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Retinal vasculature in glaucoma: a review

Despite the critical impact of glaucoma on global blindness, its aetiology is not fully characterised. Elevated intraocular pressure is highly associated with glaucomatous optic neuropathy. However, visual field loss still progresses in some patients with normal or even low intraocular pressure. Vas...

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Autores principales: Chan, Karen K W, Tang, Fangyao, Tham, Clement C Y, Young, Alvin L, Cheung, Carol Y
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Open Ophthalmology 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721639/
https://www.ncbi.nlm.nih.gov/pubmed/29354699
http://dx.doi.org/10.1136/bmjophth-2016-000032
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author Chan, Karen K W
Tang, Fangyao
Tham, Clement C Y
Young, Alvin L
Cheung, Carol Y
author_facet Chan, Karen K W
Tang, Fangyao
Tham, Clement C Y
Young, Alvin L
Cheung, Carol Y
author_sort Chan, Karen K W
collection PubMed
description Despite the critical impact of glaucoma on global blindness, its aetiology is not fully characterised. Elevated intraocular pressure is highly associated with glaucomatous optic neuropathy. However, visual field loss still progresses in some patients with normal or even low intraocular pressure. Vascular factors have been suggested to play a role in glaucoma development, based on numerous studies showing associations of glaucoma with blood pressure, ocular perfusion pressure, vasospasm, cardiovascular disease and ocular blood flow. As the retinal vasculature is the only part of the human circulation that readily allows non-invasive visualisation of the microcirculation, a number of quantitative retinal vascular parameters measured from retinal photographs using computer software (eg, calibre, fractal dimension, tortuosity and branching angle) are currently being explored for any association with glaucoma and its progression. Several population-based and clinical studies have reported that changes in retinal vasculature (eg, retinal arteriolar narrowing and decreased fractal dimension) are associated with optic nerve damage and glaucoma, supporting the vascular theory of glaucoma pathogenesis. This review summarises recent findings on the relationships between quantitatively measured structural retinal vascular changes with glaucoma and other markers of optic nerve head damage, including retinal nerve fibre layer thickness. Clinical implications, recent new advances in retinal vascular imaging (eg, optical coherence tomography angiography) and future research directions are also discussed.
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spelling pubmed-57216392018-01-19 Retinal vasculature in glaucoma: a review Chan, Karen K W Tang, Fangyao Tham, Clement C Y Young, Alvin L Cheung, Carol Y BMJ Open Ophthalmol Review Despite the critical impact of glaucoma on global blindness, its aetiology is not fully characterised. Elevated intraocular pressure is highly associated with glaucomatous optic neuropathy. However, visual field loss still progresses in some patients with normal or even low intraocular pressure. Vascular factors have been suggested to play a role in glaucoma development, based on numerous studies showing associations of glaucoma with blood pressure, ocular perfusion pressure, vasospasm, cardiovascular disease and ocular blood flow. As the retinal vasculature is the only part of the human circulation that readily allows non-invasive visualisation of the microcirculation, a number of quantitative retinal vascular parameters measured from retinal photographs using computer software (eg, calibre, fractal dimension, tortuosity and branching angle) are currently being explored for any association with glaucoma and its progression. Several population-based and clinical studies have reported that changes in retinal vasculature (eg, retinal arteriolar narrowing and decreased fractal dimension) are associated with optic nerve damage and glaucoma, supporting the vascular theory of glaucoma pathogenesis. This review summarises recent findings on the relationships between quantitatively measured structural retinal vascular changes with glaucoma and other markers of optic nerve head damage, including retinal nerve fibre layer thickness. Clinical implications, recent new advances in retinal vascular imaging (eg, optical coherence tomography angiography) and future research directions are also discussed. BMJ Open Ophthalmology 2017-07-11 /pmc/articles/PMC5721639/ /pubmed/29354699 http://dx.doi.org/10.1136/bmjophth-2016-000032 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Review
Chan, Karen K W
Tang, Fangyao
Tham, Clement C Y
Young, Alvin L
Cheung, Carol Y
Retinal vasculature in glaucoma: a review
title Retinal vasculature in glaucoma: a review
title_full Retinal vasculature in glaucoma: a review
title_fullStr Retinal vasculature in glaucoma: a review
title_full_unstemmed Retinal vasculature in glaucoma: a review
title_short Retinal vasculature in glaucoma: a review
title_sort retinal vasculature in glaucoma: a review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721639/
https://www.ncbi.nlm.nih.gov/pubmed/29354699
http://dx.doi.org/10.1136/bmjophth-2016-000032
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