Electrodes Device for Impedance Diagnostics of the Blood Flow in the

Ophthalmic Artery

Petr V. Luzhnov

, Anna A. Kiseleva

and Elena N. Iomdina

Bauman Moscow State Technical University, Moscow, Russian Federation

Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russian Federation

Keywords: Impedance Diagnostics, Transpalpebral Rheoophthalmography, Blood Flow, Eye.

Abstract: The paper presents new electrodes device for diagnostics of the eye blood filling based on the registration of

rheographic signals. The methods of bipolar rheoophthalmography and tetrapolar transpalpebral

rheoophthalmography are briefly discussed. The elastic tape is presented as electrodes device. All main

parameters of new electrodes device are chosen. An electrodes system has been developed for recording the

pulse blood filling of main large arteries near eye: ophthalmic artery, internal carotid artery, anterior

cerebral artery and middle cerebral artery. The application of this technique was shown in the example.

Calculations made in analyzing signals obtained from patients without an ophthalmopathology are

presented, which show that eye blood filling in the ophthalmic artery was 30-42 % above, than at research

of an eye by a technique transpalpebral rheoophthalmography.

1 INTRODUCTION

A comprehensive analysis of blood flow is necessary

for obtaining complete information about the eye

blood flow and forming effective diagnostic

conclusions on this basis. Currently, for studying the

blood flow in the eye arteries, the transpalpebral

ultrasound method is known - ultrasound color

mapping (Machekhin and Vlazneva, 2009; Kiseleva,

2004). In addition, contactless optical methods are

known - optical coherence tomography, angiography

(Kurysheva et al., 2017) and laser Doppler

flowmetry (Kiseleva and Adzhemyan, 2015).

Electrical impedance methods are now known,

including methods for obtaining the impedance

distribution in a human body through non-invasive

electrical sounding, calculations and reconstruction

algorithms (Patterson, 2005). The rheography is the

electrical impedance method for studying the pulse

oscillations of the blood flow in the vessels of

various organs and tissues which based on the

graphic recording of changes in the total electrical

resistance of tissues (Sokolova et al., 1977). In

electrical impedance diagnostics the

ophthalmoplethysmography and the

rheoophthalmography are also known (Avetisov et

al., 1967; Lazarenko et al., 1999; Lazarenko and

Komarovskikh, 2004). Rheoophthalmography

(ROG) is the method for assessing the state of the

blood flow in the eye. ROG is a method for studying

the pulse blood filling in the vessels of various

organs and tissues, based on recording changes in

the total electrical resistance of tissues. In the

classical method of ROG registration, the electrodes

are mounted directly on the surface of the eye near

the lens. It leads to necessity of anesthesia for

conducting diagnostic researches.

To solve the limitations of the classical

technique, a new registration technique has been

developed - the method of transpalpebral

rheoophthalmography (TP ROG) (Luzhnov et al.,

2015; Luzhnov et al., 2017; Luzhnov et al., 2018;

Shamaev et al., 2018). In this version of the study,

the electrodes for TP ROG are positioned on the

closed upper eyelid. This method provides for

applying the special device for positioning the

electrodes during the research (Luzhnov et al.,

2017). The method is designed for obtaining

quantitative parameters of uveal ocular blood flow.

The main disadvantage of this method and device

for its implementation is the impossibility of

simultaneous evaluation of the blood flow in the

ophthalmic artery and cerebral arteries.

The rheography electrodes system proposed by

K.K. Yarullin are used in the studying of the brain

256

Luzhnov, P., Kiseleva, A. and Iomdina, E.

Electrodes Device for Impedance Diagnostics of the Blood Flow in the Ophthalmic Artery.

DOI: 10.5220/0007570802560260

In Proceedings of the 12th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2019), pages 256-260

ISBN: 978-989-758-353-7

(Yarullin et al., 1980). This electrodes system allow

to estimate the blood flow in the main cerebral

arteries: the anterior cerebral, middle cerebral,

posterior cerebral and vertebral arteries (Bodo,

2010). The main drawback of this method is the

impossibility of registration the pulse volume of the

ophthalmic artery.

The above-mentioned methods do not allow a

comprehensive assessment of the blood flow in the

eye vessels, due to the fact of examining the blood

flow in each vessel separately. At the same time,

with the help of the electrical impedance method, it

is possible to evaluate the blood flow not only in the

individual arteries, but also in the whole vascular

system of the eye. The main task of this work is a

development of a device for the integrated

assessment of blood circulation in the vessels of the

eye and in addition of the brain, namely in the

ophthalmic artery, (from which all the vessels of the

eye branch off), and in the vessels of the anterior

brain, the anterior cerebral artery and middle

cerebral artery.

2 MATERIALS AND METHODS

2.1 Problem Statement

The electrical impedance methods ROG and TP

ROG require to placing electrodes (see the Figure 1)

for estimating the pulse volume of blood in

intraocular vessels.

Both of these methods survey blood vessels from

the first area (see the Figure 2) in diagnostic

procedures. The rheoencephalography method

(Sokolova et al., 1977) allows to estimate the blood

flow in the third area in the Figure 2.

The diagnosing, for example, of patients with

glaucoma (Luzhnov et al., 2018), demands a blood

flow definition in vessels from the second area.

Electrodes systems for ROG or TP ROG do not

approach for this purpose.

Therefore the special electrodes device has been

developed in our work. A distinctive feature is the

possibility of conducting a comprehensive analysis

of the blood flow in the ophthalmic artery and the

vessels of the anterior part of the brain for further

diagnosing, including early hemodynamic disorders

in eye diseases and evaluating the effectiveness of

their therapy. It is achieved through using sixteen

electrodes system, positioned in accordance with the

anatomical location of the analyzed vessels parts

(internal carotid artery, anterior cerebral artery,

middle cerebral artery and ophthalmic artery).

Figure 1: The electrodes systems for ROG and TP ROG.

Figure 2: The areas of ocular blood vessels.

2.2 Electrodes Device

The device is an elastic tape with holes for further

accommodation of 16 electrodes. 12 holes are

located on the tape itself, and 4 holes are on 4 plates

attached to the tape and protruding beyond tape’s

borders. The tape has a pair of Velcro fasteners.

They are providing, if necessary, the length

changing of the tape.

A schematic picture of the device is shown at the

Figure 3.

On the Figure 3 are shown:

1 – The elastic tape with a hexagonal hole in the

center;

2 – Velcro fasteners at the borders of the tape,

separated by a notch in the tape;

3 – The plates with holes for the electrodes

protruding beyond tape’s borders;

4 – The holes for electrodes.

Velcro fasteners (at the borders of the tape) provide,

if necessary, changing in the length of the tape in

accordance with the anthropometric data of the

Electrodes Device for Impedance Diagnostics of the Blood Flow in the Ophthalmic Artery

257

patient's head and the necessary level for pressing

the device to the patient's head. A pair of Velcro

fasteners is located on the left and right ends of the

tape. Structurally they are separated from each other

by a notch in the tape, preferably 10.0 ± 1.0 mm

wide. It allows to adjust the tension of the tape

separately along its upper and lower edges, also for

avoiding warping tape while fixing it on the

patient’s head.

As a result, the perimeter of the tape in the

buttoned state can vary in the range of 550-600 mm

and can be chosen individually for each patient. The

distance can be 20.0 ± 2.0 mm between the holes of

the electrodes. The attachment points of the outside

electrodes on the left and right sides of the tape (four

electrodes on each side) are used for registration the

pulse volume of the internal carotid artery, the

anterior cerebral artery and the middle cerebral

artery.

Figure 3: The elastic tape as electrodes device.

The holes for mounting the electrodes can have a

diameter of Ø7.0 ± 0.7 mm. Each hole for mounting

the electrode can be equipped with an insulating

stopper, which allows to mount reusable metal

electrodes.

Four plates (pos.3 in the Figure 3), made, for

example, of ABS plastic (acrylonitrile butadiene

styrene), are fixed on the tape. The location of the

plates in the device is selected in accordance with

the anatomical location of the ophthalmic artery.

Each plate can be located at a distance of 25.0 ± 2.5

mm from the horizontal symmetry axis of the tape.

Each plate has two holes for fixing the electrodes.

One of the holes is taken out of the tape’s borders,

and the other coincides with the corresponding hole

in the tape.

The mounting holes for the electrodes preferably

have a diameter of Ø7.0 ± 0.7 mm. Each hole of the

electrode can be equipped with an insulating stopper

in the case of mounting reusable metal electrodes.

2.3 Using in Clinical Practice

The device is used as follows: a device with

electrodes located in it, fixed on an elastic tape and

its plates, is mounted on the patient's head in the

periorbital region (on the closed eye). The location

of the plates is determined in accordance with the

patient's nasal bone - the plates should be placed at a

distance of 15 ± 3 mm from the nasal septum.

Further, fixation on the patient's head is carried out

with the help of Velcro elastic tape. After that, the

device is ready for operation and further connection

to the device of recording electrical impedance

signals.

While using the device, it is possible to

simultaneously obtain quantitative parameters of the

blood flow in the ophthalmic artery and the blood

flow in the vessels of the anterior part of the brain.

An example of the electrodes positioning scheme

is shown at the Figure 4. This example shows use of

the device for studying the left hemisphere of the

brain. The scheme for studying the right hemisphere

is symmetric relative to the sagittal plane.

In our research, TP ROG signals were analyzed

in a group of patients without an

ophthalmopathology. In total, four pairs of records

with duration of two minutes each were analyzed.

Each pair contained TP ROG signal (as in the Figure

1) and ROG signal from new electrodes device (as

shown in the Figure 4).

Figure 4: The registration of impedance signals for

studying the left hemisphere of the brain.

BIODEVICES 2019 - 12th International Conference on Biomedical Electronics and Devices

258

This study was performed in accordance with the

Declaration of Helsinki and was approved by the

Local Committee of Biomedical Ethics of the

Moscow Helmholtz Research Institute of Eye

Diseases. A written informed consent was obtained

from all participants.

3 RESULTS

The example of typical TP ROG signal, which is

recorded in the 29 years old patient without an

ophthalmopathology, is shown in the Figure 5. TP

ROG signal shows blood flow pulse oscillations.

Base impedance (BI) reflects blood filling level of

eyes tissues.

Figure 5: The example of TP ROG signal.

The results of using our electrodes device with

such an arrangement of a tape with electrodes

showed compliance with theoretical calculations

which were obtained on the basis of a mathematical

model (Shamaev et al., 2017) for TP ROG.

Value of BI parameter at blood flow research in

the ophthalmic artery was 30-42 % above, than at

research of an eye by a technique TP ROG. This

result coincides with a theoretical estimation which

gives increase of a base impedance parameter in this

case.

4 CONCLUSIONS

The constructed device provides the ability for

conducting multichannel electrical impedance

studies in ophthalmology, with simultaneous

assessment of blood flow in the orbital artery

without contact with the eye surface, as well as in

the vessels of the anterior part of the brain, which

can have great importance in clinical practice - for

the diagnosis of eye diseases and control the

effectiveness of their treatment.

CONFLICT OF INTEREST

The authors declare that they have no conflict of

interest. The paper was supported by a grant from

RFBR (No.18-08-01192).

REFERENCES

Avetisov, E.S., Katsnelson, L.A., Savitskaia, N.F. (1967)

Rheocyclographic examinations in myopia. Vestnik

Oftal’mologii 80(3), 3–7.

Bodo, M. (2010) Studies in Rheoencephalography.

Journal of Electrical Bioimpedance 1, 18–40.

Calvo, P. et al. (2012) Predictive value of retrobulbar

blood flow velocities in glaucoma suspects. Investig.

Ophthalmol. Vis. Sci. 53, 3875–3884.

Caprioli, J., Coleman, A. L. (2010) Blood Pressure,

Perfusion Pressure, and Glaucoma. Am. J.

Ophthalmol. 149, 704–712.

Cherecheanu A.P., Garhofer G., Schmidl D., Werkmeister

R., Schmetterer L. Ocular perfusion pressure and

ocular blood flow in glaucoma. CurrOpinPharmacol.

2013; 13: 36-42. DOI: 10.1016/j.coph.2012. 09.003.

Kiseleva A., Luzhnov P., Dyachenko A. and Semenov Y.

(2018). Rheography and Spirography Signal Analysis

by Method of Nonlinear Dynamics. In Proceedings of

the 11th International Joint Conference on Biomedical

Engineering Systems and Technologies - Volume 1:

BIODEVICES, ISBN 978-989-758-277-6, pages 136-

140. DOI: 10.5220/0006579301360140.

Kiseleva, T.N. (2004) Ultrasonic methods blood flow

studies in the diagnosis of ischemic lesions of the eye.

Bulletin of Ophthalmology 4: 3-5.

Kiseleva, T.N., Adzhemyan, N.A. (2015) Methods for

assessing ocular blood flow in vascular eye pathology.

Regional blood circulation and microcirculation 4: 4-

10.

Kurysheva, N.I., Trubilina, A.V., Maslova, E.V. (2017)

Optical coherent tomography - angiography and

pattern-electroretinography in early diagnosis of

glaucoma. Glaucoma news 1: 66-69.

Lazarenko, V.I., Komarovskikh, E.N. (2004) Results of

the examination of hemodynamics of the eye and brain

in patients with primary open-angle glaucoma. Vestnik

Oftal’mologii 120(1), 32–36.

Lazarenko, V.I., Kornilovsky, I.M., Ilenkov, S.S. et al.

(1999) Our method of functional rheography of eye.

Vestnik Oftal’mologii 115(4), 33–37.

Luzhnov P.V., Shamaev D.M., Iomdina E.N., Markosyan

G.A., Tarutta E.P., Sianosyan A.A. (2017) Using

quantitative parameters of ocular blood filling with

transpalpebralrheoophthalmography. In: Eskola H.,

Väisänen O., Viik J., Hyttinen J. (editors). EMBEC &

Electrodes Device for Impedance Diagnostics of the Blood Flow in the Ophthalmic Artery

259

NBC 2017. IFMBE Proceedings, vol. 65; p. 37–40,

DOI:10.1007/978-981-10-5122-7_10.

Luzhnov P.V., Shamaev D.M., Iomdina E.N., Tarutta E.P.,

Markosyan G.A., Shamkina L.A., Sianosyan A.A.

(2015) Transpalpebral tetrapolar reoophtalmography

in the assessment of parameters of the eye blood

circulatory system. Vestnik Rossiiskoi akademii

meditsinskikh nauk 70(3): 372–377,

DOI:10.15690/vramn.v70i3.1336.

Luzhnov P.V., Shamaev D.M., Kiseleva A.A. et al. (2018)

Using nonlinear dynamics for signal analysis in

transpalpebral rheoophthalmography. Sovremennye

tehnologii v medicine 10(3): 160-167,

DOI:10.17691/stm2018.10.3.20

Luzhnov P.V., Shamaev D.M., Kiseleva A.A., Iomdina

E.N. (2018), Analyzing rheoophthalmic signals in

glaucoma by nonlinear dynamics methods. IFMBE

Proceedings 68/2: pp.827-831. DOI: 10.1007/978-

981-10-9038-7_152.

Machekhin, V.A., Vlazneva, I.N. (2009) Study of the

blood supply to the eye using color ultrasound

dopplerography. Siberian National Medical Journal 4:

100-103.

Patterson, R. (2005) Electrical Impedance Tomography:

Methods, History, and Applications (Institute of

Physics Medical Physics Series), Physics in Medicine

and Biology 10: 2427-2428.

Quigley, H. A., Broman, A. T. (2006) Number of people

with glaucoma worldwide. Br. J. Ophthalmol. 90,

262–267.

Shamaev D. M., Luzhnov P. V., Iomdina E. N., (2018),

Mathematical modeling of ocular pulse blood filling in

rheoophthalmography. IFMBE Proceedings 68/1,

pp.495–498. DOI: 10.1007/978-981-10-9035-6_91

Sokolova, I.V., Yarullin, K.K., Maksimenko, I.M.,

Ronkin, M.A. (1977) Analysis of the structure of

rheoencephalogram as a pulse filling of blood. Journal

of Nevropathol 77, 1314–1321.

Venkataraman, S. T., Flanagan, J. G. & Hudson, C.

(2010) Vascular Reactivity of Optic Nerve Head and

Retinal Blood Vessels in Glaucoma- A Review.

Microcirculation 17, 568–581.

Yarullin, K.K., Krupina, T.N., Alekseev, D.A. (1980)

Rheo- and encephalographic criteria for diagnosing

latent cerebral circulation insufficiency in patients

with cervical osteochondrosis. Sovetskaya Meditsina

43(3), 9–15.

BIODEVICES 2019 - 12th International Conference on Biomedical Electronics and Devices

260