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IV Glybina, IV Zapuskalov; Toward Ocular Hypotony: Pathogenesisin Ciliochoroidal Detachment . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3284.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To study the pathogenesis of ocular hypotony in patients with ciliochoroidal detachment. Methods: Tonography, vasotonometry, photocalibrometry of episcleral vessels, registration of central retinal vein and central retinal artery pulsations together with electrocardiography, color Doppler imaging, ultrasonography of eyeball and development of mathematic model of intraocular fluid secretion were used to assess ocular hemodynamics in norm and in ciliochoroidal detachment. Ocular hemodynamics of patients with ciliochoroidal detachment was compared with ocular hemodynamics of healthy volunteers. Results: In normal eyes in the systole phase of cardiac cycle venous vessels lumen at certain level is closed, and venous blood flow is blocked. Ocular veins are squeezed at the level they leave eyeball: junction of superior and inferior branches of central retinal vein, ampules of vortex veins. In the diastole phase of cardiac cycle venous vessels lumen is open, and venous outflow is resumed. In all cases of ciliochoroidal detachment we observed the decrease of the rate of intraocular fluid secretion, hypertension and venostasis in episcleral veins system, disappearing of vortex veins pulsation. Conclusion: Systaltic blood flow in vortex veins maintains high pressure in the capillaries of ciliary body. In ciliochoroidal detachment the mechanism of periodical squeezing of vortex veins ampules is destroyed, that leads to lowering of capillary pressure in ciliary body and decrease of intraocular fluid secretion. Thus, main direction in the treatment of ciliochoroidal detachment should be manipulations for re-establishment of vortex veins ampules systole pressing between choroid and sclera.
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