The primary vascular dysregulation syndrome: implications for eye diseases
Reads0
Chats0
TLDR
Taking into consideration the high prevalence of PVD in the population and potentially linked pathologies, the authors provide recommendations on how to effectively promote the field in order to create innovative diagnostic tools to predict the pathology and develop more efficient treatment approaches tailored to the person.Abstract:
Vascular dysregulation refers to the regulation of blood flow that is not adapted to the needs of the respective tissue. We distinguish primary vascular dysregulation (PVD, formerly called vasospastic syndrome) and secondary vascular dysregulation (SVD). Subjects with PVD tend to have cold extremities, low blood pressure, reduced feeling of thirst, altered drug sensitivity, increased pain sensitivity, prolonged sleep onset time, altered gene expression in the lymphocytes, signs of oxidative stress, slightly increased endothelin-1 plasma level, low body mass index and often diffuse and fluctuating visual field defects. Coldness, emotional or mechanical stress and starving can provoke symptoms. Virtually all organs, particularly the eye, can be involved. In subjects with PVD, retinal vessels are stiffer and more irregular, and both neurovascular coupling and autoregulation capacity are reduced while retinal venous pressure is often increased. Subjects with PVD have increased risk for normal-tension glaucoma, optic nerve compartment syndrome, central serous choroidopathy, Susac syndrome, retinal artery and vein occlusions and anterior ischaemic neuropathy without atherosclerosis. Further characteristics are their weaker blood–brain and blood-retinal barriers and the higher prevalence of optic disc haemorrhages and activated astrocytes. Subjects with PVD tend to suffer more often from tinnitus, muscle cramps, migraine with aura and silent myocardial ischaemic and are at greater risk for altitude sickness. While the main cause of vascular dysregulation is vascular endotheliopathy, dysfunction of the autonomic nervous system is also involved. In contrast, SVD occurs in the context of other diseases such as multiple sclerosis, retrobulbar neuritis, rheumatoid arthritis, fibromyalgia and giant cell arteritis. Taking into consideration the high prevalence of PVD in the population and potentially linked pathologies, in the current article, the authors provide recommendations on how to effectively promote the field in order to create innovative diagnostic tools to predict the pathology and develop more efficient treatment approaches tailored to the person.read more
Citations
More filters
Journal ArticleDOI
Glaucoma: the retina and beyond.
Benjamin M. Davis,Laura Crawley,Milena Pahlitzsch,Fatimah Zara Javaid,Maria Francesca Cordeiro,Maria Francesca Cordeiro +5 more
TL;DR: The current understanding of the potential mechanisms underlying RGC and axonal loss in glaucoma is outlined, and an overview of recent developments in techniques for monitoring RGC health is provided, including recent progress towards the development of RGC specific contrast agents.
Journal ArticleDOI
Neuroprotective strategies for retinal disease.
TL;DR: Six strategies that preserve retinal neurons across multiple diseases are presented, including drugs that target survival pathways, therapies that target retinal dopamine, and neurotrophic factors, and rehabilitative methods that increase endogenous repair mechanisms, including exercise and electrical stimulation therapies.
Journal ArticleDOI
Flammer syndrome
Katarzyna Konieczka,Robert Ritch,Carlo Enrico Traverso,Dong Myung Kim,Michael S. Kook,Augusto Gallino,Olga Golubnitschaja,Carl Erb,Herbert A. Reitsamer,Teruyo Kida,Natalia Kurysheva,Ke Yao +11 more
TL;DR: Flammer syndrome as discussed by the authors describes a phenotype characterized by the presence of primary vascular dysregulation together with a cluster of symptoms and signs that may occur in healthy people as well as people with disease.
Journal ArticleDOI
Optic Disc Perfusion in Primary Open Angle and Normal Tension Glaucoma Eyes Using Optical Coherence Tomography-Based Microangiography
Karine D. Bojikian,Chieh-Li Chen,Joanne C Wen,Qinqin Zhang,Chen Xin,Chen Xin,Divakar Gupta,Raghu C. Mudumbai,Murray A. Johnstone,Ruikang K. Wang,Philip P. Chen +10 more
TL;DR: Vascular changes at the optic disc as measured by optical microangiography based optical coherence tomography (OCT) angiography technique may provide useful information for diagnosis and monitoring of glaucoma.
Journal ArticleDOI
Mental stress as consequence and cause of vision loss: the dawn of psychosomatic ophthalmology for preventive and personalized medicine.
TL;DR: It is concluded that stress is both consequence and cause of vision loss, and stress reduction and relaxation techniques (e.g., meditation, autogenic training, stress management training, and psychotherapy to learn to cope) should be recommended not only as complementary to traditional treatments of sight loss but possibly as preventive means to reduce progression of vision Loss.
References
More filters
Journal ArticleDOI
The impact of ocular blood flow in glaucoma.
Josef Flammer,Selim Orgül,Vital Paulino Costa,Nicola Orzalesi,Günter K. Krieglstein,Luis Metzner Serra,Jean-Paul Renard,Einar Stefánsson +7 more
TL;DR: The potential role of OBf in glaucoma is discussed and how a disturbance of OBF could increase the optic nerve's sensitivity to IOP is discussed.
Journal ArticleDOI
Angina pectoris. I. A variant form of angina pectoris; preliminary report.
Journal ArticleDOI
The Assessment of Endothelial Function From Research Into Clinical Practice
Andreas J. Flammer,Todd J. Anderson,David S. Celermajer,Mark A. Creager,Mark A. Creager,John E. Deanfield,Peter Ganz,Naomi M. Hamburg,Thomas F. Lüscher,Michael Shechter,Stefano Taddei,Joseph A. Vita,Amir Lerman +12 more
TL;DR: The assessment of its vasodilator properties resulting from NO and other molecules may provide information on the integrity and function of the endothelium, and most, if not all, cardiovascular risk factors are associated with endothelial dysfunction, and risk factor modification leads to improvement in vascular function.
Journal ArticleDOI
Retinal ischemia: mechanisms of damage and potential therapeutic strategies.
TL;DR: Given the increasing understanding of the events involved in ischemic neuronal injury, it is hoped that clinically effective treatments for retinal ischemia will soon be available.
Journal ArticleDOI
Large diurnal fluctuations in intraocular pressure are an independent risk factor in patients with glaucoma.
TL;DR: In patients with glaucoma with office IOP in the normal range, large fluctuations in diurnal IOP are a significant risk factor, independent of parameters obtained in the office.