Retinal venous pressure measurements in patients with Flammer syndrome and metabolic syndrome

Mustur, Dominique; Vahedian, Zakieh; Bovet, Jérôme; Mozaffarieh, Maneli

doi:10.1007/s13167-017-0105-7

Cited by 16 publications

(15 citation statements)

References 37 publications

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“…Retinal venous pressure (RVP) may be measured noninvasively by ophthalmodynamometry [27,28]. While RVP is equal to or slightly above IOP in healthy people, it is often increased in patients with eye or systemic diseases.…”

Section: Etiologymentioning

confidence: 99%

Normal tension glaucoma: Prevalence, etiology and treatment

George¹,

Yanan²,

Dominic³

2021

J Clin Res Ophthalmol

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Normal tension glaucoma is the most common type of glaucoma among people of east Asian countries. While a signifi cant minority of cases of normal tension glaucoma respond to drugs or surgical procedures that lower intra-ocular pressure, most cases continue to progress, resulting in a continuing loss of visual fi eld and blindness. We here review the current state of knowledge of this debilitating disease, and evaluate a promising pilot study showing a potential route to evaluate normal tension glaucoma and to effectively treat it with a vitamin and mineral supplement.

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Section: Etiologymentioning

confidence: 99%

Normal tension glaucoma: Prevalence, etiology and treatment

George¹,

Yanan²,

Dominic³

2021

J Clin Res Ophthalmol

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“…The observations above lead to the pathogenic concept of GON by J Flammer. Both an increased IOP as well as a decreased blood pressure and increased retinal venous pressure [18], commonly seen in people with the Flammer-Syndrome, can lead to glaucomatous damage. As a result of the increased or fluctuating IOP and blood flow regulation disturbances, there is an enhanced level of oxidative stress [19], inducing the formation of free radicals in the axons of the optic nerve head and thereby destroying various structures.…”

Section: Pathogenetic Concept Of Gonmentioning

confidence: 99%

Managing Glaucoma beyond Intraocular Pressure

Fischer

Mozaffarieh

2019

CTOY

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Glaucoma is a major cause of vision loss worldwide with nearly 8 million people bilaterally blind from the disease. This number is estimated to increase over the next years. The key to preventing blindness from glaucoma is effective diagnosis and treatment. The classical glaucoma treatment focuses on IOP reduction. Increased IOP is indeed an undisputable risk factor for the development and progression of Glaucomatous Optic Neuropathy (GON). But there is mounting evidence in literature that other risk factors are involved as well. These additional factors may by themselves lead to GON or they may render the eye more sensitive to IOP. Among the most often described factors are: Flammer-syndrome, low blood pressure, increased retinal venous pressure, oxidative stress. Better knowledge of the pathogenesis has opened up additional therapeutical approaches often called non-IOP lowering treatment. Whilst most of these new avenues of treatment are still in the experimental phase, others are already used by some physicians. Non-IOP lowering treatment includes improvements of ocular blood flow, particularly blood flow regulation. This can be achieved by improving the regulation of ocular blood flow (improving auto regulation) by drugs such as carbonic anhydrase inhibitors, magnesium or calcium channel blockers. These drugs also in part decrease increased retinal venous pressure in the eyes of patients. Increased retinal venous pressure decreases perfusion pressure in the patients’ eyes and thus increases the risk of glaucomatous progression. The patients’ blood pressure also needs to be monitored carefully as low blood pressure, particularly nocturnal over dips or blood pressure fluctuations, increase the risk of further damage. Blood pressure can be increased by an increase in salt intake or in rare cases by treatment with fludrocortisone. Reduction of oxidative stress, especially at the level of mitochondria, also seems to be protective. This can be achieved by gingko or foods rich in polyphenolic flavonoids.This review describes the individual mechanisms which may be targeted by non-IOP lowering treatment.

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“…Although the underlying mechanisms leading to glaucomatous atrophy in PACG cases are not fully understood, several mechanisms have been suggested. For example, inflammation [3], microangiopathy [4][5][6][7][8][9] and oxidative stress [10,11] are all currently being discussed in terms of the leading factors causing PACG, which can damage the optic nerve and lead to the progressive loss of retinal ganglion cells and their axons.…”

Section: Introductionmentioning

confidence: 99%

Associations between the red blood cell distribution width and primary angle-closure glaucoma: a potential for disease prediction

et al. 2019

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The red blood cell distribution width (RDW) is a simple and inexpensive laboratory parameter that can be linked to oxidative stress, inflammation and microvascular flow resistance. For this research, we performed a large-sample case-control study to describe the relationships between the RDW and primary angle-closure glaucoma (PACG). A total of 1191 PACG patients (422 males and 769 females), who were divided into mild, moderate and severe PACG groups, and 982 healthy controls (344 males and 638 females) were recruited between January 2008 and June 2018. Detailed eye and physical examinations were performed for each subject. Based on the laboratory results, the mean RDW was significantly higher (p < 0.001) in the PACG group (13.01 ± 0.82%) than in the control group (12.65 ± 0.53%). Moreover, the mean RDW level was lower (p < 0.05) in the mild PACG group than in the moderate and severe PACG groups. The Pearson correlation analyses showed significant positive correlations between the mean deviation and the RDW (r = 0.141, p < 0.001) and the intraocular pressure and the RDW (r = 0.085, p = 0.004). After adjusting for the confounding factors, the logistic regression analyses indicated that the odds ratio for the PACG group was 2.318 (p < 0.001, 95% confidence interval 1.997, 2.690) when compared to the control group. Additionally, an increased RDW was associated with the PACG severity, and this trend was also observed in the gender and age subgroups. In summary, the results of our study showed that an elevated RDW was associated with PACG and its severity. If future studies confirm this relationship, the use of an RDW assessment may help to predict the PACG severity in each patient in order to better customise effective prevention treatments.

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Retinal venous pressure measurements in patients with Flammer syndrome and metabolic syndrome

Cited by 16 publications

References 37 publications

Normal tension glaucoma: Prevalence, etiology and treatment

Normal tension glaucoma: Prevalence, etiology and treatment

Managing Glaucoma beyond Intraocular Pressure

Associations between the red blood cell distribution width and primary angle-closure glaucoma: a potential for disease prediction

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