There were four principal sections to the work:
1. Investigation of ocular and systemic vascular risk factors in POAG.
The principal findings of this work were: a). Glaucoma patients exhibit an anticipatory reaction to the physical stress, similar to subjects at risk for cardiovascular diseases; a blunted BP response and a reduction in ONH blood flow in response to cold provocation was also recorded. b). Silent myocardial ischaemic episodes occurred during peaks in systemic BP and HR. c). Independent of a positive history for cardiovascular diseases, patients suffering from POAG demonstrate a blunt circadian rhythm of the ANS.
2. Assessment of the relationship between vascular and systemic vascular risk factors in GON.
The principal findings of this work were: a). POAG patients demonstrate a high sympathetic tonus over a 24-h period. b). POAG patients with lower OBF demonstrate both 24-h systemic BP and HRV abnormalities. c). OBF alterations observed in some glaucoma patients could be either primary or secondary to systemic haemodynamic disturbances and not a consequence of ONH damage.
3. Assessment of the level of systemic anti-oxidant defence in POAG patients.
The principal finding of this work was: Patients suffering from POAG demonstrated significantly lower GSH and t-GSH levels than normal controls.
4. Investigation of the effect of treatment with latanoprost 0.005% on visual function and OBF.
The findings of this work were: a). Treatment with latanoprost 0.005% resulted in a significant decrease in IOP and increase in OPP. VF damage progression has also been stopped. b). Treatment with latanoprost 0.005% resulted in a significant increase in the OBF parameters measured at the ONH and peripapillary retina levels.
Finally, the importance of a clear protocol for managing new POAG cases is highlighted and a clinical conduit is proposed.
|Date of Award||2004|
|Supervisor||Sarah L Hosking (Supervisor)|
- Autonomic dysfunction
- systemic oxidative stress
- glaucomatous optic neuropathy