Heidelberg retinal flowmetry: factors affecting blood flow measurement
Abstract
AIMS—To evaluate factors affecting Heidelberg retinal flowmeter (HRF) measurements of retinal and optic nerve head blood flow in human subjects.
METHODS—The angle of incidence between laser beam and fundus, and camera distance from the eye, were evaluated for their effect upon measures of blood volume, velocity, and flow in a single 100 ×100 × 400 µm volume of temporal peripapillary retinal tissue in normal volunteers. Both intra and intersession reproducibility of these measures were studied. Intersession data were obtained by taking one image per week for 4 weeks. Finally, the intersession haemodynamic data were examined in the entire image (640 × 2560× 400 µm), using histograms of pixel by pixel blood flow.
RESULTS—Measures of blood volume, velocity, and flow from a single anatomical site were unaffected by laser beam to fundus angle of incidence (n = 12). As camera distance from the eye was increased (from 2 to 5 to 7 cm), flow measurements showed increasing individual changes, despite unaltered measured vessel lengths and constant overall mean flow (n = 14). The coefficient of variation for two intrasession images of optic nerve head blood flow averaged 7% (n = 20); in contrast, the 4 week intersession coefficient of variation averaged 30% (n = 15). Intersession reproducibility was increased by using flow histograms from the entire image: the coefficients of variation averaged 16% for total flow and 17% for flow in the pixel of median flow.
CONCLUSION—HRF measures of flow are independent of the laser beam to fundus angle of the incidence and dependent upon camera distance from the eye. Intersession reproducibility is best using pixel by pixel analysis of the entire image.
Keywords: retina; optic nerve head; glaucoma; diabetic retinopathy
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Selected References
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- Friedlander M, Theesfeld CL, Sugita M, Fruttiger M, Thomas MA, Chang S, Cheresh DA. Involvement of integrins alpha v beta 3 and alpha v beta 5 in ocular neovascular diseases. Proc Natl Acad Sci U S A. 1996 Sep 3;93(18):9764–9769.[PMC free article] [PubMed] [Google Scholar]
- Rassam SM, Patel V, Chen HC, Kohner EM. Regional retinal blood flow and vascular autoregulation. Eye (Lond) 1996;10(Pt 3):331–337. [PubMed] [Google Scholar]
- Grunwald JE, DuPont J, Riva CE. Retinal haemodynamics in patients with early diabetes mellitus. Br J Ophthalmol. 1996 Apr;80(4):327–331.[PMC free article] [PubMed] [Google Scholar]
- Konno S, Feke GT, Yoshida A, Fujio N, Goger DG, Buzney SM. Retinal blood flow changes in type I diabetes. A long-term follow-up study. Invest Ophthalmol Vis Sci. 1996 May;37(6):1140–1148. [PubMed] [Google Scholar]
- Bursell SE, Clermont AC, Kinsley BT, Simonson DC, Aiello LM, Wolpert HA. Retinal blood flow changes in patients with insulin-dependent diabetes mellitus and no diabetic retinopathy. Invest Ophthalmol Vis Sci. 1996 Apr;37(5):886–897. [PubMed] [Google Scholar]
- Quigley HA, Hohman RM, Sanchez R, Addicks EM. Optic nerve head blood flow in chronic experimental glaucoma. Arch Ophthalmol. 1985 Jul;103(7):956–962. [PubMed] [Google Scholar]
- Sossi N, Anderson DR. Effect of elevated intraocular pressure on blood flow. Occurrence in cat optic nerve head studied with iodoantipyrine I 125. Arch Ophthalmol. 1983 Jan;101(1):98–101. [PubMed] [Google Scholar]
- Nanba K, Schwartz B. Nerve fiber layer and optic disc fluorescein defects in glaucoma and ocular hypertension. Ophthalmology. 1988 Sep;95(9):1227–1233. [PubMed] [Google Scholar]
- Michelson G, Langhans MJ, Groh MJ. Clinical investigation of the combination of a scanning laser ophthalmoscope and laser Doppler flowmeter. Ger J Ophthalmol. 1995 Nov;4(6):342–349. [PubMed] [Google Scholar]
- Michelson G, Schmauss B. Two dimensional mapping of the perfusion of the retina and optic nerve head. Br J Ophthalmol. 1995 Dec;79(12):1126–1132.[PMC free article] [PubMed] [Google Scholar]
- Groh MJ, Michelson G, Langhans MJ, Harazny J. Influence of age on retinal and optic nerve head blood circulation. Ophthalmology. 1996 Mar;103(3):529–534. [PubMed] [Google Scholar]
- Michelson G, Groh M, Langhans M, Schmauss B. Zweidimensionale Kartierung der retinalen und papillären Mikrozirkulation mittels Scanning-Laser-Doppler-Flowmetrie. Klin Monbl Augenheilkd. 1995 Sep;207(3):180–190. [PubMed] [Google Scholar]
- TOUSSAINT D, KUWABARA T, COGAN DG. Retinal vascular patterns. II. Human retinal vessels studied in three dimensions. Arch Ophthalmol. 1961 Apr;65:575–581. [PubMed] [Google Scholar]
- ZWEIFACH BW, METZ DB. Selective distribution of blood through the terminal vascular bed of mesenteric structures and skeletal muscle. Angiology. 1955 Aug;6(4):282–290. [PubMed] [Google Scholar]
- Lassen NA, Palm T, Nielsen SL. Recruitment of muscle capillaries in man. Bibl Anat. 1977;(15 Pt 1):504–505. [PubMed] [Google Scholar]
Abstract
AIMS—To evaluate factors affecting Heidelberg retinal flowmeter (HRF) measurements of retinal and optic nerve head blood flow in human subjects.
METHODS—The angle of incidence between laser beam and fundus, and camera distance from the eye, were evaluated for their effect upon measures of blood volume, velocity, and flow in a single 100 ×100 × 400 µm volume of temporal peripapillary retinal tissue in normal volunteers. Both intra and intersession reproducibility of these measures were studied. Intersession data were obtained by taking one image per week for 4 weeks. Finally, the intersession haemodynamic data were examined in the entire image (640 × 2560× 400 µm), using histograms of pixel by pixel blood flow.
RESULTS—Measures of blood volume, velocity, and flow from a single anatomical site were unaffected by laser beam to fundus angle of incidence (n = 12). As camera distance from the eye was increased (from 2 to 5 to 7 cm), flow measurements showed increasing individual changes, despite unaltered measured vessel lengths and constant overall mean flow (n = 14). The coefficient of variation for two intrasession images of optic nerve head blood flow averaged 7% (n = 20); in contrast, the 4 week intersession coefficient of variation averaged 30% (n = 15). Intersession reproducibility was increased by using flow histograms from the entire image: the coefficients of variation averaged 16% for total flow and 17% for flow in the pixel of median flow.
CONCLUSION—HRF measures of flow are independent of the laser beam to fundus angle of the incidence and dependent upon camera distance from the eye. Intersession reproducibility is best using pixel by pixel analysis of the entire image.
Keywords: retina; optic nerve head; glaucoma; diabetic retinopathy




