[The correlation between general arterial pressure and intraocular pressure].
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Bilateral recordings with the applanating suction cup tonograph on eyes of 85 persons with and without glaucoma show that the intraocular pressure pulse amplitudes (IOPA) increase in size with the intraocular pressure (IOP) from an average of 1.85 mmHg at 12 mmHg IOP to 4.8 mmHg at 37 mmHg IOP. This relation resembles the one found between IOP increments and IOP by the injection of 157 equal volumes of saline into 10 eyes of human cadavers. The resemblance indicates that the IOPA versus IOP relation of the live eyes in all essentials is explained by systolic net equal-volume inputs of blood into eyes with elastic properties determined by the cornea and sclera. --IOPA are of equal size in eyes with and without glaucomatous cups and visual field defects. Since IOPA are produced mainly by volume changes in the choroid, it is concluded that the choroid is not among the tissues undergoing a general pressure atrophy in the glaucoma (cases of absolute glaucoma were not studied).
In our long term evaluation of patients with Hansen's disease we have frequently found reduction of their intraocular pressure. Furthermore, we noted changes in their intraocular pressure on change of posture. To determine if these changes have any significance we measured the intraocular pressures of 24 experimentally infected and 39 control monkeys in both sitting and reclining positions. We found significant reduction of intraocular pressure in 66.7% compared with controls in the sitting position, and a significant increase in intraocular pressure in 79% when checked first in the sitting then in the reclining position. We offer a possible pathophysiological explanation as to why the changes occur.
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The pathogenesis of neovascular glaucoma is summarized. Elevation of intraocular pressure is mostly associated with mechanical obstruction of the anterior chamber angle by the fibrovascular membrane, as well as with an enhanced ultrafiltration from the newly formed vessels. Drug therapy is insufficient. Standard filtering surgery is unsatisfactory with regard to the control of intraocular pressure and hemorrhagic complications. The drainage implants appear to be promising. Panretinal photocoagulation is unfavorable due to turbidity of the optical media. Favorable therapeutical results were achieved with cryosurgical techniques, namely panretinal cryocoagulation, combined with cyclocryocoagulation. Cyclocryocoagulation alone accounts for a high percentage of complications and therapeutical results are not convincing.
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