Dysfunctional regulation of ocular blood flow: A risk factor for glaucoma?

Moore, Danny; Harris, Alon; WuDunn, Darrell; Kheradiya, Nisha; Siesky, Brent

doi:10.2147/opth.s2774

Cited by 100 publications

(39 citation statements)

References 128 publications

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“…Glaucomatous optic nerve damage has recently been suggested to be the result of vascular and other pathogenic mechanisms in addition to elevated intraocular pressure [28,29]. The dysregulation of optic nerve circulation found in OSAHS may cause RNFL changes that are similar to glaucoma.…”

Section: Discussionmentioning

confidence: 99%

Changes in Retinal Nerve Fiber Layer Thickness in Obstructive Sleep Apnea/Hypopnea Syndrome: A Meta-Analysis

Mei

Feng

et al. 2016

Ophthalmic Res

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Purpose: To evaluate and compare changes in retinal nerve fiber layer (RNFL) thickness in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods: The Cochrane Library, Medline, and Embase were screened using our key words. Results were carefully reviewed to ensure that the included studies met the inclusion/exclusion criteria, and the quality of the studies was assessed using the Newcastle-Ottawa Scale. All included studies categorized patients with OSAHS into 3 groups (mild, moderate, and severe), and measured average and 4-quadrant (temporal, superior, nasal, and inferior) RNFL thickness. All studies included a healthy control group. The weighted mean differences and 95% confidence intervals were calculated for the continuous outcomes. Results: Ten case-control studies were included in the meta-analysis, consisting of a total of 811 OSAHS group and 868 healthy eyes. A meta-analysis of the data showed that the average RNFL thicknesses in the mild, moderate, and severe OSAHS groups were significantly decreased compared to healthy controls. Additionally, RNFL thickness was significantly reduced in all but the temporal quadrant in the moderate and severe OSAHS groups when compared to healthy controls. Conclusions: On the basis of these results, we suggest that peripapillary RNFL thickness as measured by optical coherence tomography could be a useful tool to monitor and assess the severity of OSAHS in patients. Further studies are required in order to differentiate these RNFL changes from glaucomatous changes. This has not been properly examined in any of the studies we were able to identify.

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Section: Discussionmentioning

confidence: 99%

Changes in Retinal Nerve Fiber Layer Thickness in Obstructive Sleep Apnea/Hypopnea Syndrome: A Meta-Analysis

Mei

Feng

et al. 2016

Ophthalmic Res

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“…Whether abnormal ONH blood flow response patterns to changes in OPP predispose to ocular vascular diseases is unknown. For several common eye diseases such as diabetic retinopathy[ 2 , 35 ] and glaucoma[ 5 , 6 , 36 ] abnormalities in ocular blood flow autoregulation have been reported. In primary open glaucoma reduced OPP is a risk factor for the disease[ 6 , 37 – 39 ] and it has been hypothesized that ONH blood flow falls below the lower limit of autoregulation during periods of low blood pressure or high IOP[ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Optic Nerve Head Blood Flow Autoregulation during Changes in Arterial Blood Pressure in Healthy Young Subjects

et al. 2013

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AimIn the present study the response of optic nerve head blood flow to an increase in ocular perfusion pressure during isometric exercise was studied. Based on our previous studies we hypothesized that subjects with an abnormal blood flow response, defined as a decrease in blood flow of more than 10% during or after isometric exercise, could be identified.MethodsA total of 40 healthy subjects were included in this study. Three periods of isometric exercise were scheduled, each consisting of 2 minutes of handgripping. Optic nerve head blood flow was measured continuously before, during and after handgripping using laser Doppler flowmetry. Blood pressure was measured non-invasively in one-minute intervals. Intraocular pressure was measured at the beginning and the end of the measurements and ocular perfusion pressure was calculated as 2/3*mean arterial pressure –intraocular pressure. ResultsIsometric exercise was associated with an increase in ocular perfusion pressure during all handgripping periods (p < 0.001). By contrast no change in optic nerve head blood flow was seen. However, in a subgroup of three subjects blood flow showed a consistent decrease of more than 10% during isometric exercise although their blood pressure values increased. In addition, three other subjects showed a consistent decline of blood flow of more than 10% during the recovery periods.ConclusionOur data confirm previous results indicating that optic nerve head blood flow is autoregulated during an increase in perfusion pressure. In addition, we observed a subgroup of 6 subjects (15%) that showed an abnormal response, which is in keeping with our previous data. The mechanisms underlying this abnormal response remain to be shown.

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“…Both impaired blood flow and impaired vascular autoregulation have been described in glaucoma patients (Flammer et al, 2002 ; Feke and Pasquale, 2008 ; Moore et al, 2008 ; Feke et al, 2011 ). Large epidemiologic studies have found adverse associations between POAG and low ocular perfusion pressure (OPP) (Hulsman et al, 2007 ; Leske, 2009 ) or low systemic blood pressure (Bonomi et al, 2000 ).…”

Section: Glaucoma and Vascular Dysfunctionmentioning

confidence: 99%

Regulation of intraocular pressure by soluble and membrane guanylate cyclases and their role in glaucoma

Buys

Potter

Pasquale

et al. 2014

Front. Mol. Neurosci.

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Glaucoma is a progressive optic neuropathy characterized by visual field defects that ultimately lead to irreversible blindness (Alward, 2000; Anderson et al., 2006). By the year 2020, an estimated 80 million people will have glaucoma, 11 million of which will be bilaterally blind. Primary open-angle glaucoma (POAG) is the most common type of glaucoma. Elevated intraocular pressure (IOP) is currently the only risk factor amenable to treatment. How IOP is regulated and can be modulated remains a topic of active investigation. Available therapies, mostly geared toward lowering IOP, offer incomplete protection, and POAG often goes undetected until irreparable damage has been done, highlighting the need for novel therapeutic approaches, drug targets, and biomarkers (Heijl et al., 2002; Quigley, 2011). In this review, the role of soluble (nitric oxide (NO)-activated) and membrane-bound, natriuretic peptide (NP)-activated guanylate cyclases that generate the secondary signaling molecule cyclic guanosine monophosphate (cGMP) in the regulation of IOP and in the pathophysiology of POAG will be discussed.

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Dysfunctional regulation of ocular blood flow: A risk factor for glaucoma?

Cited by 100 publications

References 128 publications

Changes in Retinal Nerve Fiber Layer Thickness in Obstructive Sleep Apnea/Hypopnea Syndrome: A Meta-Analysis

Changes in Retinal Nerve Fiber Layer Thickness in Obstructive Sleep Apnea/Hypopnea Syndrome: A Meta-Analysis

Optic Nerve Head Blood Flow Autoregulation during Changes in Arterial Blood Pressure in Healthy Young Subjects

Regulation of intraocular pressure by soluble and membrane guanylate cyclases and their role in glaucoma

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