Flammer J
University Eye Clinic, Basel, Switzerland.
Surv Ophthalmol. 1994 May;38 Suppl:S3-6. doi: 10.1016/0039-6257(94)90041-8.
The regulation of ocular perfusion is different for different parts of the eye. Observations on the retina can, therefore, not be extrapolated to the optic nerve head. Extraocular vessels, especially the short posterior ciliary arteries, might play a major role in regulation of ocular circulation, but additional regulation takes place in the eye itself. Dysregulation might be transient and, thus, not necessarily present and detectable at any one examination. Older patients with arteriosclerotic vessels may behave differently in this regard than do young, healthy animals. Not only the arterial but also the venous side of the circulation may be disturbed. Disk hemorrhages can not only be a sign of damage; they can also provoke ischemia. Besides hypoxia, diseased vessel walls might play a direct role in the pathogenesis of optic nerve head cupping. Finally, a relation between vascular dysregulation and aqueous-humor dynamics is conceivable.
眼部不同部位的眼灌注调节有所不同。因此，对视网膜的观察结果不能外推至视神经乳头。眼外血管，尤其是睫状后短动脉，可能在眼循环调节中起主要作用，但眼内自身也存在额外的调节机制。调节异常可能是短暂的，因此在任何一次检查中不一定会出现或被检测到。患有动脉硬化血管的老年患者在这方面的表现可能与年轻健康动物不同。不仅循环系统的动脉侧，静脉侧也可能受到干扰。视盘出血不仅可能是损伤的迹象；它们还可能引发局部缺血。除了缺氧，病变的血管壁可能在视神经乳头杯状凹陷的发病机制中起直接作用。最后，血管调节异常与房水动力学之间的关系是可以想象的。
