The role of lipid dysregulation and vascular risk factors in glaucomatous retrobulbar circulation

Abstract

The aim of this study was to evaluate selected lipid-related and vascular factors and their effect on retrobulbar hemodynamics in glaucoma. Fifty-six patients with primary open angle glaucoma (POAG) [POAG group; mean age 68.32 years (SD±0.21)] and 54 patients in control group [CG, mean age 68.1 years (SD±5.34)] were examined. Peak systolic velocity, end-diastolic velocity, mean velocity, pulsatility index, and resistive index of the ophthalmic artery, the central retinal artery and the posterior ciliary arteries were measured by Color Doppler Imaging. Selected lipid-related, systemic and local vascular parameters were evaluated. Statistical methods included Shapiro-Wilk, Student-t and Mann-Whitney U tests, and Spearman rank correlations. In POAG group systolic arterial blood pressure, diastolic arterial blood pressure, total cholesterol, low density lipoprotein cholesterol (LDL-ch), and intraocular pressure were significantly higher; while ocular perfusion pressure, high density lipoprotein cholesterol (HDL-ch) and diastolic ocular perfusion pressure were significantly lower (p≤0.05). Color Doppler Imaging confirmed blood flow abnormalities in all investigated arteries. In addition, significant correlations of HDL-ch, LDL-ch and triglycerides (TG) with peak systolic velocity, end-diastolic velocity and mean velocity were found in individual arteries (p≤0.05). Also, significant associations of systolic arterial blood pressure, ocular perfusion pressure, systolic oclular perfusion pressure and diastolic ocular perfusion pressure with peak systolic velocity, end-diastolic velocity, mean velocity and resistive index were revealed in the posterior ciliary arteries (p≤0.05). Dysregulation of lipid-related and vascular factors, as well as statistical correlation between the above and retrobulbar blood flow indices, might imply their role in vasoconstrictive processes during glaucomatous endotheliopathy.

Age-related changes in retrobulbar circulation: a literature review

“…Causative treatment relies on a detailed understanding of the aetiology of diseases and the causes of disorders leading to their development. It has been demonstrated that age-related hemodynamic and vascular changes in retrobulbar vessels may induce pathological processes leading to ocular diseases potentially associated with significant visual impairment or irreversible blindness [1,2]. This hypothesis seems to be confirmed by the increased prevalence of many ocular diseases, in particular, glaucoma, age-related macular degeneration (AMD), and thromboembolic changes in retinal vasculature in older age groups.…”

Association Between Serum Lipid Levels and Patients With Primary Angle-Closure Glaucoma in China: A Cross Sectional, Case–Control Study

“…Furthermore, Tang et al ( 18 ) showed that TRIG were higher, and was an independent risk factor for POAG. Other studies have also confirmed the association between LDL-C and glaucoma ( 9 , 19 ). Yilmaz et al ( 9 ) also found increased TRIG and CHOL levels in normal intraocular pressure glaucoma.…”

Higher serum lipids and oxidative stress in patients with normal tension glaucoma, but not pseudoexfoliative glaucoma

“…Having presumed glaucoma a vascular disorder, one should investigate the role of dyslipidemia in its etiopathogenesis. Indeed, there is research showing increased levels of TC, TG and LDL, and decreased HDL in POAG and NTG patients [35][36][37]. Furthermore, one population analysis has linked dyslipidemia with increased IOP in people not receiving glaucoma treatment, suggesting that hyperlipidemia may play a role in the onset of glaucoma [38].…”