A review of ocular perfusion pressure and retinal thickness: A case for the role of systemic hypotension in glaucoma

Naazia Vawda, A. Munsamy
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引用次数: 0

Abstract

Background: Ocular perfusion pressure (OPP) is defined as blood pressure (BP) minus intraocular pressure (IOP). Low OPP may result in decreased ocular blood flow (OBF) and oxygen to the optic nerve head (ONH) and retina.Aim: To review the role of systemic hypotension and similar conditions in OPP and its influence on retinal nerve fibre layer (RNFL) thickness and the ganglion cell complex (GCC).Method: A literature search was conducted using the following search terms: ‘systemic hypotension’; ‘glaucoma’; ‘retinal nerve fibre layer’; ‘optic nerve’; ‘ocular blood flow’ and ‘ocular perfusion pressure’.Results: The Los Angeles Eye Study and Barbados Eye Study found that decreased OPP and BP increased the risk of glaucoma development by up to six times. Reduced retinal perfusion with resultant thinning of the RNFL in conditions with a similar mechanism, such as obstructive sleep apnoea syndrome, has indicated the importance of reduced OPP in retinal thickness. In the absence of any study directly showing the effect of systemic hypotension on OPP and retinal thickness, a working hypothesis proposes that reduced BP with or without normal-to-raised IOP will reduce OPP. The reduced OPP and OBF in those with systemic hypotension may result in oxidative stress and hypoxia which may then cause retinal ganglion cell death and the resultant retinal thinning.Conclusion: The increased risk of glaucoma development and progression relating to decreased BP and OPP has been proven to be of importance. Monitoring patients with systemic hypotension and evaluating the macula, ONH RNFL and GCC thickness may alert clinicians to possible glaucomatous changes.
眼灌注压和视网膜厚度的研究进展:系统性低血压在青光眼中的作用
背景:眼灌注压(OPP)定义为血压(BP)减去眼内压(IOP)。低OPP可能导致眼血流量(OBF)和视神经头(ONH)和视网膜的氧气减少。目的:探讨全身性低血压及类似情况在OPP中的作用及其对视网膜神经纤维层(RNFL)厚度和神经节细胞复合体(GCC)的影响。方法:使用以下检索词进行文献检索:“全身性低血压”;“青光眼”;“视网膜神经纤维层”;视神经的;“眼血流”和“眼灌注压”。结果:洛杉矶眼科研究和巴巴多斯眼科研究发现,OPP和BP的降低使青光眼发展的风险增加了6倍。在类似机制的情况下,如阻塞性睡眠呼吸暂停综合征,视网膜灌注减少导致RNFL变薄,这表明OPP减少对视网膜厚度的重要性。在没有任何研究直接显示全身性低血压对OPP和视网膜厚度的影响的情况下,一种可行的假设提出,降低血压,无论眼压是否正常或升高,都会降低OPP。全身性低血压患者的OPP和OBF降低可能导致氧化应激和缺氧,从而导致视网膜神经节细胞死亡和视网膜变薄。结论:青光眼发生和进展的风险增加与血压和OPP降低有关,已被证明是重要的。监测全身性低血压患者并评估黄斑、ONH RNFL和GCC厚度可以提醒临床医生注意可能的青光眼变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
African Vision and Eye Health
African Vision and Eye Health Health Professions-Optometry
CiteScore
1.00
自引率
0.00%
发文量
46
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