Pillunat Karin R, Pillunat Lutz E
Universitätsaugenklinik Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Ophthalmologe. 2021 May;118(5):431-438. doi: 10.1007/s00347-020-01239-7.
Approximately 40% of all open-angle glaucomas do not show high intraocular pressure (IOP). Vascular risk factors play an important role in the pathogeneses of normal pressure glaucoma but high pressure glaucoma is also often accompanied by significant vascular components.
What are the practice relevant possibilities of vascular glaucoma treatment?
An evaluation of scientific articles from PubMed dealing with vascular glaucoma was carried out.
The treatment of vascular risk factors in glaucoma patients requires a thorough medical history regarding vascular symptoms (peripheral vasospasm, tinnitus, migraine etc.) and information on the presence of systemic diseases. Furthermore, a 24h blood pressure profile and the determination of the fat metabolism status represent important and simple examinations.
Besides optimizing systemic blood pressure, reducing an increased central retinal venous pressure, treatment with statins, calcium channel blockers, Ginkgo biloba extract, increased physical exercise and fluid replacement are options to ameliorate vascular conditions. An interdisciplinary cooperation with general practitioners and internists is an important component of holistic treatment.
所有开角型青光眼患者中约40%眼压不高。血管危险因素在正常眼压性青光眼的发病机制中起重要作用,但高眼压性青光眼也常伴有明显的血管成分。
治疗血管性青光眼有哪些与临床实践相关的可能性?
对来自PubMed的有关血管性青光眼的科学文献进行评估。
青光眼患者血管危险因素的治疗需要详细了解血管症状(外周血管痉挛、耳鸣、偏头痛等)的病史以及全身性疾病的情况。此外,24小时血压监测和脂肪代谢状态测定是重要且简单的检查。
除了优化全身血压、降低升高的视网膜中央静脉压外,使用他汀类药物、钙通道阻滞剂、银杏叶提取物治疗、增加体育锻炼和补充液体也是改善血管状况的选择。与全科医生和内科医生的跨学科合作是整体治疗的重要组成部分。