Gliosis-Like Retinal Alterations in Glaucoma Patients

T, Graf; Prünte, Christian; Hendrickson, Phillip

doi:10.1097/00061198-199300240-00006

Cited by 19 publications

(33 citation statements)

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“…(Middle and bottom) Activated astrocytes increase light scattering, visible in red-free light (right), but not visible in colour photos (left). (From [214] (top), [215] (middle) and [216] (bottom), with permission).…”

Section: Visual Signs and Symptoms Of Pvdmentioning

confidence: 99%

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The primary vascular dysregulation syndrome: implications for eye diseases

2013

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Vascular dysregulation refers to the regulation of blood flow that is not adapted to the needs of the respective tissue. We distinguish primary vascular dysregulation (PVD, formerly called vasospastic syndrome) and secondary vascular dysregulation (SVD). Subjects with PVD tend to have cold extremities, low blood pressure, reduced feeling of thirst, altered drug sensitivity, increased pain sensitivity, prolonged sleep onset time, altered gene expression in the lymphocytes, signs of oxidative stress, slightly increased endothelin-1 plasma level, low body mass index and often diffuse and fluctuating visual field defects. Coldness, emotional or mechanical stress and starving can provoke symptoms. Virtually all organs, particularly the eye, can be involved. In subjects with PVD, retinal vessels are stiffer and more irregular, and both neurovascular coupling and autoregulation capacity are reduced while retinal venous pressure is often increased. Subjects with PVD have increased risk for normal-tension glaucoma, optic nerve compartment syndrome, central serous choroidopathy, Susac syndrome, retinal artery and vein occlusions and anterior ischaemic neuropathy without atherosclerosis. Further characteristics are their weaker blood–brain and blood-retinal barriers and the higher prevalence of optic disc haemorrhages and activated astrocytes. Subjects with PVD tend to suffer more often from tinnitus, muscle cramps, migraine with aura and silent myocardial ischaemic and are at greater risk for altitude sickness. While the main cause of vascular dysregulation is vascular endotheliopathy, dysfunction of the autonomic nervous system is also involved. In contrast, SVD occurs in the context of other diseases such as multiple sclerosis, retrobulbar neuritis, rheumatoid arthritis, fibromyalgia and giant cell arteritis. Taking into consideration the high prevalence of PVD in the population and potentially linked pathologies, in the current article, the authors provide recommendations on how to effectively promote the field in order to create innovative diagnostic tools to predict the pathology and develop more efficient treatment approaches tailored to the person.

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Section: Visual Signs and Symptoms Of Pvdmentioning

confidence: 99%

“…We have first described the clinical correlate of astrocytes activation in the retina [215]. Activated astrocytes change not only gene expression but also their morphology, leading to an increased backscatter [83].…”

Section: Visual Signs and Symptoms Of Pvdmentioning

confidence: 99%

The primary vascular dysregulation syndrome: implications for eye diseases

2013

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“…The finding that presumed ARAM is common in patients with glaucoma but rare in controls has some desirable clinical implications . The studies that first reported the potential relation between presumed ARAM and glaucomatous degeneration identified the presumed ARAM on fundus camera images, and it is not clear what the implications of the findings are for optical coherence tomography (OCT) en‐face imaging, a contemporary imaging technology.…”

Section: Introductionmentioning

confidence: 99%

Retinal putative glial alterations: implication for glaucoma care

Ashimatey

King

Swanson

2017

Ophthalmic Physiologic Optic

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PurposeGliosis‐like retinal alterations, presumed to be activated retinal astrocytes and Müller cells (ARAM), have been reported to occur frequently in patients with glaucoma but rarely in controls. We investigated the association between glaucomatous abnormality and the presence, the extent of retinal region, and the spatial distribution, of hyperreflective retinal alterations on optical coherence tomography (OCT) en‐face images, presumed to be ARAM.MethodsFindings of hyperreflective structures, presumed to be ARAM, in the central retinal ±24 degrees of OCT en‐face images (acquired with the SPECTRALIS® OCT) were compared between 35 younger controls, 42 older controls and 38 patients with glaucoma. Presumed ARAM was defined as reflective structures on the en‐face images other than retinal vasculature and retinal nerve fibre bundles. Chi‐square tests were used to compare the proportion of younger controls vs older controls with presumed ARAM to investigate the effect of ageing, and the proportion of patients vs age‐similar older controls with presumed ARAM to investigate the effect of disease. We also investigated the effect of glaucoma on the retinal area with presumed ARAM when it was present; we used an analysis of covariance (ancova) to compare the retinal area with hyperreflectivity in patients vs controls, adjusting for the effects of age and axial length.ResultsThe mean (S.D.) age of the younger controls, older controls, and patients with glaucoma was 26 (3), 62 (10) and 69 (8) years, respectively. The median (25th quartile, 75th quartile) of the retinal region with the hyperreflective structures, presumed to be ARAM, was zero (0,0), 1 (0,6), and 11 (0,43) degrees square in the younger controls, older controls and patients with glaucoma respectively. The chi‐square test investigating the effect of ageing found χ2(1, N = 77) = 24.8, p < 0.001, and that investigating the effect of disease found χ2(1, N = 80) = 2.3, p = 0.1. The ancova found F(1, 46) = 10.32, P = 0.02.ConclusionsThere was an effect of ageing on the presence of the hyperreflective structures, presumed to be ARAM, on OCT images. Compared to the presence of hyperreflective structures, the extent of retinal region with the hyperreflective structures has a greater potential of being an indicator of glaucomatous degeneration. Further study is needed to investigate the nature of the relation between glaucomatous abnormality and the extent of the retina with the hyperreflective structures, presumed to be ARAM.

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“…7,17 ARAM was more frequent in female patients, 7 while patients with progressive field loss had a higher prevalence of ARAM (86.7%) compared to those without progressive field loss (14.3%). 6 In 1993, Graf et al found ARAM in 87% of POAG patients (n = 45), but none in the controls (n = 10). 6 In 2007, Grieshaber et al observed that more female patients with POAG (41%) had ARAM when compared with male patients (18%), and suggested a relationship between peripheral vascular dysregulation in females and the development of ARAM.…”

Section: Discussionmentioning

confidence: 98%

“…This study aimed to use a large sample size in an attempt to replicate the finding reported by Ashimatey et al 8 that ARAM is found in healthy controls, as previous reports from our literature review all had relatively small samples. [5][6][7] This study also tested the hypothesis of a relationship between ARAM and PVD in healthy controls and in patients with glaucoma.…”

Section: Introductionmentioning

confidence: 98%