The Vascular Aspect of Glaucoma ‐ What should we look at?

Abstract

AbstractPurpose Glaucoma is an optic neuropathy of unknown origin. Increased intraocular pressure is the most important risk factor for the disease. In addition, reduced ocular perfusion pressure has been identified as a risk factor for glaucomatous optic neuropathy.Methods In a variety of studies we have focused on the complex interaction between intraocular pressure, mean arterial blood pressure, ocular perfusion pressure and ocular blood flow. In these studies various strategies were used to manipulate intraocular pressure, mean arterial blood pressure and ocular perfusion pressure and choroidal and optic nerve head blood flow were measured.Results In vivo the capacity of choroidal and optic nerve head blood flow to regulate its vascular tone during changes in ocular perfusion pressure strongly depends on the way how perfusion pressure is manipulated. Generally ocular vascular beds regulate better during changes in blood pressure than during changes in intraocular pressure.Conclusion With the improved understanding of ocular blood flow regulation in humans our understanding of perfusion abnormalities in glaucoma has also increased. Most importantly these studies show that any reduction in intraocular pressure has a strong impact on ocular blood flow regulation.