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A new technique of noninvasive evaluation of the intracranial pressure with retinal vessel analyzer
Author(s) -
GENEVOIS O,
MURAINE M,
PAQUES M
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.t131.x
Subject(s) - medicine , retinal , lumbar puncture , intracranial pressure , population , ophthalmology , cardiology , papilledema , blood pressure , radiology , cerebrospinal fluid , environmental health
Purpose One of the clinical signs observed at the funduscopic examination of the eye of the intracranial hypertension patients, apart from the papillary edema is the reduction, even the disappearance of the spontaneous pulsatility of the retinal vessels..A new device, Retinal Vessel Analyzer (Imedos) now makes it possible to measure negligible variations of the vascular diameter (arteriolar and venular) . We thus measured the retinal vascular pulsatility found among patients having a benign intracranial hypertension (BIH) which we compared with a control population. Methods We included 6 patients presenting a benign intracranial hypertension. For each participant, an examination with RVA was carried out right before the lumbar puncture (J0) then at 1 month (M1) and 3 months intervals (3M). We compared these results with a control population (n=76). Results The mean venous pulsatility found at the 76 controls was 5,07m ± 1,57. Our 6 patients presenting a BIH, had a venous pulsatility that was lower than 0,5m at D0 (p < 0,05), lower than 0,8m± 0,52 at M1 (p < 0,05) and between 0,5 and 3m at m3. All the 6 patients had an abnormal measurement of the intracranial pressure . It was not found a correlation between the value of pulsatility and the value of the intracranial pressure Conclusion The variation of the vascular diameter, measured by RVA, is an indirect reflection of the vascular transmural pressure.Our results show that even in the case of a moderate BIH it exist an early, identifiable repercussion at the level of the retinal vascular network quantifiable by RVA.This reduction in the venous pulsatility can be explained by an increase in the intravascular pressure and/or by a parietal remodeling, especially at the later stage.