Top

Graefe's Archive for Clinical and Experimental Ophthalmology

Published in:

01-07-2019 | Glaucoma | Glaucoma

Central retinal venous pressure is higher than intraocular pressure during amateur trumpet playing

Authors: Egbert Matthé, Marie-Caroline Schlief, Sylvana Georgii, Richard Stodtmeister, Lutz E. Pillunat, Hans-Christian Jabusch

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 7/2019

Abstract

Background

It has been shown in the literature that the Valsalva manoeuvre influences ocular perfusion by changing intraocular pressure and central retinal venous pressure (CRVP). High-resistance wind instrument (HRWI) playing is a common situation resembling a Valsalva manoeuvre. The aim of this investigation was to explore the influence of amateur trumpet playing on CRVP.

Methods

The left eyes of 20 healthy non-professional trumpet players (median age 26, range 19–52 years; 17 males, 3 females) were included in this investigation. Subjects, sitting at a slit lamp, were asked to play the tone b’ flat with their own mouthpiece on the same trumpet for at least 30 s with moderate loudness. The following data were obtained: intraocular pressure (IOP) by applanation tonometry before and during playing, CRVP by contact lens dynamometry before and during playing, airway pressure (AirP) using a pressure sensor during playing and blood pressure and heart rate using the common cuff method before and during playing.

Results

The results are presented as the medians before vs during playing: a calculated mean ophthalmic artery pressure of 66 vs 72 mmHg, heart rate of 76 vs 82 beats per minute, airway pressure of 0 vs 17 mmHg, IOP 12 vs 13 mmHg and CRVP of 24 vs 55 mmHg (Wilcoxon test: p = 0.00009), respectively. A correlation between the CRVP during playing and the height of the spontaneous CRVP is noted (Spearman rank correlation coefficient: ρ = 0.68).

Conclusions

Amateur trumpet playing increases CRVP, airway pressure and IOP. The increase in CRVP is greater than that of the intraocular pressure. The increase in CRVP seems to be more important for retinal perfusion changes during trumpet playing than the increase of IOP. It can be hypothesised that high airway pressure during playing may cause a permanent increase in CRVP, at least in a subgroup of trumpet players.

Schmidtmann G, Jahnke S, Seidel EJ, Sickenberger W, Grein HJ (2011) Intraocular pressure fluctuations in professional brass and woodwind musicians during common playing conditions. Graefes Arch Clin Exp Ophthalmol 249(6):895–901. https://doi.org/10.1007/s00417-010-1600-x[doi]

Kappmeyer K, Lanzl IM (2010) Intra-ocular pressure during and after playing high and low resistance wind instruments. Ophthalmologe 107(1):41–46. https://doi.org/10.1007/s00347-009-2055-5[doi]

Schuman JS, Massicotte EC, Connolly S, Hertzmark E, Mukherji B, Kunen MZ (2000) Increased intraocular pressure and visual field defects in high resistance wind instrument players. Ophthalmology 107(1):127–133CrossRefPubMed

Schmidl D, Werkmeister R, Garhofer G, Schmetterer L (2015) Ocular perfusion pressure and its relevance for glaucoma. Klin Monatsbl Augenheilkd 232(2):141–146. https://doi.org/10.1055/s-0034-1383398 CrossRefPubMed

Costa VP, Arcieri ES, Harris A (2009) Blood pressure and glaucoma. Br J Ophthalmol 93(10):1276–1282. https://doi.org/10.1136/bjo.2008.149047 CrossRef

Schmidl D, Garhofer G, Schmetterer L (2011) The complex interaction between ocular perfusion pressure and ocular blood flow - relevance for glaucoma. Exp Eye Res 93(2):141–155. https://doi.org/10.1016/j.exer.2010.09.002[doi]

Cherecheanu AP, Garhofer G, Schmidl D, Werkmeister R, Schmetterer L (2013) Ocular perfusion pressure and ocular blood flow in glaucoma. Curr Opin Pharmacol 13(1):36–42. https://doi.org/10.1016/j.coph.2012.09.003[doi]

Costa VP, Harris A, Anderson D, Stodtmeister R, Cremasco F, Kergoat H, Lovasik J, Stalmans I, Zeitz O, Lanzl I, Gugleta K, Schmetterer L (2014) Ocular perfusion pressure in glaucoma. Acta Ophthalmol 92(4):e252–e266. https://doi.org/10.1111/aos.12298 CrossRefPubMed

Schwab B, Schultze-Florey A (2004) Intraorale Druckentwicklung bei Holz- und Blechblaesern. Musikphysiologie und Musikermedizin 11(4):183–194

10.

Stodtmeister R, Heyde M, Georgii S, Matthe E, Spoerl E, Pillunat LE (2017) Retinal venous pressure is higher than the airway pressure and the intraocular pressure during the Valsalva manoeuvre. Acta Ophthalmol. https://doi.org/10.1111/aos.13485

11.

Löw UG (2002) Kalibrierung des Kontaktglasdynamometers an enukleierten Schweineaugen und klinischer Vergleich zwischen dem Kontaktglasdynamometer und der Smartlens. Doctoral thesis, Medizinische Fakultaet der Universitaet des Saarlandes, Homburg, Germany

12.

Morgan WH, Cringle SJ, Kang MH, Pandav S, Balaratnasingam C, Ezekial D, Yu DY (2010) Optimizing the calibration and interpretation of dynamic ocular force measurements. Graefes Arch Clin Exp Ophthalmol 248(3):401–407CrossRefPubMed

13.

Jabusch HC, Alpers H, Kopiez R, Vauth H, Altenmuller E (2009) The influence of practice on the development of motor skills in pianists: a longitudinal study in a selected motor task. Hum Mov Sci 28(1):74–84. https://doi.org/10.1016/j.humov.2008.08.001 CrossRefPubMed

14.

Van Vugt FT, Treutler K, Altenmuller E, Jabusch HC (2013) The influence of chronotype on making music: circadian fluctuations in pianists’ fine motor skills. Front Hum Neurosci 7:347. https://doi.org/10.3389/fnhum.2013.00347 CrossRefPubMedPubMedCentral

15.

Duke-Elder WS (1926) The venous pressure of the eye and its relation to the intra-ocular pressure. J Physiol 61:409–418CrossRefPubMedPubMedCentral

16.

Meyer-Schwickerath R, Stodtmeister R, Hartmann K (2004) Die nicht-invasive Bestimmung des Hirndruckes durch den Augenarzt: physiologische Grundlagen und Vorgehen in der Praxis. Klin Monatsbl Augenheilkd 221(12):1007–1011CrossRefPubMed

17.

Stodtmeister R, Ventzke S, Spoerl E, Boehm AG, Terai N, Haustein M, Pillunat LE (2013) Enhanced pressure in the central retinal vein decreases the perfusion pressure in the prelaminar region of the optic nerve head. Invest Ophthalmol Vis Sci 54(7):4698–4704. https://doi.org/10.1167/iovs.12-10607[doi]

18.

Caprioli J, Coleman AL (2010) Blood pressure, perfusion pressure, and glaucoma. Am J Ophthalmol 149(5):704–712. https://doi.org/10.1016/j.ajo.2010.01.018[doi]

19.

Westlake WH, Morgan WH, Yu DY (2001) A pilot study of in vivo venous pressures in the pig retinal circulation. Clin Exp Ophthalmol 29(3):167–170CrossRefPubMed

20.

Morgan WH, Yu DY, Cooper RL, Alder VA, Cringle SJ, Constable IJ (1997) Retinal artery and vein pressures in the dog and their relationship to aortic, intraocular, and cerebrospinal fluid pressures. Microvasc Res 53(3):211–221CrossRefPubMed

21.

Pott F, Van Lieshout JJ, Ide K, Madsen P, Secher NH (2000) Middle cerebral artery blood velocity during a Valsalva maneuver in the standing position. J Appl Physiol (1985 ) 88(5):1545–1550CrossRef

22.

Morgan WH, Balaratnasingam C, Hazelton ML, House PH, Cringle SJ, Yu DY (2005) The force required to induce hemivein pulsation is associated with the site of maximum field loss in glaucoma. Invest Ophthalmol Vis Sci 46(4):1307–1312CrossRefPubMed

23.

Kreuter M, Kreuter C, Herth F (2008) Pneumological aspects of wind instrument performance--physiological, pathophysiological and therapeutic considerations. Pneumologie 62(2):83–87. https://doi.org/10.1055/s-2007-996164[doi]

24.

Brody S, Erb C, Veit R, Rau H (1999) Intraocular pressure changes: the influence of psychological stress and the Valsalva maneuver. Biol Psychol 51(1):43–57CrossRefPubMed

25.

Oggel K, Sommer G, Neuhann T, Hinz J (1982) Variations of intraocular pressure during Valsalva’s maneuver in relation to body position and length of the bulbus in myopia (author’s transl). Graefes Arch Clin Exp Ophthalmol 218(1):51–54CrossRefPubMed

26.

Aykan U, Erdurmus M, Yilmaz B, Bilge AH (2010) Intraocular pressure and ocular pulse amplitude variations during the Valsalva maneuver. Graefes Arch Clin Exp Ophthalmol 248(8):1183–1186. https://doi.org/10.1007/s00417-010-1359-0 CrossRefPubMed

27.

Zhang Z, Wang X, Jonas JB, Wang H, Zhang X, Peng X, Ritch R, Tian G, Yang D, Li L, Li J, Wang N (2014) Valsalva manoeuver, intra-ocular pressure, cerebrospinal fluid pressure, optic disc topography: Beijing intracranial and intra-ocular pressure study. Acta Ophthalmol 92(6):e475–e480. https://doi.org/10.1111/aos.12263 CrossRefPubMed

28.

Looga R (2005) The Valsalva manoeuvre--cardiovascular effects and performance technique: a critical review. Respir Physiol Neurobiol 147(1):39–49. https://doi.org/10.1016/j.resp.2005.01.003 CrossRefPubMed

29.

Schmetterer L, Dallinger S, Findl O, Strenn K, Graselli U, Eichler HG, Wolzt M (1998) Noninvasive investigations of the normal ocular circulation in humans. Invest Ophthalmol Vis Sci 39(7):1210–1220PubMed

30.

Lovasik JV, Kergoat H (2012) Systemic determinants. In: Schmetterer L, Kiel JW (eds) Ocular blood flow, 1st edn. Springer, Heidelberg, pp 173–210CrossRef

31.

Khan JC, Hughes EH, Tom BD, Diamond JP (2002) Pulsatile ocular blood flow: the effect of the Valsalva manoeuvre in open angle and normal tension glaucoma: a case report and prospective study. Br J Ophthalmol 86(10):1089–1092CrossRefPubMedPubMedCentral

32.

Lam AK, Lam CH (2004) Effect of breath-holding on pulsatile ocular blood flow measurement in normal subjects. Optom Vis Sci 81(8):597–600CrossRefPubMed

33.

de Crom R, Webers CAB, van Kooten-Noordzij MAW, Michiels AC, Schouten J, Berendschot T, Beckers HJM (2017) Intraocular pressure fluctuations and 24-hour continuous monitoring for glaucoma risk in wind instrument players. J Glaucoma 26(10):923–928. https://doi.org/10.1097/IJG.0000000000000747 CrossRefPubMed

Title: Central retinal venous pressure is higher than intraocular pressure during amateur trumpet playing
Authors: Egbert Matthé
Marie-Caroline Schlief
Sylvana Georgii
Richard Stodtmeister
Lutz E. Pillunat
Hans-Christian Jabusch
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keyword: Glaucoma
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 7/2019
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-019-04334-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Central retinal venous pressure is higher than intraocular pressure during amateur trumpet playing

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 7/2019

Protein kinase C-mediated insulin receptor phosphorylation in diabetic rat retina

Correction to: Intravitreal bevacizumab injections combined with laser photocoagulation for adult-onset Coats’ disease

Monitoring of visual field over 6 months after active ocular toxoplasmosis

Use of low-vault posterior chamber collagen copolymer phakic intraocular lenses for the correction of myopia: a 3-year follow-up

Usefulness of the dacryoscintigraphy in patients with nasolacrimal duct obstruction prior to endoscopic dacryocystorhinostomy

Visual and refractive outcomes of 100 small incision lenticule extractions (SMILE) in moderate and high myopia: a 24-month follow-up study