± 3% (SEM) and 43% ± 3%, respectively. The increase in F of 19% ± 8%, resulting from an increase in Vel (17% ± 7%) and Vol (6% ± 7%), was significantly less than predicted for a passive autoregulatory response, as revealed also by the increase in vascular resistance (R = OPP/F). Spearman test of linear correlations between F and time during handgrip led to the identification of one group of eight subjects (with a stable F) and one group of six subjects (with an increase in F). A closed-loop gain (G) of the regulatory process, defined as G = 1 - {(F - Fbl)/Fbl}/{(OPP - OPPbl)/OPPbl}, was found to be rather independent from the OPP, with an average value 0.7 ± 0.07. G was 0.83 ± 0.06 for the group of eight subjects with stable F and 0.3 ± 0.15 for the group of six subjects with F increasing with the OPP.
  
  
  CONCLUSIONS
  The continuous recording of both BP and LDFs represents a novel and more precise approach to the characterization of ONH hemodynamics during isometric exercise, especially useful in the future for patients with ocular diseases. The efficiency of the ONH blood flow autoregulation appears to vary significantly between healthy subjects. (ClinicalTrials.gov number, NCT00874913.).
authors.affiliation: Université Joseph Fourier Grenoble 1, Grenoble, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Chiquet
authors.forename: Tiffany
authors.initials: T
authors.lastname: Lacharme
authors.forename: Charles
authors.initials: C
authors.lastname: Riva
authors.forename: Ahmed
authors.initials: A
authors.lastname: Almanjoumi
authors.forename: Florent
authors.initials: F
authors.lastname: Aptel
authors.forename: Hafide
authors.initials: H
authors.lastname: Khayi
authors.forename: Nathalie
authors.initials: N
authors.lastname: Arnol
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Romanet
authors.forename: Martial
authors.initials: M
authors.lastname: Geiser
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D007429:Intraocular Pressure / Q000502:physiology*; D017078:Laser-Doppler Flowmetry; D008297:Male; D009898:Optic Disk / Q000098:blood supply*; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology*; D014655:Vascular Resistance; D055815:Young Adult
keywords: autoregulation; isometric exercise; laser Doppler flowmetry; optic nerve head hemodynamics; vascular resistance