Vascular dysregulation
| The diameter of the blood vessels regulates the local blood flow, which is permanently adjusted to the tissue's needs. If the blood vessels are made wider or narrower than the tissue needs, this is called vascular dysregulation. Such dysregulations can occur in arteries, capillaries and veins. If they are the result of another disorder or disease, then we speak of secondary vascular dysregulation (SVD). Often, however, dysregulations are not the result of other diseases, but are the consequence of a congenital altered form of reaction. In such people, stimuli such as cold or emotional stress can trigger an abnormal vascular response. We then speak of primary vascular dysregulation (PVD). PVD plays a role in many diseases. We focus here on the role of PVD in glaucoma. | |
 J Flammer, IO Haefliger, S Orgül, Th Resink: Vascular Dysregulation: A Principal Risk Factor for Glaucomatous Damage? |
Flammer and coworkers were the first to recognize that vascular dysregulation is common in glaucoma patients and that primary vascular dysregulation (PVD) is a major risk factor for the onset and progression of glaucoma damage, especially in patients with normal tension glaucoma. |
 K Konieczka, S Fränkl: Primary Vascular Dysregulation and Glaucoma |
Konieczka and Fränkl explain pathophysiologically how vascular dysregulation can lead to glaucoma damage. In people with primary vascular dysregulation, the autoregulation of ocular blood flow is disturbed. Thus, fluctuations in intraocular pressure and blood pressure lead to unstable oxygen supply to the eye. This in turn results in an increase in oxidative stress, especially in the mitochondria of the optic nerve head. This leads to a reduction in the energy supply and, in the longer term, to the loss of the axons. |
 J Flammer, K Konieczka AJ Flammer: The primary vascular dysregulation syndrome: implications for eye diseases |
In this review "The primary vascular dysregulation syndrome: implications for eye diseases" Flammer and Konieczka describe in detail and clearly the different aspects of both secondary and primary vascular dysregulation and their consequences, especially for the eye. It is at the same time a summary of the research of this group. In this context, the influences of vascular dysregulation on the blood vessels in the optic nerve head, the optic disc hemorrhages, the activation of astrocytes, the oxidative stress in the mitochondria of the axons are of particular interest. |
 T Binggeli A Schötzau K Konieczka: In glaucoma patients, low blood pressure is accompanied by vascular dysregulation |
Konieczka's research group has shown that there is a relationship between primary vascular dysregulation and arterial hypotension. Both are risk factors for the occurrence and progression of glaucoma damage, especially in normal tension glaucoma. Therefore, in such patients it is difficult to evaluate whether the damage is caused more by the dysregulation or more by the low blood pressure. Therefore, it makes sense to therapeutically address both. |