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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This case-control study was undertaken to determine if recurrent herpes labialis posed an independent risk factor for the development of nonarteritic anterior ischemic optic neuropathy among individuals with small optic nerve cup:disk ratio. The study population was comprised of 43 nonarteritic anterior ischemic optic neuropathy cases and 30 consecutive control subjects with < or = 0.1 optic nerve cup:disk ratio. The two groups were compared with respect to the history of recurrent herpes labialis, cigarette smoking status, hypertension, diabetes mellitus, cardiovascular disease, and cerebrovascular disease. The nonarteritic anterior ischemic optic neuropathy cases were comparable to controls with respect to cigarette smoking status, hypertension, diabetes mellitus, cardiovascular disease, and cerebrovascular disease status. Nonarteritic anterior ischemic optic neuropathy cases were significantly more likely to have a history of recurrent herpes labialis than controls. Herpes simplex virus as identified by recurrent herpes labialis plays a role in the development of nonarteritic anterior ischemic optic neuropathy. However, a casual relationship cannot be established.
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PMID:Recurrent herpes labialis as a potential risk factor for nonarteritic anterior ischemic optic neuropathy. 869 98

The objective of this study was to determine if aspirin reduces the incidence of second eye involvement after nonarteritic anterior ischemic optic neuropathy (NAION) in one eye. Records were reviewed of 131 patients who sustained unilateral NAION. Of these, the 33 patients who sustained second eye NAION were compared to those followed for a minimum of 2 years without sustaining a second eye NAION (67). Thirty-one of the 131 patients were excluded because of inadequate follow-up. Except for diabetes (relative risk [RR] 1.43, p = 0.05), the incidence of second eye NAION was independent of gender, age, cup/disk, hypertension, anemia, and migraine. The degree of visual acuity or field dysfunction in the first eye correlated poorly with the acuity (r = 0.28) and field (r = 0.33) loss in the second eye. Aspirin (65-1,300 mg) taken two or more times per week decreased the incidence (17.5% vs. 53.5%) and relative risk (RR = 0.44, p = 0.0002) of second eye AION regardless of the usual risk factors. Even after eliminating those patients who had bilateral disease when first referred, ASA still reduced the incidence of second eye involvement (35% vs. 13%, RR = 0.74, p = 0.01). Aspirin may be an effective means of reducing second eye NAION.
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PMID:Aspirin reduces the incidence of second eye NAION: a retrospective study. 942 77

We retrospectively analyzed 22 patients with non-arteritic anterior ischemic optic neuropathy (NAION) seen at Chung-Ho memorial hospital between 1994 and 1996 to investigate the risk factors of NAION. The risk factors were divided into two groups: ocular and systemic. The ocular factors include refractive state, intraocular pressure, and cup-disk ratio of fellow eye. The systemic factors include diabetes, hypertension and cardiovascular diseases. The analysis revealed: (1) only 22.6% of patients with NAION have systemic risk factors; (2) intraocular pressure is not specific to NAION; (3) most of fellow eyes (72.6%) have cup-disk ratio not more than 0.1; and (4) most patients (90.9%) are hyperopic or emmetropic, only 9% of patients are myopic in either affected or fellow eyes. The statistical comparison between ocular (including cup-disk ratio and refractive state) and systemic factors is significant. The correlation with systemic factors in our study was not so high as previous study had reported. On the contrary, crowding effect of small cup-disk ratio, which induces a vicious circle of generally circulatory compromised disk, may play an important role in NAION. Besides, hyperopic or at least emmetropic eyes are more prone to NAION than myopic eyes. This may be due to lack of flattening of the temporal excavation, therefore adding a predisposing factor to a generally circulatory compromised disk. The risk factors associated with NAION seem more strongly correlated with ocular factors than with systemic factors.
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PMID:Risk factors of non-arteritic anterior ischemic optic neuropathy (NAION): ocular or systemic. 958 16

We report a case of a 31 year-old man who presented a bilateral ischemic optic neuropathy associated with headaches and severe systemic hypertension. This episode appeared after administration of ergotamine tartrate and macrolides. This medication probably led to a vasospasm which occurs in patients with hypertension. The cardiovascular and serum lipid evaluations were normal. A migraine optic neuropathy can be evoked.
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PMID:[Bilateral ischemic optic neuropathy secondary to acute ergotism]. 975 93

A nonrandomized, prospective, interdisciplinary pilot study of 102 patients with noncompressive optic disc swelling with visual loss (ODSWVL) was performed in order to investigate etiologic and pathogenetic mechanisms. Forty-six patients suffered from underlying inflammatory disease. Seventeen patients suffered from highly probable cardiogenic embolization, 16 patients from multiple vascular risk factors. The remaining patients of the noninflammatory disease group suffered from leukemia, previously unknown or severely decompensated diabetes mellitus, acute arterial hypertension, different kinds of coagulopathies and others. Ninety-six of the 102 patients required medical treatment according to general medical standards. Inhomogeneity of the underlying disease processes explains the ineffectiveness of different monotherapies in previous studies. Interdisciplinary search for the underlying causes allows causative treatment. ODSWVL and anterior ischemic optic neuropathy in particular seem to be a common final pathway of various pathogenetic mechanisms due to different etiologies rather than a disease entity by itself.
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PMID:Etiology and pathogenetic mechanisms of optic disc swelling with visual loss. An interdisciplinary prospective pilot study of 102 cases. 983 56

During the past year, there has been increased understanding of the ocular manifestations of various cardiovascular and hematologic disorders. Carotid and vertebral artery lesions may lead to significant and varied ophthalmic pathology. Disorders of blood pressure may influence the intraocular pressure and play a role in the progression of glaucoma. Cardiovascular risk factors such as smoking, hyperlipidemia, hypertension, and diabetes mellitus, may also play a role in the development of anterior ischemic optic neuropathy. Several cardiac anomalies as well as the cardiac use of streptokinase have been reported to have secondary ocular involvement. Both benign and malignant hematologic disorders may result in serious ocular morbidity. Recent publications have focused on the secondary ophthalmic complications from the hemoglobinopathies, problems with blood viscosity, the lymphomas, the leukemias, and bone marrow transplantation.
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PMID:Ocular manifestations of cardiovascular and hematologic disorders. 1016 Apr 27

Recent population-based studies suggest that the fundus lesions of hypertension also occur in people without hypertension. In experimental studies, hypertensive lesions, which used to be the backbone of older classifications of the severity of hypertension, did not correlate sufficiently with severity to allow reliable grading. Hypertensive retinopathy, choroidopathy, and optic neuropathy are independent processes. Vascular narrowing appears to occur early in the disease process, whereas retinal hemorrhages and retinal lipid may occur later. Branch vein occlusion is a complication of hypertension, whereas open-angle glaucoma may not be. Choroidal neovascularization in the fellow eyes of patients with macular degeneration is associated with high blood pressure. Laser treatment for this disorder is less effective in patients with high blood pressure than it is in normotensive individuals, which suggests that choroidal neovascularization may be an expression of chronic hypertensive choroidopathy. Hypertensive optic neuropathy, a variant of ischemic optic neuropathy, has delayed onset compared with retinopathy and, in experimental studies, has not been linked to the severity of hypertension. Given these findings, it may be better to describe than to grade fundus lesions. In either event, it is important to take blood pressures accurately. Fundus lesions suggest high blood pressure. Sphygmomanometry is more specific and reliable than funduscopy in making that diagnosis.
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PMID:Ocular manifestations of systemic hypertension. 1038 39

Patients with autosomal recessive polycystic kidney disease (ARPKD) often present with renal insufficiency and hypertension. We present two children with ARPKD and end-stage renal disease who developed anterior ischemic optic neuropathy and vision loss. Anterior ischemic optic neuropathy occurs rarely in children and has never been reported in children with ARPKD or end-stage renal disease. Both of our patients were chronically hypotensive and anemic, which are known risk factors for ischemic optic neuropathy.
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PMID:Acute vision loss in children with autosomal recessive polycystic kidney disease. 1058 23

There are well-known associations between systemic arterial hypertension and a variety of ocular disorders that were previously considered to be primarily manifestations of arterial hypertension. Recent studies with 24-hour ambulatory blood pressure monitoring have shown that the development and progression of nonarteric anterior ischemic optic neuropathy and glaucomatous optic neuropathy are significantly correlated with nocturnal arterial hypotension, particularly in hypertensive patients receiving oral hypertensive therapy. These studies suggest that several of the ocular or optic nerve head ischemic or ocular vascular disorders previously thought to be manifestations of arterial hypertension may, in fact, be due to a combination of systemic arterial hypertension and hypotension, with arterial hypertension acting as a predisposing factor and arterial hypotension actually producing the disorders. This paper reviews this subject in light of recent studies and discusses the physiopathologic bases of the disorders in question. With the development of potent arterial hypotensive medications for arterial hypertension, arterial hypotension (particularly nocturnal hypotension) is increasingly emerging as an important cause of visual disorders. Therefore, it is strongly recommended that when a patient is at risk for ocular or optic nerve head ischemic or ocular vascular disorders, the ophthalmologist should talk to the treating physician about the potential risks of intensive arterial hypotensive therapy, particularly that administered in the evening or at bedtime.
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PMID:Role of nocturnal arterial hypotension in the development of ocular manifestations of systemic arterial hypertension. 1066 54

There are many risk factors involved in the development of ischemic optic neuropathy such as diabetes mellitus, hypertension, arteriosclerosis, and vascular incompetence. Therefore, the treatment of ischemic optic neuropathy should not be solely based on proper diagnosis but should also involve a thorough and systemic investigation to identify those multifactorial possibilities, which may contribute to the pathogenesis of the disease. We report upon a patient who developed non-arteritic ischemic optic neuropathy following treatment of a sphenoethmoid mucocele, which lead to recovered vision and a satisfactory improvement of visual field defects, after percutaneous trans-coronary angiography with stent insertion of the coronary arteries.
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PMID:A case of optic neuropathy treated by percutaneous trans-coronary angiography. 1076 9


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