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Emer Henry, David E. Newby, David J. Webb, Colm O’Brien; Peripheral Endothelial Dysfunction in Normal Pressure Glaucoma. Invest. Ophthalmol. Vis. Sci. 1999;40(8):1710-1714.
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purpose. To assess vascular endothelial function in patients with normal
pressure glaucoma using forearm blood flow responses to intra-arterial
infusions of endothelial-dependent and -independent vasoactive agents.
methods. Eight patients with newly diagnosed and untreated normal pressure
glaucoma and eight healthy age- and sex-matched control volunteers
underwent measurement of forearm blood flow using venous occlusion
plethysmography. Blood flow was assessed in response to incremental
doses of sodium nitroprusside (an endothelial-independent vasodilator),
acetylcholine (an endothelial-dependent vasodilator) and the
NG-monomethyl-l-arginine (an inhibitor
of nitric oxide synthase).
results. Sodium nitroprusside caused a dose-related increase in forearm blood
flow in patients and controls. Glaucoma patients appeared to have an
increased vasodilatory response, but this was not significant
(P = 0.23). Acetylcholine also induced
vasodilatation in both groups, but the response was significantly
reduced in the glaucoma group (P = 0.04). N G-monomethyl-l-arginine induced
a similar degree of vasoconstriction in both groups
(P = 0.76).
conclusions. This study has shown an impairment of peripheral endothelium-mediated
vasodilatation in normal pressure glaucoma. These findings would
support the concept of a generalized vascular endothelial dysfunction
in patients with this condition.
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