Provincial Centre of Diabetology and Metabolic Diseases, M. Pirogow Hospital, Lodz, Poland.
Med Sci Monit. 2010 Oct;16(10):CR501-9.
At present, the vascular theory of glaucomatous neuropathy is still the subject of intensive scientific studies aiming at settling the relationship between the development of glaucomatous neuropathy and vascular factors. Therefore the purpose of this study was to assess the blood flow parameters in the posterior ciliary artery and middle cerebral artery in patients with glaucoma and the correlation of glaucomatous changes with flow in vessels supplying the retina, choroid and anterior segment of the optic nerve in patients with glaucoma with and without coexisting arterial hypertension.
MATERIAL/METHODS: The study comprised 50 patients who were divided into two groups: group I - 25 patients (50 eyes) with primary open angle glaucoma (POAG) without coexisting arterial hypertension; and group II - 25 patients (50 eyes) with POAG with diagnosed and treated arterial hypertension.
The median of the mean maximal velocity in posterior ciliary arteries was 10.4 cm/s in patients from group I. In patients with POAG and arterial hypertension the median of the mean maximal velocity in posterior ciliary arteries was 8.95 cm/s (p<0.002). In group I the median of the Gosling pulsatility index (PI) in posterior ciliary arteries was 1.0, whereas in group II the median was 1.16 (p<0.002). The median of the pulsatility transmission index (PTI) for cerebral and ocular vessels was 1.3 in group I, whereas in group II the median was 1.38 (p<0.02).
The coexistence of arterial hypertension in glaucoma patients significantly worsens microcirculation in the area of posterior ciliary arteries and may be the cause of accelerated progression of glaucomatous neuropathy.
目前,青光眼神经病变的血管理论仍是科学研究的热点,旨在解决青光眼神经病变的发展与血管因素之间的关系。因此,本研究旨在评估青光眼患者睫状后动脉和大脑中动脉的血流参数,以及伴有和不伴有并存动脉高血压的青光眼患者视网膜、脉络膜和视神经前段血管供应的血流变化与青光眼变化的相关性。
材料/方法:本研究纳入了 50 名患者,分为两组:I 组-25 名(50 只眼)患有原发性开角型青光眼(POAG)且无并存动脉高血压;II 组-25 名(50 只眼)患有 POAG 并确诊和治疗动脉高血压。
I 组患者睫状后动脉平均最大速度的中位数为 10.4cm/s。POAG 伴动脉高血压患者睫状后动脉平均最大速度的中位数为 8.95cm/s(p<0.002)。I 组患者睫状后动脉 Gosling 搏动指数(PI)的中位数为 1.0,而 II 组的中位数为 1.16(p<0.002)。I 组脑和眼血管搏动传输指数(PTI)的中位数为 1.3,而 II 组的中位数为 1.38(p<0.02)。
青光眼患者并存动脉高血压显著恶化了睫状后动脉区域的微循环,可能是加速青光眼神经病变进展的原因。