Department of Ophthalmology/Optometry, Johannes Kepler University, 4020 Linz, Austria.
Int J Mol Sci. 2021 Apr 28;22(9):4662. doi: 10.3390/ijms22094662.
Glaucomatous optic neuropathies have been regarded as diseases caused by high intraocular pressure for a long time, despite the concept of vascular glaucoma dating back to von Graefe in 1854. Since then, a tremendous amount of knowledge about the ocular vasculature has been gained; cohort studies have established new vascular risk factors for glaucoma as well as identifying protective measures acting on blood vessels. The knowledge about the physiology and pathophysiology of the choroidal, retinal, as well as ciliary and episcleral circulation has also advanced. Only recently have novel drugs based on that knowledge been approved for clinical use, with more to follow. This review provides an overview of the current vascular concepts in glaucoma, ranging from novel pathogenesis insights to promising therapeutic approaches, covering the supply of the optic nerve head as well as the aqueous humor production and drainage system.
长期以来，青光眼性视神经病变一直被认为是由眼内压升高引起的疾病，尽管血管性青光眼的概念可以追溯到 von Graefe 在 1854 年的研究。从那时起，人们对眼部血管系统有了大量的了解；队列研究确定了青光眼的新血管危险因素，并确定了对血管起保护作用的措施。关于脉络膜、视网膜以及睫状体和巩膜循环的生理学和病理生理学的知识也取得了进展。直到最近，基于这些知识的新型药物才被批准用于临床，未来还会有更多的药物问世。这篇综述概述了青光眼的当前血管概念，从新的发病机制见解到有前途的治疗方法，涵盖了视神经头部的供应以及房水的产生和引流系统。
