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Rola przepływu naczyniowego w przebiegu jaskry – problem wciąż aktualny
The Role of Ocular Blood Flow in Glaucoma – Problem Still Under Consideration
Joanna Piłat, Dorota Pożarowska, Tomasz Żarnowski
Klinika Diagnostyki i Mikrochirurgii Jaskry Uniwersytetu Medycznego w Lublinie
Kierownik: prof. zw. dr hab. n. med. Tomasz Żarnowski
Summary: Glaucoma is a chronic optic nerve neuropathy and one of the leading causes of blindness in the world with an increasing prevalence. The disease is multifactorial but currently the only modifiable risk factor is increased intraocular pressure. In some patients, however, glaucoma progresses despite effective hypotensive treatment. The abnormal ocular blood flow and vascular autoregulation disorders are the causes of ischemic changes and neuropathy, especially in the case of normal-tension glaucoma. In recent years, new ophthalmology imaging techniques have been developed that provide detailed information on ocular circulation. Many studies show lower density and diameter of small retinal vessels as well as a smaller diameter of large vessels on the optic nerve disc in people suffering from glaucoma. Also, circulation disorders such as increased activation of the sympathetic nervous system, nocturnal hypotension, low mean blood pressure, low end-diastolic velocities in the central retinal artery and ophthalmic artery as well as diseases with increased resistance in the internal carotid or ophthalmic artery can affect development of glaucoma. The ischemia of the optic nerve can also be caused by vasospastic diseases, i.e. in migraine and Raynaud"s disease. It is also known that capillary blood flow disorders have been demonstrated in glaucoma patients, especially with normal-pressure glaucoma. Inhibitors of carbonic anhydrase have a double beneficial effect in the pharmacotherapy of glaucoma by reducing intraocular pressure and enhancing ocular blood flow.
Słowa kluczowe: jaskra, czynniki ryzyka, przepływ krwi, ciśnienie perfuzji ocznej, inhibitory anhydrazy węglanowej.
Keywords: glaucoma, risk factors, blood flow, ocular perfusion pressure, carbonic anhydrase inhibitors.