The clinical significance of spontaneous pulsations of the retinal vein
B. E. Levin
A search for spontaneous retinal venous pulsations was carried out in 218
subjects. Spontaneous venous pulsations were present in 87.6% of 146
unselected subjects 20 to 90 years of age and absent in 100% of 33 patients
with raised intracranial pressure without papilledema and ten patients with
papilledema. Lumbar puncture in nine patients with raised intracranial
pressure established the upper level at which spontaneous pulsations
disappear as 190 mm H2O, and no pressure above 180 mm H2O was found in 29
patients with venous pulsations present prior to lumbar puncture. There was
no correlation between the presence or absence of venous pulsations and
blood pressure. Some normal subjects with absent pulsations showed definite
pulsations on subsequent examinations. These findings confirm that the
presence of spontaneous venous pulsations is a reliable indicator of an
intracranial pressure below 180 to 190 mm H2O, while the absence of
pulsations may be found with normal intracranial pressure and is therefore
not a reliable guide to raised intracranial pressure.
