Treatment of Glaucoma Patients with Flammer Syndrome

Abstract

Flammer syndrome (FS) describes a phenotype characterized by the presence of primary vascular dysregulation along with a number of symptoms and signs. Although most people with FS are healthy, FS favors the occurrence of certain diseases, such as normal tension glaucoma. This is because disturbed autoregulation makes the eye more sensitive to intraocular pressure (IOP) spikes or blood pressure drops. Treatment of FS is generally appropriate when patients either suffer greatly from their symptoms or if we can assume that it has contributed to a disease. In glaucoma, this may be the case if the glaucoma damage progresses despite well-controlled IOP. Both the still sparse scientific studies and our long clinical experience suggest that FS-targeted therapy not only relieves the symptoms of FS but also slows the progression of glaucoma damage in selected cases. This description is intended not only to help affected patients but to also motivate clinicians and researchers to conduct therapy studies to confirm or refute our observations.

Glaukompatient mit Verdacht auf Flammer-Syndrom: diagnostische Schritte und therapeutische Konsequenzen

“…Zum Schutz der Mitochondrien vor oxidativem Stress empfehlen wir auch Ginkgo biloba 42 sowie eine antioxidative Ernährung, z. B. dunkle Schokolade (Polyphenole), Rotwein (Resveratrol), Kaffee (Polyphenole und 3-Methyl-1,2-cyclopentanedion, auch ein Scavenger von Peroxynitrit), Grüntee (Flavonoide, z.…”

“…Weitere ausführlichere Informationen zu diesem Thema finden Sie in diesem Review 42 oder auf diesen Webpages: und .…”

“…B. Nifedipin)[40] oder mit Ocufolin forte, einem Vitaminpräparat, das L-Methylfolat enthält[41]. L-Methylfolat ist zudem ein sehr potenter Scavenger von Peroxynitrit.Zum Schutz der Mitochondrien vor oxidativem Stress empfehlen wir auch Ginkgo biloba[42] sowie eine antioxidative Ernährung, z. B. dunkle Schokolade (Polyphenole), Rotwein (Resveratrol), Kaffee (Polyphenole und 3-Methyl-1,2-cyclopentanedion, auch ein Scavenger von Peroxynitrit), Grüntee (Flavonoide, z.…”

Ocular and Systemic Factors Associated with Glaucoma

“…Patients of primary vascular dysregulation syndrome, aka Flammer syndrome, have an increased incidence of NTG and can experience a sudden worsening of scotoma when exposed to cold temperatures. 47 Unstable perfusion (under perfusion followed by reperfusion) in these conditions leads to oxidative damage. 48 …”

Role of ocular blood flow in normal tension glaucoma

“… 134 Under normal condition, the doses we used were very low that hardly ever lower BP but it does have an effect on NTG. 135 In addition, some side effects, including peripheral edema, may limit the utility of CCBs for certain patients. 136 …”