scholarly journals Vascular and vegetative factors of glaucoma attack

2021 ◽  
Vol 14 (4) ◽  
pp. 22-30
Author(s):  
N. A. Bakunina ◽  
L. N. Kolesnikova ◽  
G. V. Poryadin ◽  
J. M. Salmasi ◽  
L. M. Balashova

Purpose. To study the involvement of vascular and vegetative factors in the pathogenesis of glaucoma attack. Material and methods. 12 patients (24 eyes) aged 49 to 82 — 5 men and 7 women, including 3 patients with acute glaucoma and 9 patients with subacute glaucoma were subjected to an ophthalmological examination that included visometry, tonometry, automated static perimetry, OCT and OCT angiography. They were also tested for heart rate variability (HRV) using a Polar heart rate monitor, and for plasminogen content and products of fibrin/fibrinogen degradation in the tear. For comparison, the contralateral eyes of these patients were examined. Results. In the eyes with an acute glaucoma attack, the vascular network was noticeably weakened, especially in the area of the deep peripapillary vascular plexus at the lamina cribrosa level, and focal capillary loss was observed. The peripapillary density of the deep vascular plexus in the eyes with an acute attack was 33.0 ± 5.6 % (М ± m), which was significantly (p < 0.01) lower as compared to 50.0 ± 4.7 % in the unaffected eyes. This indicator correlated with the thickness of the ganglion cell complex (GCC) (p < 0.01). In unaffected eyes, no correlations were found between these glaucoma-related parameters. A significant amount of fibrin/fibrinogen degradation products was found in the tear of glaucoma patients, which may point to a violation of blood circulation in the optic nerve vessels. It has been established that glaucoma attack occurs with increased activity of sympathetic regulation of blood flow. Conclusion. When monitoring this contingent of patients, it is essential to determine the sympathetic-parasympathetic status of the patient. Taking into account the vascular component of the condition, it is expedient to introduce the necessary additions into its treatment plans

2021 ◽  
Vol 18 (4) ◽  
pp. 885-896
Author(s):  
N. A. Bakunina ◽  
L. N. Kolesnikova ◽  
J. M. Salmasi ◽  
L. M. Balashova

Purpose. To study the effectiveness of vascular, anti-inflammatory and fibrinolytic therapy, to conduct a comparative assessment with treatment without vascular therapy in patients with angle-closure (ACG) and mixed glaucoma.Methods. A total of 55 patients with angle-closure and mixed glaucoma, mainly with hypermetropic refraction of varying degrees, were examined: 7 people with acute glaucoma attack, 6 people with subacute glaucoma attack (group 1, with anti-inflammatory treatment), 7 people with acute glaucoma attack and 6 people with subacute glaucoma attack (group 2, with vascular treatment), 14 people with chronic angle-closure glaucoma (group 3) and 15 people with mixed glaucoma (group 4). All patients underwent an ophthalmological examination, which included visometry, refractometry, tonometry, computer perimetry, OCT and OCT angiography, and an ELISA analysis to determine cytokines.Results. The administration of the drug Pentoxifylline as a cytokine blocker and antiplatelet agent in ACG contributed, in our opinion, to an improvement in visual acuity, perimetry (MD), an increase in the density of capillaries of the deep vascular plexus at the level of lamina cribrosa in the peripapillary zone (%), i.e. improved blood circulation in the vessels of the optic nerve disc and also contributed to the blockade of cytokines, mainly in the 2-nd group of patients. In our opinion, a personalized approach to the treatment of ACG is to maintain the improvement of blood circulation in the peripapillary zone by prescribing a course of treatment with Pentoxifylline for 6 months after surgery. After phacoemulsification, there was a significant increase in the density of capillaries of the deep peripapillary vascular plexus at the level of lamina cribrosa (p ≤ 0.05) (51.0 ± 3.5 %), and after further treatment with Pentoxifylline, the capillary density continued to increase in 2–4 groups in the next 6 months of follow-up. The thickness of RNFL (Retinal nerve fiber layer, structural parameter) decreased due to a decrease in edema in 1–2 groups, slightly increased in 3–4 groups, in our opinion, due to improved blood circulation. Increased reperfusion in the capillaries of the deep plexus during normalization of IOP in glaucoma patients and further treatment with pentoxifylline indicates the effectiveness of the proposed treatment in addition to surgical treatment. The results obtained emphasize the advantages of the proposed therapy for the treatment of patients with angle-closure and mixed glaucoma.Conclusion. To date, there are no clear recommendations of vascular therapy for the treatment of patients with ACG and mixed glaucoma, which creates the need for its addition to treatment regimens, taking into account the vascular component of ACG and mixed glaucoma.


2000 ◽  
Vol 278 (4) ◽  
pp. H1269-H1273 ◽  
Author(s):  
Cheryl C. H. Yang ◽  
Te-Chang Chao ◽  
Terry B. J. Kuo ◽  
Chang-Sheng Yin ◽  
Hsing I. Chen

Previous work from our laboratory using heart rate variability (HRV) has demonstrated that women before menopause have a more dominant parasympathetic and less effective sympathetic regulations of heart rate compared with men. Because it is still not clear whether normal or preeclamptic pregnancy coincides with alternations in the autonomic functions, we evaluated the changes of HRV in 17 nonpregnant, 17 normotensive pregnant, and 11 preeclamptic women who were clinically diagnosed without history of diabetic neuropathy, cardiac arrhythmia, and other cardiovascular diseases. Frequency-domain analysis of short-term, stationary R-R intervals was performed to evaluate the total variance, low-frequency power (LF; 0.04–0.15 Hz), high-frequency power (HF; 0.15–0.40 Hz), ratio of LF to HF (LF/HF), and LF in normalized units (LF%). Natural logarithm transformation was applied to variance, LF, HF, and LF/HF for the adjustment of the skewness of distribution. We found that the normal pregnant group had a lower R-R value and HF but had a higher LF/HF and LF% compared with the nonpregnant group. The preeclamptic group had lower HF but higher LF/HF compared with either the normal pregnant or nonpregnant group. Our results suggest that normal pregnancy is associated with a facilitation of sympathetic regulation and an attenuation of parasympathetic influence of heart rate, and such alterations are enhanced in preeclamptic pregnancy.


Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1751
Author(s):  
Annabella Salerni ◽  
Gloria Gambini ◽  
Chiara Fedeli ◽  
Ludovica Paris ◽  
Emanuele Crincoli ◽  
...  

There is no consensus on whether amblyopia affects the retinal vascular plexus and morphology. Previous studies focused on the differences between amblyopic patients and normal controls without evaluating amblyopic eyes after patching. To evaluate differences in the superficial vascular density of amblyopic eyes, normal eyes, and amblyopic eyes reaching normal BCVA after patch therapy, OCTA was used. All patients underwent a comprehensive ophthalmological examination, including visual acuity, refraction, ocular motility tests, and anterior and posterior segment examination. OCTA was performed by an expert physician using the Zeiss Cirrus 5000-HD-OCT Angioplex (Carl Zeiss, Meditec, Inc., Dublin, OH, USA). OCTA scans were performed using a 3 × 3 mm2 and 6 × 6 mm2 fovea-centered image setting. The mean outer macular vessel density in the previously amblyopic group was 19.15 ± 0.51%. This was statistically significantly higher than in both the amblyopic group (18.70 ± 1.14%) and the normal controls (18.18 ± 1.40%) (p = 0.014). The previously amblyopic group also significantly differed from both normal controls and amblyopic eyes with regards to the inner (p = 0.011), outer (p = 0.006), and full (p = 0.003) macular perfusion. Finally, linear regression analysis revealed that BCVA was linearly correlated to outer perfusion in amblyopic (p = 0.003) and ex amblyopic eyes (p < 0.001). Considering the cross-sectional nature of our study, from our results, we can only hypothesize a possible correlation between light stimulation and retinal vasculature development. However, further longitudinal studies are needed to support this hypothesis.


2010 ◽  
Vol 136 (3) ◽  
pp. 247-258 ◽  
Author(s):  
Zhandi Liao ◽  
Dean Lockhead ◽  
Eric D. Larson ◽  
Catherine Proenza

The sympathetic nervous system increases heart rate by activating β adrenergic receptors and increasing cAMP levels in myocytes in the sinoatrial node. The molecular basis for this response is not well understood; however, the cardiac funny current (If) is thought to be among the end effectors for cAMP signaling in sinoatrial myocytes. If is produced by hyperpolarization-activated cyclic nucleotide–sensitive (HCN4) channels, which can be potentiated by direct binding of cAMP to a conserved cyclic nucleotide binding domain in the C terminus of the channels. β adrenergic regulation of If in the sinoatrial node is thought to occur via this direct binding mechanism, independent of phosphorylation. Here, we have investigated whether the cAMP-activated protein kinase (PKA) can also regulate sinoatrial HCN4 channels. We found that inhibition of PKA significantly reduced the ability of β adrenergic agonists to shift the voltage dependence of If in isolated sinoatrial myocytes from mice. PKA also shifted the voltage dependence of activation to more positive potentials for heterologously expressed HCN4 channels. In vitro phosphorylation assays and mass spectrometry revealed that PKA can directly phosphorylate at least 13 sites on HCN4, including at least three residues in the N terminus and at least 10 in the C terminus. Functional analysis of truncated and alanine-substituted HCN4 channels identified a PKA regulatory site in the distal C terminus of HCN4, which is required for PKA modulation of If. Collectively, these data show that native and expressed HCN4 channels can be regulated by PKA, and raise the possibility that this mechanism could contribute to sympathetic regulation of heart rate.


Author(s):  
Divyesh Parmar ◽  
Rishi Mistry ◽  
Yash Kava

The heart rate is one of the significant physiological parameters of the human cardiovascular system. Heart rate is the number of times the heart beats per minute. Heart rate data reflects various physiological states such as biological workload,stress at work and concentration on tasks, drowsiness and the active state of the autonomic nervous system. Human cardiac dynamics are driven by the complex nonlinear interactions of two competing forces: sympathetic regulation increases and parasympathetic regulation decreases the heart rate. Thus,monitoring of heart rate plays a significant role in providing the status of cardiovascular system and clinically correlated information to medical professionals. Heart rate measurement is also regarded as an essential parameter in patient care monitoring system. Heart rate can be measured either by the ECG waveform or by sensing the pulse - the rhythmic expansion and contraction of an artery as blood is forced through it by the regular contractions of the heart. The pulse can be felt from those areas where the artery is close to the skin. This paper highlights on the design of a microcontroller (PIC series) based heart rate counter that is able to capture the pulse from finger tip by sensing the change in blood volume. The heart rates of fifteen healthy normal subjects (students of age 21-22 yrs.) both in relaxed and excited states were measured using the designed device and a standard heart rate measuring device. The outputs of the measured device were satisfactory. Also, the designed device,being noninvasive one, can easily find its place in health care monitoring system.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Inès Ben Ghezala ◽  
Déa Haddad ◽  
Julie Blanc ◽  
Cyril Meillon ◽  
Rachid Madkouri ◽  
...  

Purpose. To evaluate the vessel density (VD) of the radial peripapillary capillary (RPC) network using swept-source optical coherence tomography angiography (SS-OCTA) “en face” images of eyes with chiasmal compression caused by brain tumors before and after decompressive surgery compared with healthy controls. Methods. A cross-sectional study was conducted in 12 patients with chiasmal compression confirmed by neuroimaging. Sixteen healthy participants were also included. All patients with chiasmal compression underwent a neuro-ophthalmological examination one week before and 6 months after brain surgery, including static automated perimetry as well as measurement of the thickness of the retinal nerve fiber layer (RNFL) and the ganglion cell complex (GCC) with spectral-domain optical coherence tomography (SD-OCT). Based on this neuro-ophthalmological examination, the presence of an optic neuropathy (ON) was evaluated. Peripapillary VD was obtained in four sectors on a 6 × 6 mm SS-OCTA image using the Cirrus Plex Elite 9000. Results. Baseline average VD was significantly lower in patients with chiasmal compression and ON than in controls (median: 55.62; interquartile range (IQR): 2.96 vs. 58.53; IQR: 2.02; p = 0.003 ). This decrease was also found in the temporal, superior, and nasal sectors. Average postoperative VD was decreased in patients with chiasmal compression compared with average preoperative VD (median: 56.16; IQR: 4.07 vs. 57.48; IQR: 3.83; p = 0.004 ). Preoperative VD was significantly correlated with RNFL, GCC thickness, and visual field defects. Conclusions. The VD of the RPC network was decreased in chiasmal compressive ON, and it was further decreased at 6 months after decompressive surgery.


Author(s):  
Felix Heine ◽  
Jona F. Schick ◽  
Gabriele E. Lang

Abstract Background OCT angiography (OCT-A) allows non-invasive blood flow registration of the retina and choroid. In contrast to fluorescein angiography (FA), no dye has to be administered. The OCT-A also provides depth-selective information. OCT-A and FA were compared in patients with neovascular age-related macular degeneration (AMD) with retinal angiomatous proliferation (RAP) stage 1. In stage 1, the neovascularizations are intraretinal. In contrast to the two-dimensional total image of the FA, the OCT-A allows a depth-selective display of the individual retinal layers. In this way, a conclusion can be drawn about the place of origin of the RAP. Patients and Methods Three patients with neovascular AMD and RAP stage 1 were included. They were examined with OCT (ZEISS CIRRUS HD-OCT 5000, Carl Zeiss Meditec, Inc., Dublin, USA), OCT-A (ZEISS AngioPlex OCT-Angiography) as well as FA (HRA2, Heidelberg Engineering) between January 2016 and March 2019. A complete ophthalmological examination was performed. A qualitative analysis of the OCT-A images (3 × 3 and 6 × 6 mm) and the FA images was carried out. Leaks in the FA were compared with the en-face images of the OCT-A followed by a depth-selective assignment using the corresponding B-scans of the OCT-A. Results It was one woman and two men aged 66 – 89 years. The visual acuity was 0.4 in the first, 0.5 p in the second and 0.8 in the third patient. The diagnosis of RAP stage 1 could be made both in the OCT, the FA and the OCT-A. All patients showed macular edema in the OCT. The FA showed selective hyperfluorescence in the early phase and fluorescein extravasation in the late phase. In OCT-A, the blood flow in all patients could be shown in the hyperreflective structure of the RAP in the B-scan. The first patient showed two RAP lesions in the FA, which were in the deep vascular plexus in the OCT-A. In the second patient, three RAP lesions were found in the FA, and a total of five RAP lesions in the OCT-A. One could be located in the superficial and deep vascular plexus, four in the deep vascular plexus. The third patient showed one RAP lesion in the FA as well as in the OCT-A, which could be assigned to the superficial vascular plexus. Conclusion The OCT-A is well suited for the diagnosis of RAP stage 1. In the present cases, the diagnosis in the OCT-A could be made as clearly as by FA. A major advantage of the OCT-A results from the non-invasive character and the depth selectivity. The RAP 1 lesions could be assigned to both the superficial and the deep vascular plexus. Depth selection is not possible with the FA due to the summary picture.


2011 ◽  
Vol 1 ◽  
pp. 10-15
Author(s):  
Ashfaq Ahmad ◽  

Myocardial infarction is simply due to decreased supply of oxygen and blood to the particular tissue of heart which ultimately leads to the death of tissue. Naturally heart is quite stable in its involuntary action due to balance between oxygen supply and oxygen demand of the cardiac muscle. when this balance is disturbed by the clot formation(atherosclerosis) in coronary artery or increased demand of oxygen due to increased heart rate then clinical situation arises as tightening of chest,laboured breathing, sweating and radiating pain originating form chest and terminating to left arm and jaws as well. A male of 55 years was hospitalized in one of the most well reputed hospital of Federal area of Pakistan. The patients was nimble due to cold sweating, sever radiating left sided chest pain and was in the state of fear and apprehension.


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