[Glaucomatous optic neuropathy: a reperfusion injury].
BACKGROUND
We introduce a pathogenetic concept which explains the present known clinical and experimental facts.


METHODS
The known clinical risk factors for glaucomatous optic neuropathy as well as the outcomes of the experimental studies were systematically collected.


RESULTS
IOP fluctuations are more damaging than a stable increased IOP, reduced circulation due to vascular dysregulation is more damaging than reduced circulation due to arteriosclerosis and the glaucomatous damage is clearly different from a pure ischemic lesion.


CONCLUSIONS
Although IOP can damage mechanically, IOP fluctuation and blood pressure drops may lead to short term ischemia, followed by a reperfusion damage. A vascular dysregulation interferes with the autoregulation of ocular perfusion and renders the eye more sensitive to IOP increase or blood pressure decrease.
Flammer
J
J
D001161:Arteriosclerosis / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D005901:Glaucoma / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D009900:Optic Nerve / Q000098:blood supply*; D018917:Optic Neuropathy, Ischemic / Q000503:physiopathology*; D015427:Reperfusion Injury / Q000503:physiopathology*; D012307:Risk Factors