Glaucoma patients demonstrate faulty autoregulation of ocular blood flow during posture change

Evans, David W.; Harris, Alon; Garrett, Melanie E.; Chung, Ho Seok; Kagemann, Larry

doi:10.1136/bjo.83.7.809

Cited by 108 publications

(55 citation statements)

References 25 publications

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“…[12][13][14] Recent studies have indicated that blood flow regulatory mechanisms may be deficient in patients with glaucoma, particularly in the subgroup with NTG. [15][16][17] In most people, systemic arterial BP decreases physiologically during sleep. A marked nocturnal fall in BP, particularly if autoregulation capacity is diminished, may lead to ischemic damage in the optic nerve head.…”

Section: Discussionmentioning

confidence: 99%

Comparison of ambulatory blood pressure values in patients with glaucoma and ocular hypertension

Yazıcı

Usta

Ertürk

et al. 2003

Eye

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Section: Discussionmentioning

confidence: 99%

Comparison of ambulatory blood pressure values in patients with glaucoma and ocular hypertension

Yazıcı

Usta

Ertürk

et al. 2003

Eye

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“…Nevertheless, there is strong evidence that the optic nerve head region is the site of injury to the ganglion cells in glaucomatous optic neuropathy [1][2][3] and discussions have centred on whether injury to the ganglion cell axons in this location is primarily caused by mechanical trauma 3 or by alterations in the dynamics of blood flow. [4][5][6] It should of course be noted that clinical changes…”

Section: Introductionmentioning

confidence: 99%

Optic nerve and neuroprotection strategies

Osborne

Chidlow

Layton

et al. 2004

Eye

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Background Experimental studies have yielded a wealth of information related to the mechanism of ganglion cell death following injury either to the mylinated ganglion cell axon or to the ganglion cell body. However, no suitable animal models exist where injury can be directed to the optic nerve head region, particularly the unmylinated ganglion cell axons. The process of relating the data from the various animal models to many different types of optic neuropathies in man must, therefore, be cautious. Results Extensive studies on the isolated optic nerve have yielded valuable information on the way white matter is affected by ischaemia and how certain types of compounds can attenuate the process. Moreover, there are now persuasive data on how ganglion cell survival is affected when the ocular blood flow is reduced in various animal models. As a consequence, the molecular mechanisms involved in ganglion cell death are fairly well understood and various pharmacological agents have been shown to blunt the process when delivered before or shortly after the insult. Conclusions A battery of agents now exist that can blunt animal ganglion cell death irrespective of whether the insult was to the ganglion cell body or the mylinated axon. Whether this information can be applied for use in patients remains a matter of debate, and major obstacles need to be overcome before the laboratory studies may be applied clinically. These include the delivery of the pharmacological agents to the site of ganglion cell injury and side effects to the patients. Moreover, it is necessary to establish whether effective neuroprotection is only possible when the drug is administered at a defined time after injury to the ganglion cells. This information is essential in order to pursue the idea that a neuroprotective strategy can be applied to a disease like glaucoma, where

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“…Hypertension is known to be prevalent among ARM patients and blood pressure and posture have been found to affect central retinal circulation. 18,19 However, blood pressure and posture during measurement have not been reported in the above mentioned studies. Except for the inclusion criteria, we suspect these to be among the possible reasons why the results from the present and the mentioned studies differ with respect to the results of the central retinal artery circulation.…”

Section: (1) Study Of Retrobulbar Circulation In Stages Of Armmentioning

confidence: 96%

Retrobulbar circulation in patients with age-related maculopathy

Dimitrova

Tamaki

Kato

2002

Eye

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circulation in patients with age-related maculopathy AbstractPurpose To investigate retrobulbar circulation in stages of age-related maculopathy (ARM) and in normal fellow eyes of patients with unilateral exudative ARM. Methods Color Doppler Imaging was used to measure circulatory parameters (peak-systolic velocity-PSV, end-diastolic velocity-EDV, pulsatility index-PI and resistivity index-RI) in the central retinal, posterior ciliary and ophthalmic arteries of 44 patients with age-related maculopathy (ARM) and 32 control subjects. Patients with ARM consisted of 11 with early ARM and 33 with late ARM. Twenty-one patients from the exudative ARM group were also included in a study of unilateral exudative ARM circulation. Results In the study of patients with ARM divided into stages, the PI and RI in the posterior ciliary artery of patients with late ARM were significantly higher than that of the control group (P ‫؍‬ 0.0064; P ‫؍‬ 0.0124). In the early ARM group, circulatory parameters did not differ significantly from those of the control group.In the study of unilateral exudative ARM, the affected eye showed significantly higher RI, as compared to the control group (P ‫؍‬ 0.0157), and the fellow eye had significantly decreased EDV as compared to the control group (P ‫؍‬ 0.0164). There was no significant difference in circulatory parameters between the affected and normal fellow eyes of patients with unilateral exudative ARM. Conclusion PI and RI in patients with late ARM and EDV in fellow eyes of patients with unilateral exudative ARM showed significant changes in the posterior ciliary artery compared to normal controls. Altered circulation in the posterior ciliary artery may be involved in the pathogenesis of ARM.

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Glaucoma patients demonstrate faulty autoregulation of ocular blood flow during posture change

Abstract: (Br J Ophthalmol 1999;83:809-813)

Cited by 108 publications

References 25 publications

Comparison of ambulatory blood pressure values in patients with glaucoma and ocular hypertension

Comparison of ambulatory blood pressure values in patients with glaucoma and ocular hypertension

Optic nerve and neuroprotection strategies

Retrobulbar circulation in patients with age-related maculopathy

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