Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Mathematical Sciences, Indiana University Purdue University, Indianapolis, IN, USA.
Acta Ophthalmol. 2020 Sep;98(6):559-571. doi: 10.1111/aos.14397. Epub 2020 Apr 5.
Abnormalities of the retinal blood supply have been widely implicated in primary open-angle glaucoma (POAG). Impaired blood supply to the retina and optic nerve head (ONH) may be a primary pathophysiologic mechanism contributing to POAG ('vascular hypothesis'). However, the decreased metabolic activity of atrophic tissue is itself known to induce both vascular changes and decreased blood flow due to reduced oxygen demand. Therefore, primary nonvascular factors could potentially induce glaucomatous atrophy, with subsequent secondary vascular pathology ('mechanical hypothesis'). Retinal oximetry holds great promise in the investigation of glaucoma pathogenesis, as it can provide useful data on retinal metabolic oxygen demand, especially when combined with measurements of retinal blood flow. This review surveys the research on retinal metabolism in POAG using spectroscopic retinal oximetry. The use of mathematical models in combination with oximetric data to investigate the role of retinal metabolism and oxygen supply in POAG is also discussed.
视网膜血液供应异常与原发性开角型青光眼（POAG）广泛相关。视网膜和视神经头（ONH）的血液供应受损可能是导致 POAG 的主要病理生理机制（“血管假说”）。然而，由于缺氧需求减少，萎缩组织的代谢活性降低本身已知会引起血管变化和血流减少。因此，原发性非血管因素可能潜在地导致青光眼性萎缩，随后出现继发性血管病变（“机械假说”）。视网膜血氧测定在青光眼发病机制的研究中具有巨大的潜力，因为它可以提供有关视网膜代谢氧需求的有用数据，尤其是当与视网膜血流测量结合使用时。本文综述了使用光谱视网膜血氧测定研究 POAG 中视网膜代谢的研究。还讨论了结合使用数学模型和血氧数据来研究视网膜代谢和氧供应在 POAG 中的作用。
