Clinical clues of vascular dysregulation and its association with glaucomaa,b

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Abstract

Vascular dysregulation is a condition in which blood flow is not properly distributed to meet the demands of different tissues and could lead to overperfusion or underperfusion. Vascular dysregulation can be primary (occurring alone) or secondary (associated with other disorders, usually autoimmune diseases), and is caused by an imbalance between vasodilator and vasoconstrictor substances produced mainly locally by the vascular endothelium. In most circumstances of vascular dysregulation, the level of endothelin-1 is increased, leading to vasospasm. Vascular dysregulation is present in at least some subgroups of patients with glaucoma, and in these individuals it might have some important therapeutic consequences. In this article we review the evidence linking vascular dysregulation and glaucoma, and evaluate the clinical characteristics that might suggest the presence of vascular dysregulation in the glaucoma patient.

Résumé

La dysrégulation vasculaire est un état où la répartition sanguine ne se fait pas adéquatement pour satisfaire à la demande des différents tissus, ce qui pourrait entraîner une surperfusion ou une sousperfusion. Elle est primaire (survenant seule) ou secondaire (associée à d’autres désordres, ordinairement des maladies autoimmunes), et elle est causée par un déséquilibre entre les substances vasodilatatrices et vasoconstrictrices produites surtout localement par l’endothélium vasculaire. Dans la plupart des cas de dysrégulation vasculaire, le niveau d’endothéline-1 monte, menant au vasospasme. La dysrégulation vasculaire est présente au moins chez certains sous-groupes de patients glaucomateux où elle peut avoir d’importantes conséquences thérapeutiques. Après une revue des données qui lient la dysrégulation vasculaire et le glaucome, cet article évalue les caractéristiques qui pourraient indiquer la présence d’une dysrégulation vasculaire chez le patient atteint du glaucome.

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  • Cited by (0)

    a

    Presented in part at the International Ocular Blood Flow Symposium in Toronto, Ont., October 13, 2007

    b

    This article has been peer-reviewed.

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