Vahedian Zakieh, Fakhraie Ghasem, Bovet Jerome, Mozaffarieh Maneli
Glaucoma Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Augen Glattzentrum, Zurich, Switzerland.
EPMA J. 2017 May 29;8(2):187-195. doi: 10.1007/s13167-017-0093-7. eCollection 2017 Jun.
The Flammer syndrome (FS) describes the phenotype of people with a predisposition for an altered reaction of the blood vessels to stimuli like coldness or emotional stress. The question whether such people should be treated is often discussed. On the one hand, most of these subjects are healthy; on the other hand, FS seems to predispose to certain eye diseases such as normal tension glaucoma or retinitis pigmentosa or systemic diseases such as multiple sclerosis or tinnitus. A compromise between doing nothing and a drug treatment is the adaption of nutrition. But what do we mean by healthy food consumption for subjects with FS? The adaption of nutrition depends on the health condition. Whereas patients with e.g. a metabolic syndrome should reduce their calorie intake, this can be counterproductive for subjects with FS, as most subjects with FS have already a low body mass index (BMI) and the lower the BMI the stronger the FS symptoms. Accordingly, while fasting is healthy e.g. for subjects with metabolic syndrome, fasting can even dangerously aggravate the vascular dysregulation, as it has been nicely demonstrated by the loss of retinal vascular regulation during fasting. To give another example, while reducing salt intake is recommended for subjects with systemic hypertensions, such a salt restriction can aggravate systemic hypotension and thereby indirectly also the vascular regulation in subjects with FS. This clearly demonstrates that such a preventive adaption of nutrition needs to be personalized.
弗拉默综合征（FS）描述了一类人的表型特征，这类人倾向于对寒冷或情绪压力等刺激产生血管反应改变。对于这类人是否应该接受治疗的问题，人们经常展开讨论。一方面，这些人中大多数是健康的；另一方面，FS似乎会使人易患某些眼部疾病，如正常眼压性青光眼或色素性视网膜炎，或全身性疾病，如多发性硬化症或耳鸣。在不采取任何措施和进行药物治疗之间的一种折衷办法是调整营养。但是，对于FS患者而言，健康的食物摄入意味着什么呢？营养调整取决于健康状况。例如，患有代谢综合征的患者应减少热量摄入，但这对FS患者可能会适得其反，因为大多数FS患者的体重指数（BMI）已经很低，而且BMI越低，FS症状越严重。因此，虽然禁食对例如患有代谢综合征的人来说是健康的，但禁食甚至可能危险地加剧血管调节异常，正如禁食期间视网膜血管调节丧失所清楚表明的那样。再举一个例子，虽然建议患有全身性高血压的人减少盐的摄入量，但这种盐限制可能会加重全身性低血压，从而间接也加重FS患者的血管调节异常。这清楚地表明，这种预防性的营养调整需要个性化。
