[Hemodynamics of optic nerve and retina in patients with unstable glaucoma and normal intraocular pressure]

The authors analyze the causes of the progress of glaucomatous atrophy of the optic nerve in normal ophthalmic tone. Ninety-four patients (105 eyes) with different stages of glaucoma were examined; intraocular pressure in them was normalized by drug therapy or surgery. In additional to functional studies, hemodynamics was assessed in all the patients by fluorescent angiography of the optic disk, vacuum ophthalmodynamometry, and ultrasonic dopplerography of the carotid artery, orbital artery, and central retinal artery. Perfusion pressure in the orbital and central retinal arteries depends on the total-systems arterial pressure, and disorders of systemic circulation are hypothesized as one cause of decreased perfusion of the optic nerve and retina. Therapy for glaucomatous atrophy of the optic nerve and retina should include, along with normalization of intraocular pressure, measures aimed at maintaining a high level of perfusion pressure and volumic bloodflow.