Increase of carotid artery stiffness and decrease of baroreflex sensitivity in exfoliation syndrome and glaucoma

Abstract

Aim: To investigate the distensibility of the common carotid artery (CCA), baroreflex sensitivity (BRS) and its relation to plasma homocysteine concentration in exfoliation syndrome or exfoliation glaucoma (XFS/XFG). Methods: Homocysteine concentrations were measured in 30 XFS/XFG patients and 18 age matched controls. In 21 patients and 17 controls the end diastolic diameter of the CCA and pulsatile distension were measured and BRS was calculated.Results: There was no significant difference between the groups in sex distribution, age, heart rate, blood pressure, systemic diseases, or medication. In XFS/XFG patients homocysteine concentration was significantly elevated (unpaired t test, p = 0.023), and CCA stiffness was higher (p,0.05), while strain, cross sectional compliance coefficient, distensibility, and BRS were significantly reduced compared to the controls (Mann-Whitney U test, p(0.013 for each parameter). In XFS/XFG patients a positive correlation was found between age and plasma homocysteine level (Pearson's correlation, r = 0.490, p = 0.007), and a negative correlation between age and BRS (Kendall's correlation r = 20.374, p = 0.021), as well as between homocysteine concentration and BRS (Kendall's correlation r = 20.377, p = 0.024). No correlation was seen between these variables in the control group. Conclusions: These results suggest a pathological large artery function as well as altered parasympathetic vascular control in XFS/XFG which increases with age and with higher homocysteine concentration.

Clonidine, moxonidine, folic acid, and mecobalamin improve baroreflex function in stroke-prone, spontaneously hypertensive rats

“…The exact mechanism of this effect by vitamin B 12 is still unclear. Visontai et al reported a negative correlation between the homocysteine concentration and BRS in exfoliation syndrome or exfoliation glaucoma patients [35] . At the same time, folic acid and vitamin B 12 decreased blood plasma homocysteine [36] .…”

Pseudoexfoliation syndrome prevalence in Greek patients with cataract and its association to glaucoma and coronary artery disease

“…A possible link between PEX syndrome and cardiovascular or cerebrovascular disease has been supported by many sources. 10,12,14,[30][31][32][33][34][35] In addition, elevated plasma homocysteine, a risk factor for cardiovascular disease, has been found more common in PEX syndrome than in healthy controls. 36 Considering the reports above, one should suggest that slit-lamp examination of the eye could identify an important marker for the risk of a systemic vascular disease.…”

Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

“…[7][8][9][10][11][12] Exfoliation material (XFM) is found not only in ocular tissues, [13][14][15] and several systemic disorders have been associated with XFS, such as peripheral vascular occlusions, increased carotid stiffness, coronary artery disease, stroke, Alzheimer's disease, and hearing loss. [16][17][18][19][20][21][22][23] The pathogeneses and clinical features of acute retinal vascular occlusions (RVOs) are still not well understood. 24,25 Central retinal vein occlusion (CRVO) has been described in eyes with XFS, even when exfoliative glaucoma (XFG, a known risk factor) was not present.…”