Support for the vasogenic theory of glaucoma: case reports and literature review.

BACKGROUND

The influence of systemic disease, vascular abnormalities, hematologic and rheologic factors, pulsatile ocular blood flow, perfusion pressure, autoregulation, optic disc hemorrhage and the results of optic nervehead fluorescein angiographic studies are reviewed in the context of supporting evidence for the vasogenic theory of glaucoma.

METHODS

Two case reports of patients with confirmed carotid artery occlusive disease and one case report of a patient with a history of hypovolemic blood loss are presented.

RESULTS

These cases illustrate the importance of hypotensive crisis, perfusion pressure, collateral blood flow and the optic nerve head vascular autoregulatory mechanism in the pathogenesis of glaucoma and the differential diagnosis of pseudoglaucoma.

CONCLUSIONS

Evaluation and consideration of both mechanical and vasogenic causes of the glaucomas is essential in the management of the glaucomas. It is also necessary to differential diagnose the "pseudo-glaucomas," and to manage them correctly.