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.
High mean IOP may be associated with poor blood reflux and filling of SC. A collapsed canal, probably secondary to high IOP, may be an underestimated sign in black African patients with POAG. The quality of blood reflux and episcleral venous egress may both be predictive of the level of IOP after surgery. Provocative gonioscopy and channelography may reflect the function of the outflow pathway and may be helpful in assessing the surgical outcome of canaloplasty.
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