Retinal venous pressure: the role of endothelin.
Retinal venous pressure: the role of endothelin.
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DOI：
10.1186/s13167-015-0043-1
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Konieczka K
中科院分区：
文献类型：
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作者：
Flammer J;Konieczka K
视网膜静脉压（RVP）可以无创测量。健康人的RVP等于或略高于眼内压（IOP），但患有眼部或全身性疾病的患者往往明显升高。除了机械性梗阻外，这种升高的主要原因是视网膜静脉的局部失调，特别是由内皮素-1 （ET-1）引起的收缩。ET-1的局部升高可由高血浆水平引起，因为ET-1可以从脉络膜的开孔毛细血管扩散到视神经头（ONH），绕过血液视网膜屏障。局部增加也可由邻近病变动脉或视网膜组织引起的局部产量增加引起。通常，增加ET-1的主要因素是局部或远端器官的炎症和缺氧。已知在青光眼、视网膜静脉闭塞（RVO）、糖尿病视网膜病变、高山病和原发性血管失调（PVD）患者中RVP升高。PVD是Flammer综合征（FS）的主要血管组成部分。RVP升高会降低灌注压，从而增加缺氧的风险。RVP升高也会使跨壁压升高，从而增加视网膜水肿的风险。在RVO患者中，高水平的RVP不仅可能是结果，而且可能是闭塞的潜在原因；因此，它有可能造成恶性循环。视网膜动脉狭窄，特别是视网膜静脉扩张是已知的未来心血管事件的危险指标。由于这种视网膜静脉扩张的主要原因是RVP增加，RVP可能是一个更强的预测因子。
The retinal venous pressure (RVP) can be measured non-invasively. While RVP is equal to or slightly above intraocular pressure (IOP) in healthy people, it is often markedly increased in patients with eye or systemic diseases. Beside a mechanical obstruction, the main cause of such an elevation is a local dysregulation of a retinal vein, particularly a constriction induced by endothelin-1 (ET-1). A local increase of ET-1 can result from a high plasma level, as ET-1 can diffuse from the fenestrated capillaries of the choroid into the optic nerve head (ONH), bypassing the blood retinal barrier. A local increase can also result from increased local production either by a sick neighboring artery or retinal tissue. Generally, the main factors increasing ET-1 are inflammations and hypoxia, either locally or in a remote organ. RVP is known to be increased in patients with glaucoma, retinal vein occlusion (RVO), diabetic retinopathy, high mountain disease, and primary vascular dysregulation (PVD). PVD is the major vascular component of Flammer syndrome (FS). An increase of RVP decreases perfusion pressure, which heightens the risk for hypoxia. An increase of RVP also elevates transmural pressure, which in turn heightens the risk for retinal edema. In patients with RVO, a high level of RVP may not only be a consequence but also a potential cause of the occlusion; therefore, it risks causing a vicious circle. Narrow retinal arteries and particularly dilated retinal veins are known risk indicators for future cardiovascular events. As the major cause for such a retinal venous dilatation is an increased RVP, RVP may likely turn out to be an even stronger predictor.