Vascular Risk Factors in Glaucoma

Böhm A. G.,
Universitätsklinikum Carl Gustav Carus, Klinik und Poliklinik für Augenheilkunde (Dresden)

Elevated intraocular pressure was thought to be the only cause for glaucomatous optic nerve damage. Today there is evidence that glaucoma is a multifactorial disease. Elevated intraocular pressure still remains the most important risk factor. But other factors like vacular risk factors seem to play a major role in the pathognesis of glaucoma. Although vascular risk factors have been detected more in normal pressure glaucoma they are present in high pressure glaucoma patients, too. Vascular risk factors are factors, which lead to an impairment of the optic nerve perfusion and possibly to glaucomatous optic nerve damage. The most important vascular risk factors are vasospasm, systemic hyper- and hypotension. Phases of systemic hyotension occur predominantly at night (nocturnal dips). For the diagnosis of vascular risc factors a precise patient history, 24-h blood pressure monitoring, ocular perfusion measurements, and provocation tests are of importance. As there are therapeutical approaches for vascular risk factors, like vasospasm, systemic hyper- and hypotension, detection of these factors and a adequate treatment are necessary to prevent progression of the glaucomatous disease.

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