ABSTRACT.The prevalence of exfoliation syndrome was studied in 39 patients suffering from dementia and cognitive impairment; a positive finding of exfoliation was detected in 11/39 of these patients. A comparison with an age-matched population survey showed that the prevalence of ocular exfoliation and the relative risk were significantly elevated. These results suggested that lesions related to the exfoliative process might be located also in the brain of patients suffering from dementia and cognitive impairment.
In a prospective study of untreated ocular hypertension 117 eyes were non-exfoliative and 20 eyes exfoliative. The percentage of optic disc pallor was significantly larger in the exfoliative than in the non-exfoliative group, whereas no significant differences were found in IOP or in the visual field.
In previous studies I reported that ascorbic acid produced a fall in the intraocular pressure of about 2 mm Hg4,5,0,7. The pressure-lowering effect was obtained after oral administration and also after topical application. The fall in pressure took place about two days following the administration of ascorbic acid. So far normal human eyes and a few glaucomatous eyes have been studied.In the first study of normal human eyes there was found to be a slight numerical increase in the facility of outflow of about 15 per cent. The reduction in the outflow pressure of about 50 per cent could hardly be entirely explained by these tonographic changes. Other possible mechanisms were therefore discussed. A reduction in the rate of aqueous flow was considered to be the most likely explanation. In further studies the results obtained by means of the suction cup technique indicated a diminished increase in pressure and volume during treatment with ascorbic acid. These results supported the explanation that the pressure fall was caused by a reduction in the rate of aqueous flow. This is however true only under the assumption that no other pathways exist by which the aqueous humour can leave the eye. A bulk drainage by way of uveo-scleral routes in addition to the conventional routes as reported by Bill2 cannot be excluded although such pathways have not been demonstrated in human eyes. According to this suggestion an increase in the drainage through the posterior part of the eye might occur if the hyaluronic acid in the posterior part of the eye was depolymerized by the high concentration of ascorbic acid.
685Acta Ophthalmol. 47, I11 41
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