The pathogenesis and simulation model of autonomic nerve response in the intraocular blood flow disorders

[背景/目的]眼内血流在较宽的灌注压范围内具有自动调节作用。本研究的目的是探讨降低眼内压（IOP）是否可以改善人眼的眼内血流动力学。[方法] 26例原发性开角型青光眼（primary open angle glaucoma，POAG）拟行小梁切除术的患者。分别于术前、术后3、6、9、12个月对患者进行评估。应用彩色多普勒超声检测双眼视网膜中央动脉（CRA）和睫状后短动脉（SPCA）血流阻力。视野检查视网膜神经节细胞功能。[结果]小梁切除术后术眼眼压明显下降，术后各次访视眼压均明显升高。手术眼CRA和SPCA血流阻力明显降低，视网膜光敏感度明显增加。未手术眼眼压、眼压、CRA和SPCA血流阻力、视网膜光敏感度无明显变化。[结论]降低眼压可改善POAG患者的眼血流及视网膜神经节细胞功能。

[Background/aim] The intraocular blood flow is autoregulated over wide range of ocular perfusion pressure (OPP). The purpose of this study is to investigate whether a reduction of intraocular pressure (IOP) may improve intraocular hemodynamics in human eyes.[Methods] 26 patients with primary open angle glaucoma (POAG) about to undergo trabeculectomy were included in the study. Patients were evaluated before surgery and at 3,6,9,12 months after trabeculectomy. Blood flow resistance of central retinal artery (CRA) and short posterior ciliary artery (SPCA) in both eyes were assessed with color Doppler imaging. Function of retinal ganglion cells were obtained with visual field examination.[Results] IOP in the operated eye was significantly decreased after trabeculectomy, and OPP was significantly increased for each postoperative visits. Blood flow resistance of CRA and SPCA were significantly decreased, and retinal light sensitivity was significantly increased in the operated eye. IOP in the unoperated eye, OPP, blood flow resistance of CRA and SPCA, and retinal light sensitivity did not significantly change.[Conclusion] The results of this study suggest that a reduction of IOP improves ocular blood flow and function of retinal ganglion cell in patients with POAG.