Risk Factors for Optic Disc Hemorrhage in the Low-Pressure Glaucoma Treatment Study

Furlanetto, Rafael; Moraes, Carlos Gustavo De; Teng, Christopher C.; Liebmann, Jeffrey M.; Greenfield, David S.; Gardiner, Stuart K.; Ritch, Robert; Krupin, Theodore

doi:10.1016/j.ajo.2014.02.009

Cited by 72 publications

(62 citation statements)

References 45 publications

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“…Brimonidine use was also associated with a trend toward less frequent occurrence of disc hemorrhages. 52 The counter view that the study did not demonstrate the neuroprotective effect of brimonidine but rather the deleterious effect of timolol seems unlikely. First the disease progression in the timolol arm of the study (39% in 3 years) was comparable to the untreated arm of the Collaborative NTG Study (35%).…”

Section: Text Of Reviewmentioning

confidence: 91%

Vascular and autonomic dysregulation in primary open-angle glaucoma

Pasquale

2016

Current Opinion in Ophthalmology

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Purpose of the review To discuss whether vascular dysfunction and autonomic dysfunction are related to primary open-angle glaucoma stratified by the intraocular pressure (IOP) level (the high tension glaucoma and normal tension glaucoma subtypes). Recent findings Patients with POAG across the spectrum of IOP exhibit a variety of ocular and non-ocular vascular abnormalities. Interestingly common genetic variation in NOS3 and the CAV1/CAV2 genomic regions, which code for proteins involved in setting vascular tone, are associated with POAG. These markers seem to stratify with POAG subtypes by sex or pattern of initial visual field loss. Overall it is clear that there is also cardiovascular autonomic dysfunction in HTG and NTG but it is unclear if this dysfunction is more common in NTG compared to HTG. Summary Overall POAG is likely a heterogeneous disease but stratifying cases by IOP level associated with initial optic nerve damage may be less useful than using other endophenotype approaches. Embracing the evidence suggesting systemic endothelial and autonomic dysfunction are operative in POAG will help move beyond an IOP-centric view of the disease and facilitate “tearing down the wall” that divides treating physicians and a better understanding of POAG pathogenesis.

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Section: Text Of Reviewmentioning

confidence: 91%

Vascular and autonomic dysregulation in primary open-angle glaucoma

Pasquale

2016

Current Opinion in Ophthalmology

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“…23 The Low-Pressure Glaucoma Treatment Study showed that a history of migraine, narrower baseline neuroretinal rim width, the use of systemic β-blockers, low mean systolic blood pressure, and low mean arterial OPP were risk factors for the occurrence of disc hemorrhage. 24 In addition, platelet function has been shown to be associated with disc hemorrhage in patients with NTG because delayed platelet aggregation can cause prolonged bleeding, delaying absorption. 25 Thus, the occurrence of disc hemorrhage is a significant risk factor for glaucoma progression, whereas migraine, low OPP, and reduced platelet function are also related.…”

Section: Disc Hemorrhagementioning

confidence: 99%

Ocular Blood Flow and Influencing Factors for Glaucoma

Nakazawa

2016

Asia-Pacific Journal of Ophthalmology

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Open-angle glaucoma (OAG) is characterized by optic nerve fiber atrophy and deterioration of the visual field, corresponding to damage to the optic nerve head. Intraocular pressure (IOP) is currently the only evidence-based, treatable risk factor for OAG. However, normal-tension glaucoma, the most common type of OAG in Asia, is a type of glaucoma with an unclear pathogenesis. Glaucoma is suspected to be a multifactorial disease with IOP-dependent and IOP-independent risk factors, including decreased ocular blood flow (OBF), oxidative stress, decreased axoplasmic flow, and genetic background. A number of epidemiological studies have generated strong evidence that OBF may be an especially important risk factor for the progression of glaucoma. Recent innovations in laser speckle flowgraphy and optical coherence tomography-based angiography have allowed us to noninvasively monitor changes in the microcirculation of the optic nerve head with high reproducibility. Laser speckle flowgraphy-derived measurement parameters include mean blur rate and pulse wave form parameters, whereas the main optical coherence tomography angiography-derived parameter is the vessel index. Decreases in these parameters are associated with the severity of glaucomatous damage, and changes are detectible even in the earliest, preperimetric stage of glaucoma. In the future, OBF analysis may improve significantly because of continuing progress in the development of the relevant instruments. This review will summarize possible connections between systemic and OBF abnormalities and OAG, describe the scientific rationale for these connections, and discuss their potential implications. Thus, this review will summarize the role of OBF in glaucoma pathogenesis and discuss the wide range of IOP-independent risk factors.

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“…Thus, we can conclude that other mechanisms exist for retinal ganglion cell death. A reduction or dysregulation of blood supply to the optic nerve is one potential mechanism in which local and/or systemic conditions, such as systemic hypotension [57][58][59] , would favor an ischemic insult of the optic nerve [60] . Other potential damage pathways are increased apoptosis (increased neurotoxicity, neurotrophin depletion) and oxidative stress, among others.…”

Section: Metabolomics In Glaucomamentioning

confidence: 99%

Clinical Metabolomics and Glaucoma

Breda

Himmelreich²,

Ghesquière³

et al. 2017

Ophthalmic Res

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Glaucoma is one of the leading causes of irreversible blindness worldwide. However, there are no biomarkers that accurately help clinicians perform an early diagnosis or detect patients with a high risk of progression. Metabolomics is the study of all metabolites in an organism, and it has the potential to provide a biomarker. This review summarizes the findings of metabolomics in glaucoma patients and explains why this field is promising for new research. We identified published studies that focused on metabolomics and ophthalmology. After providing an overview of metabolomics in ophthalmology, we focused on human glaucoma studies. Five studies have been conducted in glaucoma patients and all compared patients to healthy controls. Using mass spectrometry, significant differences were found in blood plasma in the metabolic pathways that involve palmitoylcarnitine, sphingolipids, vitamin D-related compounds, and steroid precursors. For nuclear magnetic resonance spectroscopy, a high glutamine-glutamate/creatine ratio was found in the vitreous and lateral geniculate body; no differences were detected in the optic radiations, and a lower N-acetylaspartate/choline ratio was observed in the geniculocalcarine and striate areas. Metabolomics can move glaucoma care towards a personalized approach and provide new knowledge concerning the pathophysiology of glaucoma, which can lead to new therapeutic options.

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Risk Factors for Optic Disc Hemorrhage in the Low-Pressure Glaucoma Treatment Study

Cited by 72 publications

References 45 publications

Vascular and autonomic dysregulation in primary open-angle glaucoma

Vascular and autonomic dysregulation in primary open-angle glaucoma

Ocular Blood Flow and Influencing Factors for Glaucoma

Clinical Metabolomics and Glaucoma

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