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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors performed a case-control study of risk factors for suprachoroidal expulsive hemorrhage (SEH); the study involved 68 SEH cases at their institution from 1981 to 1986. The authors examined 113 variables in the study group and a procedure-matched control group of 217 patients randomly selected from the 35,459 patients who underwent intraocular surgery during this period, and subjected them to bivariate and conditional logistic regression analysis. The incidence of SEH was 0.19% overall, 0.16% for lens-related procedures, 0.15% for glaucoma surgery, 0.41% for retinal and vitreous procedures, and 0.56% for keratoplasty. Statistically significant risk factors for SEH in age-adjusted bivariate analyses included: glaucoma (P less than 0.0001), increased axial length (P less than 0.0001), elevated intraocular pressure (IOP) (P less than 0.0001), generalized atherosclerosis (P = 0.007), and elevated intraoperative pulse (P = 0.0001). Conditional logistic regression analysis with frequency matching on age identified significant independent risks associated with a history of glaucoma, elevated IOP, increased axial length, and intraoperative tachycardia. One of the models predicts a 752-fold increased theoretical relative risk of SEH for a patient with axial length greater than or equal to 25.8 mm, a history of glaucoma, preoperative IOP greater than 18 mmHg, and intraoperative pulse greater than or equal to 85 beats per minute. The visual outcome after SEH was best in cases of extracapsular cataract extraction (ECCE), compared with other procedures. Results suggest that attention to multiple preoperative and intraoperative ocular and systemic variables may allow identification and prophylaxis of patients at risk for SEH.
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PMID:A case-control study of risk factors for intraoperative suprachoroidal expulsive hemorrhage. 200 78

In order to study effectiveness of surgical treatment in patients with glaucoma in association with atherosclerosis or diabetes mellitus, remote observations (from 1 to 8 years) were carried out over 216 patients operated at different stages of the glaucomatous process: at the initial stage--104 eyes, at the advanced--87, and the far-advanced--53 eyes. Sinusotrabeculectomy in the author's modification was used: at first the external wall of the Schlemm's canal was removed, then the trabecula was destroyed by a blunt spatula, gradually letting out the chamber aqueous. The observations carried out have shown that surgical treatment of glaucoma in patients with atherosclerosis is more effective at the initial and advanced stages. In patients with glaucoma and diabetes mellitus, surgical treatment was most effective in persons with initial stage of glaucoma. It should be noted here that surgical treatment at initial stage of glaucoma allows to preserve high visual functions for a long period of time. Stabilization of the process in persons operated at the initial stage was achieved in 95-97% of cases. This gives grounds to recommend surgical treatment of glaucoma in patients with atherosclerosis and diabetes mellitus at the initial stage of the glaucomatous process. The fall of intraocular pressure is mainly connected with improvement of the aqueous outflow.
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PMID:[The late results of the surgical treatment of glaucoma in patients with atherosclerosis and diabetes mellitus]. 228 Sep 44

A case of recurrent postprandial amaurosis fugax (AF) associated with periorbital pain is described. Clinical and angiographic examination revealed moderate atherosclerosis of the cerebral vessels and narrow-angle glaucoma. Cerebral postprandial hypoperfusion combined with increased intraocular pressure probably precipitated the painful monocular blindness. The attacks of AF subsided partially after treatment of the glaucoma.
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PMID:Postprandial transient painful amaurosis fugax. 374 61

Blood flow to the retina and optic nerve remains constant over a range of elevated intraocular pressure or mean arterial pressure, independent of sympathetic activation (pressure autoregulation). In addition, increased metabolic activity in these tissues proportionally increases blood flow (metabolic autoregulation). At constant metabolic rate, altered arterial oxygen content reciprocally alters blood flow, leaving total oxygen delivery constant, while blood flow rises and falls with the arterial carbon dioxide tension. These responses are similar to those of the cerebral circulation. However, while aging, atherosclerosis, arterial hypotension, and individual variation may profoundly alter blood flow regulation and predispose to the development of illness, these factors remain largely unexplored.
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PMID:Regulation of retinal and optic nerve blood flow. 1040 74

Factors other than intraocular pressure (IOP) elevation must be involved in initiation and progression of glaucoma. An additional element in disease causation may be ischemia in the retina and optic nerve head. Ischemic damage to neurons in the CNS is similar mechanistically and histopathologically to changes seen in glaucoma. Further, glaucoma patients with normal IOP show clear evidence for cerebral and ocular ischemia. Aging and atherosclerosis reduce the ability of the eye to autoregulate blood flow when ocular perfusion pressure changes: the dependence of blood flow on perfusion pressure links ischemia to IOP. Consequently, neuroprotective treatments for glaucoma should be designed to both reduce IOP and improve ocular nutrient delivery.
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PMID:Simultaneous management of blood flow and IOP in glaucoma. 1145 50

Two principal theories for the pathogenesis of glaucomatous optic neuropathy (GON) have been described--a mechanical and a vascular theory. Both have been defended by various research groups over the past 150 years. According to the mechanical theory, increased intraocular pressure (IOP) causes stretching of the laminar beams and damage to retinal ganglion cell axons. The vascular theory of glaucoma considers GON as a consequence of insufficient blood supply due to either increased IOP or other risk factors reducing ocular blood flow (OBF). A number of conditions such as congenital glaucoma, angle-closure glaucoma or secondary glaucomas clearly show that increased IOP is sufficient to lead to GON. However, a number of observations such as the existence of normal-tension glaucoma cannot be satisfactorily explained by a pressure theory alone. Indeed, the vast majority of published studies dealing with blood flow report a reduced ocular perfusion in glaucoma patients compared with normal subjects. The fact that the reduction of OBF often precedes the damage and blood flow can also be reduced in other parts of the body of glaucoma patients, indicate that the hemodynamic alterations may at least partially be primary. The major cause of this reduction is not atherosclerosis, but rather a vascular dysregulation, leading to both low perfusion pressure and insufficient autoregulation. This in turn may lead to unstable ocular perfusion and thereby to ischemia and reperfusion damage. This review discusses the potential role of OBF in glaucoma and how a disturbance of OBF could increase the optic nerve's sensitivity to IOP.
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PMID:The impact of ocular blood flow in glaucoma. 1215 Sep 88

The aim of this paper was to prove the relation between serum lipid values (cholesterol, triglyceride, low density cholesterol, high density cholesterol and primary open -angle glaucoma. The study includes two patient groups: 50 patients with primary open-angle glaucoma and 50 patients without this disease. However, all 100 patients were tested for serum lipid values. The research covered a period of six months (from May to December 2007.). Primary open-angle glaucoma was diagnosed with intraocular pressure values (between 20,1 and 25,6 mm Hg) measured with Schiotz tonometry. The visual field changes were confirmed with Goldmann perimetry. The gonioscopies were done for diagnosis confirmation. The serum lipid values were confirmed with enzymatic colorimetry in vitro method. U-test (Mann-Witney-Wilcox test) and t-test, as nonparametric tests, were used for statistical evaluations. The cholesterol mean value in the test group was 6,14 mol/dm (3) (3,20-8,10 mol/dm (3)) whereas in the control group it was 5,96 mol/dm(3) (2,70-8,80 mol/dm(3)). U-test was with negative ranks (z=-0,83 AS=0,678). The triglyceride mean value in the test group was 2,38 mol/dm (3) (0,84-11,73 mol/m (3)) and in the control group it was 2,04 mol/dm (3) (0,63-5,89 mol/dm(3)). U-test was with positive ranks (z=0,950 AS=0,342). High density cholesterol was average in the test group with 1,45 mol/dm (3) (0,71-3,40 mol/dm (3)) and in the control group 1,40 mol/m (3) (0,80-3,20 mol/dm (3)). Low density cholesterol in the test group was 3,98 mol/m (3) (1,82-6,49 mol/m (3)) and in the control group 4,08 mol/m (3) (2,69-5,69 mol/m (3)). These results had positive ranks according to U-test. Serum lipid values could be one of predictable factors in primary open-angle glaucoma diagnosis. Due to the patient age, cholesterol values, as common factors in primary open-angle glaucoma and atherosclerosis genesis, could be concern in the same aetiology based on dyslipidaemia as well.
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PMID:Primary open-angle glaucoma and serum lipids. 1928 2

Short chain poly-(R)-3-hydroxybutyrate (cPHB) is a ubiquitous molecule that readily adheres to others, that is covalently added to proteins and that forms, with polyphosphate, ion channels. High levels of cPHB have been implicated in atherosclerosis and in diabetes. Here, we propose a hypothesis in which cPHB adheres to filaments in the extracellular matrix and this raises intraocular pressure. In a corollary, we propose that a positive feedback relationship between cPHB adherence to filaments, raised IOP and filament stretching constitutes a switch.
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PMID:Hypothesis: poly-(R)-3-hydroxybutyrate is a major factor in intraocular pressure. 1941 Mar 79

Primary open angle glaucoma (OAG) is a multifactorial optic neuropathy characterized by progressive retinal ganglion cell death and associated visual field loss. OAG is an emerging disease with increasing costs and negative outcomes, yet its fundamental pathophysiology remains largely undetermined. A major treatable risk factor for glaucoma is elevated intraocular pressure (IOP). Despite the medical lowering of IOP, however, some glaucoma patients continue to experience disease progression and subsequent irreversible vision loss. The scientific community continues to accrue evidence suggesting that alterations in ocular blood flow play a prominent role in OAG disease processes. This article develops the thesis that dysfunctional regulation of ocular blood flow may contribute to glaucomatous optic neuropathy. Evidence suggests that impaired vascular autoregulation renders the optic nerve head susceptible to decreases in ocular perfusion pressure, increases in IOP, and/or increased local metabolic demands. Ischemic damage, which likely contributes to further impairment in autoregulation, results in changes to the optic nerve head consistent with glaucoma. Included in this review are discussions of conditions thought to contribute to vascular regulatory dysfunction in OAG, including atherosclerosis, vasospasm, and endothelial dysfunction.
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PMID:Dysfunctional regulation of ocular blood flow: A risk factor for glaucoma? 1966 39

To evaluate the pharmacological properties of cilostazol (CLZ), we examined its intraocular pressure (IOP) -lowering effect. CLZ is an inhibitor of Type III phosphodiesterase that increases intracellular cyclic AMP levels by restraining platelet aggregation, and has a potential protective effect against atherosclerosis. We attempted to apply it for use as an anti-glaucoma agent; however, the application of CLZ in the ophthalmic field is limited due to its poor water solubility. We attempted to enhance CLZ solubility using 2-hydroxypropyl-beta-cyclodextrin (HPbetaCD). The solubility of CLZ increased with increasing HPbetaCD concentrations, and 0.05% CLZ was dissolved in 10% HPbetaCD. Moreover, fine particle suspension of 0.5% CLZ in 5% HPbetaCD (soluble CLZ: ca. 0.027%) were prepared using a Microfluidizer, an impact-type emulsifying comminution device. In an in vitro transcorneal penetration experiment through the rabbit cornea, the CLZ penetration rate was dependent on the CLZ content of the solutions and suspensions. When a 0.05% CLZ ophthalmic solution was instilled into a rabbit eye, the absorption rate constant for CLZ into an aqueous humor was 0.0059+/-0.001 min(-1), and the elimination rate constant was 0.048+/-0.024 min(-1). Also CLZ ophthalmic solutions and fine particle suspension were examined to for their ability to reduce enhanced intraocular pressure (IOP) of rabbits in a darkroom. The instillation of 0.05% CLZ ophthalmic solutions and 0.5% CLZ fine particle suspensions into rabbit eyes reduced the enhanced IOP. These results demonstrate that the instillation of CLZ ophthalmic solutions and fine particle suspensions may represent an effective anti-glaucoma formulation.
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PMID:Preparation of ophthalmic formulations containing cilostazol as an anti-glaucoma agent and improvement in its permeability through the rabbit cornea. 2062 34


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