Gugleta K
Augenklinik, Universitätsspital Basel, Basel.
Praxis (Bern 1994). 2009 Feb 18;98(4):201-7. doi: 10.1024/1661-8157.98.4.201.
The major risk factor for glaucoma is the increased intraocular pressure, and its pharmacological and/or surgical reduction slows down the progression of the glaucomatous damage. However, this protective effect is only a partial one, the complete arrest of damage progression does not take place, indicating risk factors other than intraocular pressure. Among vascular factors, reduced ocular perfusion pressure, in particular the nocturnal episodes of arterial hypotony, and the vascular dysregulation play important roles in glaucoma. Combined with variable intraocular pressure, these factors lead to oxidative stress, reperfusion damage and ultimately to the hallmark of glaucoma - loss of axons and tissue remodelling (cupping). Examination of vascular risk profile is necessary in order to tailor the therapy to the patients individual need.
青光眼的主要危险因素是眼内压升高，通过药物和/或手术降低眼内压可减缓青光眼性损害的进展。然而，这种保护作用只是部分的，损害进展并未完全停止，这表明除眼内压之外还存在其他危险因素。在血管因素中，眼灌注压降低，尤其是夜间动脉低血压发作以及血管调节异常在青光眼中起重要作用。这些因素与眼内压变化相结合，导致氧化应激、再灌注损伤，并最终导致青光眼的标志——轴突丧失和组织重塑（杯状凹陷）。为了根据患者的个体需求调整治疗方案，有必要检查血管风险状况。
