endothelin-1 and Retinal-Artery-Occlusion

Vascular occlusive diseases are usually seen in the elderly but can occur even in younger patients without arteriosclerosis. We assume a vascular dysregulation as a underlying pathogenetic mechanism.. In a prospective study we analysed the clinical findings of six patients under 55 years of age, three men with retinal vein occlusions and three women with branch retinal arterial obstructions. They were examined for signs of a vascular dysregulation and the endothelin-1 (ET-1) plasma level was measured.. In all patients the ET-1 plasma level was markedly elevated. The mean value (3.72 +/- 0.8 pg/ml) was significantly increased compared to normal values for that age (1.52 +/- 0.24 pg/ml; p < 0.001). In all cases an increased tendency for vascular dysregulation could be demonstrated in nailfold capillaroscopy. Furthermore, frequent coldness of the extremities was mentioned by every patient and migraine was mentioned by four patients whereas neither changes of the vessels in carotis and ophthalmica region nor disturbances in the haemostasis and fibrinolysis could be found.. All six patients with vascular occlusive diseases occurring before the age of 55 had a vascular dysregulation and increased ET-1 plasma levels. A relationship between the vascular dysregulation and the vascular occlusive diseases is therefore likely.

Topics: Acute Disease; Adult; Endothelin-1; Endothelium, Vascular; Female; Homeostasis; Humans; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Retinal Artery Occlusion; Retinal Vein Occlusion; Risk Factors; Skin Temperature; Vascular Resistance

Electroretinogram (ERG) changes invariably accompany the selective interruption of the retinal circulation that occurs in human central retinal artery occlusion. Since arteriolar ligation or ocular hypertension in the rabbit eye is occasionally used to model human central retinal artery occlusion, we conducted the present study to determine whether selective interruption of the retinal circulation of the rabbit eye alters retinal function as measured by the ERG. The vasoconstrictor, endothelin-1, was injected into the vitreous of rabbits' eyes to induce complete vasospasm and selective interruption of the retinal circulation. This procedure was compared to vascular ligation of the ophthalmic and ciliary arteries in which both the retinal and choroidal circulations were interrupted. A total of 8 rabbits was studied. Circulation was monitored angiographically in half of the eyes, and retinal function was monitored by the ERG in the remaining eyes. Endothelin-1 obliterated retinal arteriolar blood flow without affecting choroidal blood flow for at least 1 hr. Although ERG a-wave amplitude showed a small decline over 2 hr, b-wave and oscillatory potential amplitudes (measures of inner retinal function) showed no loss over this period. In contrast, ligation of the ophthalmic and ciliary arteries produced complete obliteration of both retinal arteriolar and choroidal blood flow and complete loss of the ERG after 2 min. Endothelin-1 induces acute, selective interruption of retinal arteriolar blood flow which has no significant physiologic effect on inner retinal function of the rabbit as monitored by the ERG. The avascular rabbit retina appears to be a poor choice for modeling human retinal artery occlusion.

Topics: Animals; Electroretinography; Endothelin-1; Female; Fluorescein Angiography; Rabbits; Regional Blood Flow; Retina; Retinal Artery; Retinal Artery Occlusion; Vasoconstrictor Agents