Abstract

SO.15.02

Ocular perfusion and ocular perfusion pressure – a complex interaction

Leopold Schmetterer
Medical University of Vienna, Austria

Reduced ocular perfusion pressure is a riskfactor for the prevalence, incidence and progression of primary open angle glaucoma (POAG). Does this mean that reduced ocular perfusion is a risk factor for POAG? Given that ocular vascular beds are autoregulated, this question is not easy to answer. This means that perfusion can adapt to changes in perfusion pressure. If perfusion pressure is reduced, ocular resistance vessels react with a dilatation, leading to a decrease in vascular resistance. This reduction of vascular resistance guarantees that despite a change of perfusion pressure intact ocular perfusion is granted. In glaucoma patients, there is evidence that this autoregulation is disturbed. Consequently, a reduction of perfusion pressure can well lead to a decrease in blood flow. Recent studies indicate that ocular vessels can better adapt to a change in blood pressure than to a change in intraocular pressure. The consequence of these findings for our understanding of impaired perfusion in the pathopyhsiology of POAG will be discussed.

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