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Effects of Exercise on the Structure and Circulation of Choroid in Normal Eyes

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      Abstract

      Aims

      To determine the effects of dynamic exercise on the circulation and the luminal and stromal areas of the choroid in normal eyes.

      Methods

      This was a prospective interventional study of 38 eyes of 38 normal subjects enrolled by invitation. The systolic and diastolic blood pressures, heart rate, intraocularpressure, mean ocular perfusion pressure (MOPP), choroidal blood velocity, and enhanced depth imaging optical coherence tomographic (EDI-OCT) images were recorded before, and immediately after mild dynamic exercise. The same measurements were recorded after 10 min of rest. The choroidal blood velocity was measured bylaser speckle flowgraphy, and the mean blur rate was used for the evaluations. The horizontal EDI-OCT images of the subfoveal choroid were converted to binary images. The central choroidal thickness (CCT), total cross sectional choroidal area, luminal areas, stromal areas, and the ratio of luminal area to total choroidal area (L/C ratio) were determined from these images.

      Results

      The systolic and diastolic blood pressures, heart rate, MOPP, and the mean blur rate were significantly increased immediately after the exercise and significantly decreased 10 minutes after the exercise. There wereno significant changes in the mean CCT, the mean total choroidal area, the mean luminal and stromal areas, and the mean L/C ratio after the exercise.

      Conclusions

      Our results suggest that a rest period is needed before measurements of blood flow velocity but not necessary for the EDI-OCT imaging to determine the choroidal thickness and area.

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      Most cited references 41

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      Diurnal variation of choroidal thickness in normal, healthy subjects measured by spectral domain optical coherence tomography.

      To describe the pattern and magnitude of diurnal variation of choroidal thickness (CT), its relation to systemic and ocular factors, and to determine the intervisit reproducibility of diurnal patterns. A prospective study was conducted on 12 healthy volunteers who each underwent sequential ocular imaging on two separate days at five fixed, 2-hour time intervals. Spectral domain optical coherence tomography (OCT) with enhanced depth imaging and image tracking was performed using a standardized protocol. Choroidal and retinal thicknesses were independently assessed by two masked graders. CT diurnal variation was assessed using repeated-measures ANOVA. A significant diurnal variation in CT was observed, with mean maximum CT of 372.2 μm, minimum of 340.6 μm (P < 0.001), and mean diurnal amplitude of 33.7 μm. Retinal thickness (mean, 235.0 μm) did not exhibit significant diurnal variation (P = 0.621). The amplitude of CT variation was significantly greater for subjects with thicker morning baseline CT compared with those with thin choroids (43.1 vs. 10.5 μm, P < 0.001). There were significant correlations between amplitude of CT and age (P = 0.032), axial length (P < 0.001), and spherical equivalent (P < 0.001). The change in CT also correlated with change in systolic blood pressure (P = 0.031). Comparing CT on two different days, a similar diurnal pattern was observed, with no significant difference between corresponding measurements at the same time points (P = 0.180). There is significant diurnal variation of CT, with good intervisit reproducibility of diurnal patterns on two different days. The amplitude of variation varies with morning baseline CT, and is correlated with age, axial length, refractive error, and change in systolic blood pressure.
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        Cellular and physiological mechanisms underlying blood flow regulation in the retina and choroid in health and disease.

        We review the cellular and physiological mechanisms responsible for the regulation of blood flow in the retina and choroid in health and disease. Due to the intrinsic light sensitivity of the retina and the direct visual accessibility of fundus blood vessels, the eye offers unique opportunities for the non-invasive investigation of mechanisms of blood flow regulation. The ability of the retinal vasculature to regulate its blood flow is contrasted with the far more restricted ability of the choroidal circulation to regulate its blood flow by virtue of the absence of glial cells, the markedly reduced pericyte ensheathment of the choroidal vasculature, and the lack of intermediate filaments in choroidal pericytes. We review the cellular and molecular components of the neurovascular unit in the retina and choroid, techniques for monitoring retinal and choroidal blood flow, responses of the retinal and choroidal circulation to light stimulation, the role of capillaries, astrocytes and pericytes in regulating blood flow, putative signaling mechanisms mediating neurovascular coupling in the retina, and changes that occur in the retinal and choroidal circulation during diabetic retinopathy, age-related macular degeneration, glaucoma, and Alzheimer's disease. We close by discussing issues that remain to be explored. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.
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          Potential causes, mechanisms, and implications of post exercise hypotension.

          Post exercise hypotension (PEH) is a phenomenon of a prolonged decrease in resting blood pressure in the minutes and hours following acute exercise. Knowledge of PEH is potentially useful in designing first line strategies against hypertension as well as allowing a further understanding of blood pressure regulation in both health and disease. Following a brief review of blood pressure responses to exercise, this paper will provide a current and comprehensive summary of PEH and integrate the current state of knowledge surrounding it.
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            Author and article information

            Affiliations
            [1 ]Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
            [2 ]Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
            [3 ]Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
            Universita degli Studi di Firenze, ITALY
            Author notes

            Competing Interests: The authors have declared that no competing interests exist.

            • Conceptualization: TK YM.

            • Data curation: TK JM KS.

            • Formal analysis: TK JM KA KS YM.

            • Funding acquisition: YM.

            • Investigation: TK JM NO HI.

            • Methodology: TK YM.

            • Project administration: TK HI.

            • Resources: TK JM NO HI MI MS HM SS TS.

            • Software: SS.

            • Supervision: TS.

            • Validation: TK YM.

            • Visualization: TK JM KS YM.

            • Writing – original draft: TK.

            • Writing – review & editing: TK JM NO HI MI MS HM KA KS SS TS YM.

            Contributors
            Role: Editor
            Journal
            PLoS One
            PLoS ONE
            plos
            plosone
            PLoS ONE
            Public Library of Science (San Francisco, CA USA )
            1932-6203
            14 December 2016
            2016
            : 11
            : 12
            27973598 5156418 10.1371/journal.pone.0168336 PONE-D-16-27960
            © 2016 Kinoshita et al

            This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

            Counts
            Figures: 5, Tables: 3, Pages: 14
            Product
            Funding
            Funded by: Ministry of Education, Culture, Sports, Science, and Technology (JP)
            Award ID: 16K11288
            Award Recipient :
            This work was supported in part by grant-in-aid 16K11288 (to YM) from the Ministry of Education, Culture, Sports, Science and Technology, Japan. URL: http://www.mext.go.jp/english/. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
            Categories
            Research Article
            Medicine and Health Sciences
            Vascular Medicine
            Blood Pressure
            Biology and Life Sciences
            Anatomy
            Body Fluids
            Blood
            Blood Flow
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            Anatomy
            Body Fluids
            Blood
            Blood Flow
            Biology and Life Sciences
            Physiology
            Body Fluids
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            Physiology
            Body Fluids
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            Biology and Life Sciences
            Anatomy
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            Anatomy
            Ocular System
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            Medicine and Health Sciences
            Anatomy
            Ocular System
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            Biology and Life Sciences
            Anatomy
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            Ocular Anatomy
            Choroid
            Medicine and Health Sciences
            Anatomy
            Ocular System
            Ocular Anatomy
            Choroid
            Medicine and Health Sciences
            Hematology
            Hemodynamics
            Biology and Life Sciences
            Anatomy
            Ocular System
            Intraocular Pressure
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            Ocular System
            Intraocular Pressure
            Medicine and Health Sciences
            Cardiology
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            Public and Occupational Health
            Physical Activity
            Physical Fitness
            Exercise
            Medicine and Health Sciences
            Sports and Exercise Medicine
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            Biology and Life Sciences
            Sports Science
            Sports and Exercise Medicine
            Exercise
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