Blood flow in glaucoma.
Blood flow in glaucoma.
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DOI：
10.1097/01.icu.0000156134.38495.0b
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发表时间：
2005-04-01
影响因子：
3.7
通讯作者：
Flammer, Josef
中科院分区：
文献类型：
--
作者：
Grieshaber, Matthias C;Flammer, Josef
青光眼是世界上致盲的主要原因之一，以进行性视野丧失和视神经头明显凹陷为特征。虽然眼压升高是主要的危险因素，但越来越多的证据表明，青光眼的发病机制也与眼血流改变有关。本文综述了近年来有关青光眼血流的相关文献。最近的发现：一些研究表明，灌注不稳定，而不是眼血流量的稳定减少，可能导致青光眼视神经病变。不稳定性的主要原因是在普遍血管失调的情况下，自我调节受到干扰。这种血管失调的潜在机制尚不清楚。本文讨论了自主神经系统和血管内皮细胞的功能障碍。摘要：机械理论和血管理论并不相互排斥；相反，血管失调增加了对眼压的易感性。因此，在治疗上，可以考虑降低眼压和改善眼血流量。
PURPOSE OF REVIEW: Glaucoma, one of the leading causes of blindness in the world, is characterized by progressive visual field loss and distinctive excavation of the optic nerve head. Although elevated intraocular pressure is the major risk factor, there is increasing evidence that the pathogenesis of glaucoma is also linked to altered ocular blood flow. This review summarizes the recent publications relevant to blood flow in glaucoma.RECENT FINDINGS: Several studies indicate that a perfusion instability, rather than a steady reduction of ocular blood flow, might contribute to glaucomatous optic neuropathy. The main cause of the instability is a disturbed autoregulation in the context of a general vascular dysregulation. The underlying mechanism of such a vascular dysregulation is not known. A dysfunction of both the autonomic nervous system and vascular endothelial cells is discussed.SUMMARY: The mechanical and vascular theories are not mutually exclusive; on the contrary, a vascular dysregulation increases the susceptibility to intraocular pressure. Therapeutically, therefore, both an intraocular pressure reduction and an improvement of the ocular blood flow might be considered.