The effect of LDL apheresis on ocular microcirculation in patients with hypercholesterolemia-A pilot study
Résumé
Aim To investigate the effect of LDL (low density lipoprotein) apheresis on ocular microcirculation in patients with hypercholesterolemia Methods Six patients with hypercholesterolemia were included in this study. The diameter of retinal vessels was measured continuously with the retinal vessel analyzer (RVA) before and after LDL apheresis. After baseline assessment a monochromatic luminance flicker was applied to evoke retinal vasodilation. Flicker response was then analyzed 50, 70 and 120 sec after baseline measurement. Additionally, cholesterol-, HDL-, LDL- and triglyceride level were obtained to find a possible correlation between retinal vessel diameter changes and lipid metabolism before and after apheresis. Results The mean diameter of the arterioles at baseline was 107.6±2.1µm and the mean diameter of the venules at baseline was 132.8±3.2 µm. The diameter of the arterioles after apheresis increased to 111.2±2.3µm after 50 sec, to 113.2±2.6 µm after 70 sec and to 113.7±2.6 µm after 120 sec showing a trend to statistical significance at all time points (P=0.046, P=0.028 and P=0.028). The mean diameter of the venules after apheresis increased to 138.8±5.9 µm after 50 sec, to 139.8±6.3 µm after 70 sec and to 141.2±6.0 µm after 120 sec showing a trend to statistical significance at all time points (all P =0.028). Conclusions Changes in retinal vascular calibre seem to be associated with the systemic effect of a single LDL apheresis. Vasodilatation of the arterioles and the venules improved after LDL apheresis indicating an improvement of ocular perfusion in patients with hypercholesterolemia. Key words: LDL-apheresis, retinal vessel analyzer, microcirculation
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