Cardiovascular risk profile in the progression of glaucomatous damage
S. Kremmer, J. M. Selbach, K.-P. Steuhl
Recently, the understanding of the development and progression of glaucomatous optic nerve damage has changed. There is accumulating evidence for a multifactorial pathogenesis of glaucomatous optic neuropathy with special emphasis on vascular risk factors.
Numerous studies have shown that glaucoma is associated with cardiovascular and hematologic diseases such as arterial hypotension and hypertension, vasospastic syndromes, increased blood viscosity, sleep apnea syndrome, diabetes mellitus etc.
For instance, a particular therapeutic dilemma exists in the treatment of blood pressure, as both hypotension and hypertension may deteriorate optic nerve damage. When treating arterial hypertension it is important that the nocturnal dip of blood pressure is not lowered below the physiological level (with consecutive critical reduction of ocular perfusion pressure). Therefore a 24 hour monitoring of blood pressure is necessary.
Thus, improving cooperation between different medical divisions is of outstanding importance in diagnosis and therapy of glaucoma.
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