Effect of intraocular pressure on glaucomatous damage to the optic nerve

Abstract

Eyes with normal pressure glaucoma and eyes with high pressure glaucoma show a similar optic disc appearance with marked differences to eyes with vascular optic neuropathy. Non-vascular, potentially barotraumatic factors in addition to intraocular pressure (IOP) may thus play a role in glaucoma. Recent studies have shown that cerebrospinal fluid pressure (CSFP), arterial blood pressure and IOP are correlated with each other, higher CSFP is associated with younger age, higher blood pressure and higher body mass index, some patients with normal (IOP) pressure glaucoma have abnormally low CSFP and thus an abnormally high trans-lamina cribrosa pressure difference and a small orbital CSF space, the orbital CSF space width is associated with CSFP and the estimated CSFP correlated better with open-angle glaucoma-related parameters than IOP. The orbital CSFP as counter-pressure against IOP may play a role in the pathogenesis of glaucoma.

Trabeculectomy ab interno (trabectome): yet another possibility in the treatment of uncontrolled glaucomatocyclitic crisis under systemic valganciclovir therapy?

“…18 Examinations were performed prior to surgery, 1 day, 6 weeks, 3 months, 6 months, and 12 months after surgery. IOP readings and the number of antiglaucoma medication was evaluated at every follow-up visit.…”

Peripapillary Choroidal Thickness in Healthy Controls and Patients With Focal, Diffuse, and Sclerotic Glaucomatous Optic Disc Damage

“…Given that the age-related rate of choroidal thinning estimated from cross-sectional data is only approximately 10 to 20 µm/decade, the reduction of 25% to 30% seen in patients with sclerotic optic disc damage is substantial and adds to the evidence that there may be a connection between choroidal atrophy and glaucomatous optic disc damage of the sclerotic type. 9,28 In patients with sclerotic optic disc damage, large choroidal vessels are often clearly visible ophthalmoscopically, suggesting a loss of choriocapillaris, smaller and medium-sized vessels, and pigmentary cells. 21,29 This appearance has been described as choroidal sclerosis and has been linked to age-related atrophy of the choroidal circulation.…”

Comparison of Ahmed Glaucoma Valve Implantation and Trabeculectomy for Glaucoma: A Systematic Review and Meta-Analysis

“…Glaucoma is a common disease that results in blindness[1, 2]. There are various therapeutic options for treating glaucoma, including anti-glaucoma medication, laser, and surgery[3].…”