Vascular dysregulation: A principal risk factor for glaucomatous damage?

Both intraocular pressure (IOP) and vascular factors appear to play an impo rtant role in the pathogenesis of glaucomatous optic neuropathy (GON). Arte riosclerosis and its risk factors are of minor importance, whereas vasospas tic syndrome clearly is associated with GON. A vascular endotheliopathy see ms to be involved in the diathetic hyperresponsiveness to stimuli, such as coldness or emotional stress. This in turn leads to a compromised autoregul ation, and thereby renders the eye more sensitive to IOP or to a decrease i n blood pressure. A variation in ocular perfusion may lend to an increase i n free oxygen radicals. This may finally lead to apoptosis.