The retinal venous pressure at different levels of airway pressure



To investigate retinal venous pressure (RVP) as a function of airway pressure (AirP) during the Valsalva maneuver (VM) in human subjects.


Forty-three healthy volunteers (age, 22.0 (2.3) years) (median and interquartile range) were investigated using the following instruments: dynamic contour tonometer, contact lens dynamometer (CLD), and aneroid manometer. The following measurements were performed in their left eyes: tonometry and dynamometry during VM at different levels of airway pressure (AirP = 0, 10, 20, 30, and 40 mmHg).


The median RVP during spontaneous breathing (AirP = 0) was 19.7 (6.4) (median in mmHg (interquartile range)) and the intraocular pressure (IOP) in mydriasis was 16.3 (3.1) mmHg. Spontaneous pulsation occurred in 58.1% of the subjects. RVP increased nonlinearly. The coefficient of variation of four individual measurements of RVP at each pressure level averaged 8.1 (7.6) %. At different AirP levels of 10, 20, 30, and 40 mmHg, the following RVPs were measured: 29.6 (12.6); 34.2 (12.8); 38.0 (10.5); and 40.3 (11.0), respectively. The rise of RVP (Δ RVP) during VM was significantly higher than that of Δ IOP (p < 0.0001, Wilcoxon test). Δ RVP between 0 and 40 mmHg AirP was 20.6 mmHg and Δ IOP 1.5 mmHg. The steepest slope of the RVP/AirP curve was observed at the first step from 0 to 10 mmHg of AirP (∆ RVP = 9.9 mmHg).


A nonlinear relationship between RVP and AirP was found during VM. Small rises in AirP increase the RVP and affect retinal circulation.

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We thank Dr. A. Klimova for assistance with statistical analysis.

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Correspondence to Sofie Heimann.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The methodology for this study was approved by the ethics committee of Univ. Hospital Carl Gustav Carus, TU Dresden (Ethics approval number: EK 171042017). This article does not contain any studies with animals performed by any of the authors.

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Heimann, S., Stodtmeister, R., Pillunat, L.E. et al. The retinal venous pressure at different levels of airway pressure. Graefes Arch Clin Exp Ophthalmol (2020).

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  • Airway pressure
  • Retinal venous pressure
  • Intraocular pressure
  • Ophthalmodynamometry
  • Tonometry
  • Valsalva maneuver