Assessment of optic disk blood flow in patients with open-angle glaucoma

Findl, Oliver; Rainer, Georg; Dallinger, Susanne; Dorner, Guido T.; Polak, Kaija; Kiss, Barbara; Georgopoulos, Michael; Vass, Clemens; Schmetterer, Leopold

doi:10.1016/s0002-9394(00)00636-x

Cited by 123 publications

(86 citation statements)

References 29 publications

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“…In patients with open-angle glaucoma, a reduction in basal blood flow in the optic nerve head and retina is observed. [114][115][116] Similarly, both retinal and choroidal blood flow is reduced in the DBA/2 J mouse model of glaucoma. 117 Also, in the early stages of the disease, a reduction in flicker-evoked dilation of retinal venules but not arterioles is observed in patients.…”

Section: Modulation Of Functional Hyperemia In the Retina Oxygen Modumentioning

confidence: 97%

Functional Hyperemia and Mechanisms of Neurovascular Coupling in the Retinal Vasculature

Newman

2013

J Cereb Blood Flow Metab

191

162

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The retinal vasculature supplies cells of the inner and middle layers of the retina with oxygen and nutrients. Photic stimulation dilates retinal arterioles producing blood flow increases, a response termed functional hyperemia. Despite recent advances, the neurovascular coupling mechanisms mediating the functional hyperemia response in the retina remain unclear. In this review, the retinal functional hyperemia response is described, and the cellular mechanisms that may mediate the response are assessed. These neurovascular coupling mechanisms include neuronal stimulation of glial cells, leading to the release of vasoactive arachidonic acid metabolites onto blood vessels, release of potassium from glial cells onto vessels, and production and release of nitric oxide (NO), lactate, and adenosine from neurons and glia. The modulation of neurovascular coupling by oxygen and NO are described, and changes in functional hyperemia that occur with aging and in diabetic retinopathy, glaucoma, and other pathologies, are reviewed. Finally, outstanding questions concerning retinal blood flow in health and disease are discussed. In lower vertebrates that have thinner retinas, including amphibians, reptiles, and some mammals, the retinal vasculature is absent and the choroidal circulation supplies the entire retina. 2 The choroidal circulation is supplied by the long and short ciliary arteries and the anterior ciliary arteries, which feed the large arteries in the outer portion of the choroid. 3 These arteries branch into smaller vessels, which, in turn, feed the highly anastomosed choriocapillaris network lying at the inner border of the choroid, adjacent to the retinal pigment epithelium and retinal photoreceptors. The total blood flow supplying the choroid is much greater than that supplying the retina (606 vs. 25 mg/min/ whole tissue 4 ), to meet the high metabolic demands of the photoreceptors. 5 The retinal vasculature is supplied by the central retinal artery, which enters the retina with the optic nerve at the optic disc. The artery branches into radial arterioles and smaller vessels on the vitreal surface of the retina. 3 Pre-capillary arterioles and capillaries ramify from these surface vessels and form anastomotic networks in the ganglion cell layer, just beneath the retinal surface, and deeper in the inner nuclear layer, supplying horizontal cells, bipolar cells, amacrine cells, and Mü ller glial cells. Blood is returned through radial venules on the retinal surface that empty into the central retinal vein in the optic nerve. Journal of Cerebral BloodThe retinal and choroidal vasculatures differ in several respects. Retinal vessels lack autonomic innervation, 6,7 whereas the choroidal circulation is innervated by both sympathetic and parasympathetic

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Section: Modulation Of Functional Hyperemia In the Retina Oxygen Modumentioning

confidence: 97%

Functional Hyperemia and Mechanisms of Neurovascular Coupling in the Retinal Vasculature

Newman

2013

J Cereb Blood Flow Metab

191

162

View full text Add to dashboard Cite

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“…Identification of individuals with FS may be clinically relevant as systemic vascular dysregulation has been associated with several ocular diseases [102], including glaucoma [103][104][105][106][107][108][109][110], central serous chorioretinopathy [111], and central retinal vein occlusion. The role of the endothelium as major pathomechanistic red line connects many dots that outline a sketch of FS.…”

Section: Endothelial Dysregulation In Flammer Syndromementioning

confidence: 99%

Endothelial dysfunction in cardiovascular disease and Flammer syndrome—similarities and differences

et al. 2017

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The endothelium has increasingly been recognized as a smart barrier and a key regulator of blood flow in microand macrovascular beds. Endothelial dysfunction marks a stage of atherosclerosis and is an important prognostic marker for cardiovascular disease. Yet, some people who tend to be slim and physically active and with rather low blood pressure show a propensity to respond to certain stimuli such as emotional stress with endothelial-mediated vascular dysregulation (Flammer syndrome). This leads to characteristic vascular symptoms such as cold hands but also a risk for vascularmediated diseases such as normal-tension glaucoma. It is the aim of this review to delineate the differences between Flammer syndrome and its Bcounterpart^endothelial dysfunction in the context of cardiovascular diseases.

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“…As various ocular [1][2][3][4][5][6][7][8][9] and systemic 9-20 vascular risk factors have been linked to the occurrence and progression of glaucomatous optic neuropathy, it would follow that they should be addressed by specific therapy. Despite this knowledge, however, the principal treatment objective remains reduction of intraocular pressure (IOP) using the large therapeutic arsenal available on the market.…”

Section: Introductionmentioning

confidence: 99%

First-line therapy with latanoprost 0.005% results in improved ocular circulation in newly diagnosed primary open-angle glaucoma patients: a prospective, 6-month, open-label study

Gherghel

Hosking

Cunliffe

et al. 2006

Eye

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Purpose To evaluate the effect of latanoprost 0.005% on the optic nerve head (ONH) and retinal circulation of newly diagnosed and previously untreated primary open-angle glaucoma (POAG) patients. Methods Twenty-two newly diagnosed and previously untreated POAG patients (mean age7SD: 68.38711.92 years) were included in this longitudinal open-label study. Patients were treated with latanoprost 0.005% once a day. Intraocular pressure (IOP), systemic blood pressure (BP), mean ocular perfusion pressure (MOPP), and ocular perfusion parameters 'volume', 'velocity', and 'flow' measured at the optic nerve head (ONH) and retina by means of Heidelberg Retina Flowmeter system were evaluated during a 6-month follow-up period. Results Treatment with latanoprost 0.005% resulted in a significant decrease in IOP (Po0.0001) and increase in MOPP (Po0.0001). After correcting for changes in MOPP, the blood velocity measured at the ONH level was significantly higher after 6 months of treatment than at baseline (P ¼ 0.0310). In addition, blood volume and flow measured at the peripapillary retina level improved after 3 and 6 months of treatment (P ¼ 0.0170; P ¼ 0.0260, and P ¼ 0.0170; P ¼ 0.0240 respectively).Conclusion Previously untreated POAG patients exhibit reduced IOP, increased MOPP and improved ocular perfusion at the ONH and retina levels when treated with Latanoprost 0.005%. These effects could be beneficial for glaucoma patients suffering from ocular vascular dysregulation.

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Assessment of optic disk blood flow in patients with open-angle glaucoma

Cited by 123 publications

References 29 publications

Functional Hyperemia and Mechanisms of Neurovascular Coupling in the Retinal Vasculature

Functional Hyperemia and Mechanisms of Neurovascular Coupling in the Retinal Vasculature

Endothelial dysfunction in cardiovascular disease and Flammer syndrome—similarities and differences

First-line therapy with latanoprost 0.005% results in improved ocular circulation in newly diagnosed primary open-angle glaucoma patients: a prospective, 6-month, open-label study

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