To the Editor.
—I wish to make some comments on the article by Bosley et al1 in the March issue of the Archives regarding the use of ocular pneumoplethysmography (OPG-Gee) in the diagnosis of giant-cell arteritis (GCA). While I appreciate the results of the study, the conclusion that the OPG-Gee is a clinically practical, cost-effective, and safe procedure in the diagnosis of GCA is in question. The latter point of safety is surely the most obvious.Having observed the procedure during my residency, I was impressed by the sustained high intraocular pressure and transient ocular ischemia it produced. The intraocular pressure reaches levels between 110 to 145 mm Hg,2 which is allowed to slowly decrease in a period of 28 to 40 seconds.3 This intraocular pressure exceeds ophthalmic artery systolic pressure and causes transient occlusion of the ophthalmic artery, the posterior ciliary arteries, and the central retinal
Bates JH. Ocular Pneumoplethysmography in Giant-Cell Arteritis. Arch Ophthalmol. 1989;107(9):1279. doi:10.1001/archopht.1989.01070020349007