Glaucoma, Capillaries and Pericytes

Anderson, Douglas R.

doi:10.1159/000310722

Cited by 98 publications

(44 citation statements)

References 37 publications

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“…At P=10 mmHg, the regulatory response is only one third as efficient as that at P=30 mmHg with IOP of about 22 mmHg. Glaucomatous eyes are known to have abnormal retinal blood flow autoregulation, 25,26 which may contribute to the development of retinal hemorrhage because a sudden lowering of IOP can induce an abrupt increase in blood flow in the retinal artery, resulting in rupture of the thin retinal capillary wall. Our patient was a young woman who developed diffuse retinal hemorrhages in only one eye following bilateral trabeculectomy performed after a longstanding period of increased IOP.…”

Section: Discussionmentioning

confidence: 99%

Decompression Retinopathy after Trabeculectomy

Jea

Jung

2005

Korean J Ophthalmol

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Purpose: To present a case of a unilateral diffuse retinal hemorrhage in a 15-year-old girl, who underwent bilateral trabeculectomy for steroid induced glaucoma. Methods: Despite the maximally tolerable medical treatment, IOP in the right eye remained above 50 mmHg for four months, and was simultaneously elevated in the left eye. So we performed bilateral trabeculectomy. Results: On the first postoperative day, diffuse retinal hemorrhages were observed in the right eye; however, no retinal hemorrhage was found in the left eye. The hemorrhages resolved completely without consequences two months later. Conclusions: In the case of high IOP for a long period, sudden lowering of IOP may acutely increase the blood flow and consequently rupture multiple retinal capillaries because of altered autoregulatory function. Special care is therefore needed to prevent an abrupt fall in IOP before, during, and after surgery, especially when IOP has been highly elevated for an extended period. Several cases of choroidal hemorrhage after glaucoma filtration surgery have been reported in the literature, 1-7 but retinal hemorrhage as a complication of glaucoma surgery is relatively rare. We describe a case of diffuse retinal hemorrhages that occurred in only one eye after bilateral glaucoma filtration surgery and the possible mechanism of the hemorrhages is also discussed. Case ReportA 15-year-old Korean girl was transferred to our department in February 2003. She had a history of systemic and topical steroid treatment for uveitis in both eyes since August 2002 but had shown a poor clinical response. Initial visual acuity on presentation was 20/25 (with -8.00 diopters), and the intraocular pressure (IOP) was 19 mmHg in both eyes. Inflammatory cells were found in the anterior chamber, and 'snowball and snow bank' was observed in the vitreous cavity. No remarkable findings were noted on her general systemic evaluation, and she did not have a history of taking aspirin or any other medication that might promote bleeding. Topical and subtenon steroids were used to control the ocular inflammation in both eyes, but only after repeating temporary stabilization followed by recurrence of the inflammation. Anterior chamber inflammation and the snowball and snow bank of the vitreous cavity were controlled during August 2003. However, in the following month IOP began to increase to over 30 mmHg in the right eye (OD), and also in the left eye (OS) two months later. IOP remained above 50 mmHg for four months in the right eye and above 40 mm Hg for one month in the left eye despite maximally tolerated medical therapy. How-ever in November 2003 a glaucomatous visual field defect began to develop and cup-disc ratios 0.6 in both eyes. Patient complained side effects of medication such as tingling sensation and general weakness.Trabeculectomy was performed OD on January 15, 2004 and OS on January 22, 2004. Preoperative visual acuity was 20/20 in both eyes, and IOP was 56 mmHg OD and 48 mmHg OS. The trabeculectomies with mitomycin-C were performed under...

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Section: Discussionmentioning

confidence: 99%

Decompression Retinopathy after Trabeculectomy

Jea

Jung

2005

Korean J Ophthalmol

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“…Because the retinal vascular bed is constantly under the influence of NO, an interaction between oxygen and the NO/guanylate cyclase pathwayby modulating pericyte tone -could potentially influence flow within the retinal capillary network [4,12].…”

Section: Discussionmentioning

confidence: 99%

Effect of oxygen on relaxation of retinal pericytes by sodium nitroprusside

Haefliger¹,

Chen

Anderson

1997

Graefe's Arch Clin Exp Ophthalmol

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Abstract• Background: This study addresses whether oxygen modulates the relaxation induced in retinal pericytes by sodium nitroprusside (SNP), a nitric oxide (NO) donor that stimulates the NO/guanylate cyclase pathway.• Methods:Bovine retinal pericytes were cultured on silicone. On the silicone surface, basal pericyte contractile tone induces wrinkles. Drug-induced changes in pericyte contractile tone were assessed by changes in the number of wrinkles. The effects of 100% nitrogen (hypoxia) and 100% oxygen (hyperoxia) were studied on: (a) the basal tone of quiescent pericytes, (b) the relaxation to 3 and 10 pM SNP or 1 pM forskolin, and (c) the recontraction that followed the washout of 3 pM SNP or 1 btM forskolin.• Results: Neither hypoxia nor hyperoxia had any apparent influence on pericyte basal tone, on forskolininduced relaxation, or on pericyte recontraction after a forskolininduced relaxation. In hypoxia, relaxations to SNP 3 pM (P<0.05) and 10 btM (P<0.01) were significantly more pronounced than in hyperoxia. Hypoxia also reduced the recontraction after an SNPinduced relaxation (P<0.001).• Conclusion: Oxygen modulates the relaxation of bovine retinal pericytes evoked by SNP (guanylate cyclase-mediated), but not the relaxation induced by forskolin (adenylate cyclase-mediated). These results suggest that in the retinal capillary circulation an interaction between oxygen and the NO/guanylate cyclase pathway modulates pericyte tone, and thus potentially blood flow.

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“…The vascular hypothesis proposes a disruption in the normal vascular supply in the disc capillaries in the presence of elevated IOP or secondary to IOP. The disruption in microcirculation at the disc can result in the release of vasoactive substances (e.g., angiotensin) that block axoplasmic transport by vasoconstriction [38].…”

Section: Optic Nerve Head Disordersmentioning

confidence: 99%

Advances in Retinal Imaging

Hammer

2011

Advances in Optical Imaging for Clinical Medicine

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Glaucoma, Capillaries and Pericytes

Cited by 98 publications

References 37 publications

Decompression Retinopathy after Trabeculectomy

Decompression Retinopathy after Trabeculectomy

Effect of oxygen on relaxation of retinal pericytes by sodium nitroprusside

Advances in Retinal Imaging

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