Zusammenfassung
Hintergrund: Das Ziel dieser Studie war das Verhältnis zwischen der peripheren und chorioidalen
Zirkulation zu erforschen. Patienten und Methoden: Durch Die Aderhautdurchblutung (ADB) wurde mittels der Laser-Doppler-Flowmetrie in
73 gesunden Probanden gemessen. Basierend auf der Anamnese von kalten Händen und Füßen
wurden die Studienteilnehmer in drei Gruppen unterteilt, nämlich solche „nie”, solche
„manchmal” und solche „immer” mit kalten Akren. Zur objektiven Erfassung der Temperatur
an den Fingerspitzen wurde ein Infrarotthermometer (IRT) benutzt. Varianzanalyse der
ADB zwischen der Gruppen und zusätzlich eine Korrelation der ADB und IRT wurde durchgeführt.
Ergebnisse: Die Gruppenverteilung war folgendermaßen: 37 Probanden in der Gruppe mit „nie” kalten
Akren, 20 in der Gruppe mit „manchmal” und 16 Probanden in der Gruppe mit „immer”
kalten Akren. Das durchschnittliche Alter war 44,2 ± 12,9 Jahre. ADB war in den Gruppen
jeweils 11,5 ± 7,3 AU (arbiträre Einheiten), 13,6 ± 6,1 AU and 14,3 ± 4,6 AU. ANOVA
P-Wert betrug 0,04, Pearson’s R für die Korrelation zwischen ADB und IRT war – 0,51,
p < 0,001. Schlussfolgerung: Subjektiv und objektiv kalte Akren sind mit einer höheren ADB assoziiert, möglicherweise
wegen der Umverteilung der Durchblutung im Körper.
Abstract
Background: The aim of this study was to explore the relationship between subjectively estimated
and objectively measured finger temperature on the one, and choroidal blood flow on
the other side. Patients and Methods: We measured submacular choroidal blood flow (CBF) in 73 healthy subjects. Based on
the history of cold hands and feet, they were divided in three groups, reporting ”never”,
”sometimes” and ”always” having cold extremities. As an objective measure of finger
temperature, it was recorded at the fingertips with an infrared thermometer (IRT).
Analysis of variance for CBF based on the group selection and with blood and intraocular
pressures as covariates was performed, as well as the correlation between CBF and
IRT. Results: There were 37 subjects in the group with ”never” cold extremities, 20 in the group
with ”sometimes”, and 16 subjects in the group with ”always” cold extremities. Average
age was 44.2 ± 12.9 years. CBF was 11.5 ± 7.3 AU (arbitrary units), 13.6 ± 6.1 AU
and 14.3 ± 4.6 AU in the three groups, respectively. The ANOVA p-value was 0.04. Pearson’s
R for correlation between CBF and IRT was – 0.51, p < 0.001. Conclusion: Subjectively and objectively, colder extremities are associated with higher CBF,
possibly due to the redistribution of blood flow.
Schlüsselwörter
periphere und chorioidale Zirkulation - Fingertemperatur
Key words
peripheral and choroidal circulation - finger temperature
References
1
Alm A, Bill A.
The oxygen supply to the retina. II. Effects of high intraocular pressure and of increased
arterial carbon dioxide tension on uveal and retinal blood flow in cats. A study with
radioactively labelled microspheres including flow determinations in brain and some
other tissues.
Acta Physiol Scand.
1972;
84
306-319
2
Ansari L, Manuel F, Suh J et al.
Choroidal blood flow measurements in zero gravity (space-like) environment using laser-Doppler
flowmetry.
Invest Ophthalmol Vis Sci.
2003;
44
E-Abstract 960
3
Broadway D C, Drance S M.
Glaucoma and vasospasm.
Br J Ophthalmol.
1998;
82
862-870
4
Delaey C, Van De Voorde J.
Regulatory mechanisms in the retinal and choroidal circulation.
Ophthalmic Res.
2000;
32
249-256
5
Flammer J, Guthauser U, Mahler F.
Do ocular vasospasms help cause low-tension glaucoma?.
Doc Ophthalmol Proc Ser.
1987;
49
397-399
6
Flammer J, Haefliger I O, Orgul S et al.
Vascular dysregulation: a principal risk factor for glaucomatous damage?.
J Glaucoma.
1999;
8
212-219
7
Flammer J, Pache M, Resink T.
Vasospasm, its role in the pathogenesis of diseases with particular reference to the
eye.
Prog Ret Eye Res.
2001;
20
319-349
8
Friedman E.
Choroidal blood flow. Pressure-flow relationships.
Arch Ophthalmol.
1970;
83
95-99
9
Gasser P, Flammer J, Guthauser U et al.
Do vasospasms provoke ocular diseases?.
Angiology.
1990;
41
213-220
10
Geiser M H, Riva C E, Diermann U.
[Measuring choroid blood flow with a new confocal laser Doppler device].
Klin Monatsbl Augenheilkd.
1999;
214
285-287
11
Gugleta K, Kochkorov A, Katamay R et al.
On pulse-wave propagation in the ocular circulation.
Invest Ophthalmol Vis Sci.
2006;
47
4019-4025
12
Gugleta K, Orgul S, Hasler P et al.
Circulatory response to blood gas perturbations in vasospasm.
Invest Ophthalmol Vis Sci.
2005;
46
3288-3294
13
Gugleta K, Orgul S, Hasler P W et al.
Choroidal vascular reaction to hand-grip stress in subjects with vasospasm and its
relevance in glaucoma.
Invest Ophthalmol Vis Sci.
2003;
44
1573-1580
14
Gugleta K, Zawinka C, Rickenbacher I et al.
Analysis of retinal vasodilation after flicker light stimulation in relation to vasospastic
propensity.
Invest Ophthalmol Vis Sci.
2006;
47
4034-4041
15
Hasler P W, Orgul S, Gugleta K et al.
Vascular dysregulation in the choroid of subjects with acral vasospasm.
Arch Ophthalmol.
2002;
120
302-307
16
Henry E, Newby D E, Webb D J et al.
Peripheral endothelial dysfunction in normal pressure glaucoma.
Invest Ophthalmol Vis Sci.
1999;
40
1710-1714
17
Kaeser P, Orgul S, Zawinka C et al.
Influence of change in body position on choroidal blood flow in normal subjects.
Br J Ophthalmol.
2005;
89
1302-1305
18
Kaiser H J, Flammer J, Messerli J.
Vasospasm – a risk factor for nonarteriitic anterior ischemic optic neuropathy?.
Neuroophthalmology.
1996;
16
5-10
19
Kavroulaki D, Gugleta K, Kochkorov A et al.
Influence of gender and menopausal status on peripheral and choroidal circulation.
Acta Ophthalmol.
2010;
88
850-853
20
Kistler A, Mariauzouls C, Berlepsch von K.
Fingertip temperature as an indicator for sympathetic responses.
Int J Psychophysiol.
1998;
29
35-41
21
Kochkorov A, Gugleta K, Zawinka C et al.
Short-term retinal vessel diameter variability in relation to the history of cold
extremities.
Invest Ophthalmol Vis Sci.
2006;
47
4026-4033
22
Messerli J, Flammer J.
[Central vein thrombosis in younger patients].
Klin Monatsbl Augenheilkd.
1996;
208
303-305
23
Prunte C, Flammer J.
Choroidal capillary and venous congestion in central serous chorioretinopathy.
Am J Ophthalmol.
1996;
121
26-34
24
Riva C E, Titze P, Hero M et al.
Choroidal blood flow during isometric exercises.
Invest Ophthalmol Vis Sci.
1997;
38
2338-2343
25
Riva C E, Titze P, Hero M et al.
Effect of acute decreases of perfusion pressure on choroidal blood flow in humans.
Invest Ophthalmol Vis Sci.
1997;
38
1752-1760
26
Rubinstein E H, Sessler D I.
Skin-surface temperature gradients correlate with fingertip blood flow in humans.
Anesthesiology.
1990;
73
541-545
27
Truijen J, Bundgaard-Nielsen M, Lieshout van J J.
A definition of normovolaemia and consequences for cardiovascular control during orthostatic
and environmental stress.
Eur J Appl Physiol.
2010;
109
141-157
28
Yu D Y, Alder V A, Cringle S J et al.
Choroidal blood flow measured in the dog eye in vivo and in vitro by local hydrogen
clearance polarography: validation of a technique and response to raised intraocular
pressure.
Exp Eye Res.
1988;
46
289-303
1 The first two authors contributed equally to this work.
Konstantin Gugleta, MD
University Eye Clinic Basel
Mittlerestr. 91
CH-4031 Basel, Switzerland
Phone: ++ 41/61/2 65 87 56
Fax: ++ 41/61/2 65 86 52
Email: gugletak@uhbs.ch