Autoregulation in the human retinal circulation: assessment using isometric exercise, laser Doppler velocimetry, and computer-assisted image analysis.

Autoregulation of blood flow in response to changes in perfusion pressure is known to occur in a number of tissues including the human retina. Defective autoregulation may play a part in the pathophysiology of several retinal diseases. Laser Doppler velocimetry has been used to study retinal blood flow. Technically superior measurements are obtained from veins by this method but arterial measurements might provide additional information. The response of the normal human retina to an acute elevation of systemic blood pressure induced by isometric exercise was investigated in nine normal volunteers using laser Doppler velocimetry and computer-assisted image analysis. Measurements were taken from retinal veins and arteries. Autoregulation was demonstrated by an 8.4% rise in flow in response to a 34% rise in perfusion pressure (P = 0.0007) using data derived from veins and a 4.8% rise in flow in response to a 33% rise in perfusion pressure (P = 0.01) using data derived from arteries. Arteries constricted by 3.4% (P = 0.002) and veins dilated by 1.6% (P = 0.02). Red cell velocity rose in veins by 5.0% (P = 0.008) and in arteries by 12.2% (P = 0.02). The variability in velocity change derived from veins (SD 3.4%) was lower than that from arteries (SD 12.1%). A similar pattern of flow change was found in both sets of data. This makes venous measurements more useful for obtaining statistically reliable results from these techniques.