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Vascular endothelial dysfunction in primary open angle glaucoma
Author(s) -
CELLINI M,
GIZZI C,
STROBBE E,
FAVARETTO E,
FILIPPINI M,
PALARETI G,
CAMPOS EC
Publication year - 2009
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2009.2453.x
Subject(s) - medicine , brachial artery , ophthalmology , glaucoma , intraocular pressure , open angle glaucoma , visual field , sphygmomanometer , endothelial dysfunction , diabetes mellitus , cuff , visual field test , blood pressure , cardiology , vasodilation , surgery , endocrinology
Purpose Glaucomatous optic neuropathy (GON) is related not only to elevated intraocular pressure (IOP) but also to an insufficient ocular blood supply related to a vascular dysregulation. We evaluated peripheral vascular endothelial function in primary open‐angle glaucoma (POAG) with a non‐invasive endothelium flow mediated vasodilatation (FMD). Methods We studied 20 POAG patients. The diagnostic criteria for POAG was an IOP exceeded 22 mm/hg before treatment, open anterior chamber angle, cup/disc ratio >0.7 and optic nerve related visual field loss (MD>6 dB, SF>2.5 dB and CPSD>3 dB). Patients with systemic diseases such hypertension, heart failure and diabetes mellitus were excluded. All patients and 20 normal controls underwent measurement of FMD with high‐resolution 2‐dimensional ultrasonographic imaging of the brachial artery by a Philips ENVISOR echographic machine. To induce iperemia a sphygmomanometer cuff was inflated to 250 mm/hg for 5 minutes. The cuff then was deflated rapidly and at 60 seconds after cuff deflation 2‐D images of the brachial artery were recorded for 5 seconds. A statistical analysis was made of the FMD in POAG and in normal control patients using the Student “t” test for unpaired data and the Pearson correlation test to show the correlation between the endothelial dysfunction and the visual field indexes. Results Patients affected by POAG exhibit lower values of FMD compared with healthy people In POAG patients we found an FMD 4,28%±2,49 vs. 8,66%±3,02 (p<0.001). The mean decrease (MD) visual field index was related to FMD (p<0.05). Conclusion Patients with POAG have an impaired vascular function related to a vascular endothelium dysfunction and the MD visual field is related to FMD impairment.