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Age, Blood Pressure, and Vessel Diameter as Factors Influencing the Arterial Retinal Flicker Response

¹From Ophthalmic Private Practice, Rudolstadt, Germany; the ²Technical University, Ilmenau, Germany; ³Imedos, Weimar, Germany; and the ⁴Eye Clinic, Technical University of Munich, Munich, Germany.

PURPOSE. The present study investigated whether age, blood pressure (BP), and baseline vessel diameter influence the retinal arterial response to flicker light.

METHOD. Thirty healthy subjects (mean age, 46.3; range, 22–73 years) and 15 patients with untreated essential arterial hypertension (mean, 50.9; range, 26–69 years) were examined. The diameter of the retinal arterioles was measured by a Retinal Vessel Analyzer (RVA; Imedos, Weimar, Germany). Each examination consisted of a 100-second baseline measurement and five 20-second periods of flicker stimulation, followed by an 80-second observation period. The five stimulation periods were then averaged. The rectangular luminance flicker operated at 12.5 Hz at a wavelength of 530 to 600 nm. The baseline-corrected flicker response (bFR) was defined as the difference between the peak dilatation and subsequent constriction after flicker stimulation minus the fluctuation of the baseline. The BP was measured at 1-minute intervals during the examination.

RESULTS. In 26 subjects with normal BP, flicker light induced a bFR of +6.4% ± 2.7%. The bFR decreased nonsignificantly in healthy subjects with increasing age (y = 8.48 – 0.048x; r = 0.26). The baseline diameter did not influence the amplitude of the flicker response over a range of 70 to 140 measuring units. The hypertensive patients reacted with a bFR of +2.2% ± 2.5% (P < 0.001). Four hitherto healthy subjects with elevated BP during the examination were excluded from analysis.

CONCLUSIONS. A significant correlation of age and bFR was not found in the small sample examined. Untreated arterial hypertension appeared to be associated with a reduced flicker response. The value of such functional vessel properties in the screening of vasosclerosis and in diagnostics in arterial hypertension should be examined in further studies.

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