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The ocular pulse amplitude as a noninvasive parameter for carotid artery stenosis screening: a test accuracy study


Knecht, P B; Menghini, M; Bachmann, L M; Baumgartner, R W; Landau, K (2012). The ocular pulse amplitude as a noninvasive parameter for carotid artery stenosis screening: a test accuracy study. Ophthalmology, 119(6):1244-1249.

Abstract

PURPOSE:
To investigate a potential correlation between the ocular pulse amplitude (OPA; i.e., the intraocular pressure difference between the systolic and diastolic phases of the heartbeat) and the severity of carotid artery stenosis (CAS) and to test its role as a screening parameter for CAS during routine ophthalmic examination.
DESIGN:
Test accuracy study.
PARTICIPANTS:
Patients referred for color duplex ultrasound examination of the extra- and intracranial cerebral arteries were enrolled consecutively.
METHODS:
We measured OPA on both eyes by dynamic contour tonometry. Multivariate analyses were performed with risk factors for CAS (age, total cholesterol, low-density lipoprotein, and triglycerides) to compare the diagnostic value of OPA measurements with other non- or minimally invasive screening parameters.
MAIN OUTCOME MEASURES:
The difference between OPA measurements in patients with no (<50%) and patients with severe CAS (>70%) as well as the value of OPA measurements to predict the severity of CAS taking further risk factors of CAS into consideration.
RESULTS:
One hundred thirty-four eyes of 67 patients (25 women, 42 men) with a mean age of 67±13 years (range, 25-87) were included. The means of the OPA values of those patients showing no CAS (<50%) differed significantly (P = 0.036) from those with a stenosis of ≥70%. The multivariate model produced a statistically significant odds ratio (0.46; P = 0.007) for CAS of ≥70%.
CONCLUSIONS:
The results of the present study provide proof of principle that the OPA is reduced in patients with CAS and may be used as a noninvasive, inexpensive, readily available, and unconfounded screening parameter to detect CAS and possibly to reduce the incidence of stroke.
FINANCIAL DISCLOSURE(S):
The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Abstract

PURPOSE:
To investigate a potential correlation between the ocular pulse amplitude (OPA; i.e., the intraocular pressure difference between the systolic and diastolic phases of the heartbeat) and the severity of carotid artery stenosis (CAS) and to test its role as a screening parameter for CAS during routine ophthalmic examination.
DESIGN:
Test accuracy study.
PARTICIPANTS:
Patients referred for color duplex ultrasound examination of the extra- and intracranial cerebral arteries were enrolled consecutively.
METHODS:
We measured OPA on both eyes by dynamic contour tonometry. Multivariate analyses were performed with risk factors for CAS (age, total cholesterol, low-density lipoprotein, and triglycerides) to compare the diagnostic value of OPA measurements with other non- or minimally invasive screening parameters.
MAIN OUTCOME MEASURES:
The difference between OPA measurements in patients with no (<50%) and patients with severe CAS (>70%) as well as the value of OPA measurements to predict the severity of CAS taking further risk factors of CAS into consideration.
RESULTS:
One hundred thirty-four eyes of 67 patients (25 women, 42 men) with a mean age of 67±13 years (range, 25-87) were included. The means of the OPA values of those patients showing no CAS (<50%) differed significantly (P = 0.036) from those with a stenosis of ≥70%. The multivariate model produced a statistically significant odds ratio (0.46; P = 0.007) for CAS of ≥70%.
CONCLUSIONS:
The results of the present study provide proof of principle that the OPA is reduced in patients with CAS and may be used as a noninvasive, inexpensive, readily available, and unconfounded screening parameter to detect CAS and possibly to reduce the incidence of stroke.
FINANCIAL DISCLOSURE(S):
The authors have no proprietary or commercial interest in any of the materials discussed in this article.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Ophthalmology Clinic
04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
04 Faculty of Medicine > University Hospital Zurich > Clinic and Policlinic for Internal Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:13 Sep 2012 07:15
Last Modified:05 Apr 2016 15:57
Publisher:Elsevier
ISSN:0161-6420
Publisher DOI:https://doi.org/10.1016/j.ophtha.2011.12.040
PubMed ID:22361314

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