Top

Journal of Medical Case Reports

Published in:

Open Access 01-12-2008 | Case report

The effect of voluntary fasting and dehydration on flicker-induced retinal vascular dilation in a healthy individual: a case report

Authors: Rebekka Heitmar, Doina Gherghel, Richard Armstrong, Robert Cubbidge, Sarah Hosking

Published in: Journal of Medical Case Reports | Issue 1/2008

Abstract

Introduction

Dynamic retinal vessel analysis represents a well-established method for the assessment of vascular reactivity during both normal conditions and after various provocations. We present a case where the subject showed abnormal retinal vessel reactivity after fasting voluntarily for 20 hours.

Case presentation

A healthy, 21-year-old man who fasted voluntarily for 20 hours exhibited abnormal retinal vascular reactivity (dilation and constriction) after flicker provocation as measured using the Dynamic Retinal Vessel Analyser (Imedos, Jena, Germany).

Conclusion

The abnormal vascular reactivity induced by fasting was significant; abnormal levels of important nutrients due to fasting and dehydration could play a role through altering the concentration of vasoactive substances such as nitric oxide. This hypothesis needs further investigation.

Available only for authorised users

Nagel E, Vilser W, Lanzl I: Age, blood pressure, and vessel diameter as factors influencing the arterial retinal flicker response. Invest Ophthalmol Vis Sci. 2004, 45: 1486-1492. 10.1167/iovs.03-0667.CrossRefPubMed

Frederiksen CA, Jeppesen P, Knudsen ST, Poulsen PL, Mogensen CE, Bek T: The blood pressure-induced diameter response of retinal arterioles decreases with increasing diabetic maculopathy. Graefes Arch Clin Exp Ophthalmol. 2006

Garhofer G, Zawinka C, Resch H, Huemer KH, Schmetterer L, Dorner GT: Response of retinal vessel diameters to flicker stimulation in patients with early open angle glaucoma. J Glaucoma. 2004, 13: 340-344. 10.1097/00061198-200408000-00013.CrossRefPubMed

Garhofer G, Zawinka C, Resch H, Kothy P, Schmetterer L, Dorner GT: Reduced response of retinal vessel diameters to flicker stimulation in patients with diabetes. Br J Ophthalmol. 2004, 88: 887-891. 10.1136/bjo.2003.033548.CrossRefPubMedPubMedCentral

Vilser W, Nagel E, Lanzl I: Retinal Vessel Analysis--new possibilities. Biomed Tech (Berl). 2002, 47 Suppl 1 Pt 2: 682-685.CrossRef

Nagel E, Vilser W: Flicker observation light induces diameter response in retinal arterioles: a clinical methodological study. Br J Ophthalmol. 2004, 88: 54-56. 10.1136/bjo.88.1.54.CrossRefPubMedPubMedCentral

Nagel E, Vilser W: Autoregulative behavior of retinal arteries and veins during changes of perfusion pressure: a clinical study. Graefes Arch Clin Exp Ophthalmol. 2004, 242: 13-17. 10.1007/s00417-003-0663-3.CrossRefPubMed

Dallinger S, Sieder A, Strametz J, Bayerle-Eder M, Wolzt M, Schmetterer L: Vasodilator effects of L-arginine are stereospecific and augmented by insulin in humans. Am J Physiol Endocrinol Metab. 2003, 284: E1106-E1111.CrossRefPubMed

Garhofer G, Resch H, Lung S, Weigert G, Schmetterer L: Intravenous administration of L-arginine increases retinal and choroidal blood flow. Am J Ophthalmol. 2005, 140: 69-76.CrossRefPubMed

10.

Dorner GT, Garhofer G, Kiss B, Polska E, Polak K, Riva CE, Schmetterer L: Nitric oxide regulates retinal vascular tone in humans. Am J Physiol Heart Circ Physiol. 2003, 285: H631-H636.CrossRefPubMed

11.

Dorner GT, Garhofer G, Huemer KH, Riva CE, Wolzt M, Schmetterer L: Hyperglycemia affects flicker-induced vasodilation in the retina of healthy subjects. Vision Res. 2003, 43: 1495-1500. 10.1016/S0042-6989(03)00170-6.CrossRefPubMed

12.

Koifman B, Topilski I, Megidish R, Zelmanovich L, Chernihovsky T, Bykhovsy E, Keren G: Effects of losartan + L-arginine on nitric oxide production, endothelial cell function, and hemodynamic variables in patients with heart failure secondary to coronary heart disease. Am J Cardiol. 2006, 98: 172-177. 10.1016/j.amjcard.2006.01.085.CrossRefPubMed

13.

Inan UU, Yucel A, Ermis SS, Ozturk F: The effect of dehydration and fasting on ocular blood flow. J Glaucoma. 2002, 11: 411-415. 10.1097/00061198-200210000-00007.CrossRefPubMed

14.

Alghadyan AA: Retinal vein occlusion in Saudi Arabia: possible role of dehydration. Ann Ophthalmol. 1993, 25: 394-398.PubMed

15.

Lapeyraque AL, Haddad E, Andre JL, Bremond-Gignac D, Taylor CM, Rianthavorn P, Salusky IB, Loirat C: Sudden blindness caused by anterior ischemic optic neuropathy in 5 children on continuous peritoneal dialysis. Am J Kidney Dis. 2003, 42: E3-E9.CrossRefPubMed

Title: The effect of voluntary fasting and dehydration on flicker-induced retinal vascular dilation in a healthy individual: a case report
Authors: Rebekka Heitmar
Doina Gherghel
Richard Armstrong
Robert Cubbidge
Sarah Hosking
Publication date: 01-12-2008
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2008
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/1752-1947-2-153

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The effect of voluntary fasting and dehydration on flicker-induced retinal vascular dilation in a healthy individual: a case report

Abstract

Introduction

Case presentation

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Case presentation

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2008

Subhepatically located appendicitis due to adhesions: a case report

Juvenile polyposis syndrome affecting the stomach: A case report

Perirenal schwannoma: a case report

Ventriculitis due to Staphylococcus lugdunensis: two case reports

Metastatic rectal adenocarcinoma within haemorrhoids: a case report

Breast conserving surgery with preservation of the nipple-areola complex as a feasible and safe approach in male breast cancer: a case report