The relationship between retinal vessel tortuosity, diameter, and transmural pressure

J. A. Kylstra, T. Wierzbicki, M. L. Wolbarsht, M. B. Landers, E. Stefansson

Increases in retinal vein tortuosity are thought to be caused by increases in vascular transmural pressure. We have attempted to determine the relationship between retinal vessel tortuosity, diameter, and transmural pressure by examining the effects of changes in transmural pressure on latex tubes with fixed ends. As the transmural pressure is raised, tube diameter increases, but tortuosity does not begin increasing until a critical pressure is reached. Above the critical pressure, tortuosity increases more rapidly than diameter. Our results support the above hypothesis and also suggest that at high transmural pressures, retinal vessel tortuosity is a more sensitive indicator than is the diameter of changes in retinal venous transmural pressure, but diameter is more sensitive than tortuosity at lower pressures.