, Volume 13, Issue 4, pp 281-290

Ocular vasospasm: A risk factor in the pathogenesis of low-tension glaucoma

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Abstract

The typical morphological and consequent functional damage caused by disease entities covered by the term ‘glaucoma’ is the result of inadequate circulation to the optic nerve fibres, predominantly in the papillary region, as a result of elevated intraocular pressure.

The aim of this study is classification of different forms of glaucoma on the basis of blood flow parameters. Physiological and pathophysiological aspects of ocular blood flow and of microcirculation and hemorrheology will be considered and the significance of ocular vasospasm in low-tension glaucoma discussed.

The frequent occurrence of vasospasm in the nailfold capillaries and of visual field deterioration after a coldwater test demonstrates that vasospasm is an expression of different underlying phenomena.

Our results show that, in patients with ocular vasospasm, treatment with a calcium antagonist brings about a clear reversal of their visual field defects.

There is nothing more difficult to plan, more doubtful of success, nor more dangerous to manage, than the creation of a new system, for the initiator has the emnity of all who would profit by the preservation of the old institutions and merely lukewarm defenders in those who would gain by the new ones.
Machiavelli, The Prince, 1518
This paper is dedicated to Prof. Josef Flammer, University Eye Clinic, Basle, Switzerland, on the occasion of his 40th birthday.