El glaucoma is a multifactorial disease that produces a optic neuropathy progressive and chronic in adults, with characteristic damage to the fibers of the optic nerve and associated with a loss of campor visual.

It is the biggest cause of irreversible blindness in the world

Although the High intraocular pressure is the most common risk factor and the only one modifiable for POAG (Primary Open Angle Glaucoma), there are many other factors that can contribute to optic nerve damage or the progression of the disease.

glaucoma and heart attack

Glaucoma and eye pressure

La Intraocular pressure greater than 22 mmHg is an important but not the only factor in this disease. Age, excavation of the optic nerve, myopia, central corneal thickness, black race and family history are other factors involved in the genesis of glaucomatous damage. Even reducing intraocular pressure by up to 25%, half of patients may experience disease progression. For this reason, great importance is being given to the vascular factors that compromise blood flow, cause optic nerve ischemia and contribute to optic nerve damage: migraine, Raynaud's phenomenon, diabetes, ischemic heart disease, and cerebrovascular disease.

Independently or jointly with the IOP (intraocular pressure), other factors can individually or collectively contribute to the death of ganglion cells of the retina and nerve fibers. The retina depends on the blood supply to cover its high metabolic needs, in this way the situations of local ischemia and hypoxia due to the dysfunction of the autoregulation of the blood flow, have come to be implicated as one of those factors of production of glaucoma. The ischemic theory suggests that axonal loss in glaucoma is predominantly a result of ischemia. It is thought that elevated IOP compromises optic nerve head perfusion, causing ischemic damage, with the consequent activation of programmed cell death (apoptosis).

Glaucoma and endothelium

Arteriolar circulation depends on a balance between endothelial vasodilators, mainly nitric oxide, and vasoconstrictors, of which endothelin is the most potent. In POAG, it has been shown that there is an increase in endothelins and a decrease in nitric oxide levels, which leads to vasoconstriction. Abnormal coagulation with increased blood viscosity has also been shown, in fact a dysfunction of the vascular endothelium may be primarily responsible for a defect in autoregulation leading to increased vascular resistance and ischemia.

A hypothetical cause may be insufficiency of ocular blood flow which leads the optic nerve ischemia and the consequent glaucomatous optic neuropathy.

Based on this vascular theory of POAG, they have been carried out. Extensive epidemiological studies to investigate the relationship between cardiovascular conditions and glaucoma.

In 1920, the glaucomatous eye was already referred to as "a sick eye in a sick body."

In 2013 Flammer J and Flammer Aj already commented on the concept that vascular changes in the eye can be an early indicator of heart disease since the two organs share common characteristics and are exposed to the same intrinsic and environmental influences. In addition, patients with POAG were found to have features of arteriosclerosis, autonomic dysfunction, and dysfunction. endothelial that produce decreased ocular flow.

These characteristics can also influence the vascularization of the heart and decrease blood flow to the myocardium, inducing ischemic heart disease.

For this reason, we hypothesized that the incidence of MI could be higher in patients with POAG. Previous studies, using Holter ECG 24.0h, found in patients with POAG a higher incidence of silent myocardial ischemia and significant asymptomatic depressions of the ST-T segment.

So perhaps the function of the autonomic nervous system in patients with POAG is different from that of healthy subjects.

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Glaucoma and heart attack
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Glaucoma and heart attack
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Does glaucoma and infarction have a relationship? If you are asking this question do not hesitate to enter here to inform you of the relationship they have and how it affects.
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Área Oftalmológica Avanzada
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