Ocular perfusion pressure and glaucoma: clinical trial and epidemiologic findings.
Ocular perfusion pressure and glaucoma: clinical trial and epidemiologic findings.
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DOI：
10.1097/icu.0b013e32831eef82
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发表时间：
2009-03
影响因子：
3.7
通讯作者：
Leske MC
中科院分区：
文献类型：
--
作者：
Leske MC
眼灌注压与开角型青光眼（OAG）之间可能存在联系。这篇综述总结了提出的关系的科学依据，介绍了最近的数据，并概述了潜在的影响。基于人群的流行病学研究发现，低眼灌注压与OAG患病率以及OAG发病率之间存在密切关系。临床研究报告了低灌注压与OAG进展之间的类似关联。这些一致的研究结果表明，视盘血流的改变增加了OAG发生的风险和已建立的OAG的进展。一个潜在的因素可能是血管自动调节受损，这可能导致OAG灌注不良。相比之下，关于青光眼与血压/高血压的可能联系，有相互矛盾的证据。目前的证据支持血管因素作为OAG多因素病因的一部分的作用。由于眼灌注压反映了视盘的血管状态，它可能比单独的全身血压更相关。虽然OAG与灌注压力的关联是强烈的、一致的和生物学上合理的，但它们需要仔细解释。越来越多的证据表明OAG与血管病因有关，但对患者管理的临床意义仍不确定。
A possible connection between ocular perfusion pressure and open-angle glaucoma (OAG) has been hypothesized. This review summarizes the scientific rationale for the proposed relationship, presents recent data, and outlines potential implications. Population-based epidemiologic studies found strong relationships between low ocular perfusion pressure and OAG prevalence, as well as OAG incidence. Clinical studies report similar associations between low perfusion pressure and OAG progression. These consistent findings suggest that altered blood flow in the optic disc increases both the risk of OAG development and the progression of established OAG. An underlying factor would be impaired vascular autoregulation, which may lead to poor perfusion in OAG. In contrast, there is conflicting evidence on the possible link of glaucoma to blood pressure/hypertension. Current evidence supports the role of vascular factors as part of the multifactorial etiology of OAG. Since ocular perfusion pressure reflects the vascular status at the optic disc, it may be more relevant than systemic blood pressure alone. While the associations of OAG to perfusion pressure are strong, consistent and biologically plausible, they require careful interpretation. The evidence implicating a vascular etiology in OAG is mounting, but the clinical implications for patient management are still uncertain.