臨床眼科74巻1号

2020年01月発行

連載 今月の話題

緑内障における眼血流改善治療の可能性

著者： 清田直樹¹ 中澤徹¹

所属機関： ¹東北大学医学部眼科学教室

ページ範囲：P.6 - P.12

　緑内障は多因子疾患であり，血流障害は眼圧上昇以外の危険因子であると考えられている。本稿では，まず眼血流障害が緑内障進行のリスクである可能性について概説し，さらに一歩進んで血流改善治療が緑内障診療にもたらす可能性について述べたい。

参考文献

1）Konieczka K, Ritch R, Traverso CE et al：Flammer syndrome. EPMA J 5：11, 2014

2）Nakazawa T：Ocular blood flow and influencing factors for glaucoma. Asia Pac J Ophthalmol（Philadelphia, Pa） 5：38-44, 2016

3）Cull G, Told R, Burgoyne CF et al：Compromised optic nerve blood flow and autoregulation secondary to neural degeneration. Investig Ophthalmol Vis Sci 56：7286-7292, 2015

4）Costa VP, Harris A, Anderson D et al：Ocular perfusion pressure in glaucoma. Acta Ophthalmol 92：e252-e266, 2014

5）Shiga Y, Aizawa N, Tsuda S et al：Preperimetric Glaucoma Prospective Study（PPGPS）：Predicting visual field progression with basal optic nerve head blood flow in normotensive PPG eyes. Transl Vis Sci Technol 7：11, 2018

6）Kiyota N, Shiga Y, Yasuda M et al：Sectoral differences in the association of optic nerve head blood flow and glaucomatous visual field defect severity and progression. Invest Ophthalmol Vis Sci 60：2650-2658, 2019

7）Kiyota N, Shiga Y, Ichinohasama K et al：The impact of intraocular pressure elevation on optic nerve head and choroidal blood flow. Invest Ophthalmol Vis Sci 59：3488-3496, 2018

8）Takeshima S, Higashide T, Kimura M et al：Effects of trabeculectomy on waveform changes of laser speckle flowgraphy in open angle glaucoma. Invest Ophthalmol Vis Sci 60：677-684, 2019

9）Aizawa N, Kunikata H, Nitta F et al：Age- and sex-dependency of laser speckle flowgraphy measurements of optic nerve vessel microcirculation. PLoS One 11：1-11, 2016

10）Yamamoto T, Niwa Y, Kawakami H et al：The effect of nilvadipine, a calcium-channel blocker, on the hemodynamics of retrobulbar vessels in normal-tension glaucoma. J Glaucoma 7：301-305, 1998

11）Niwa Y, Yamamoto T, Harris A et al：Relationship between the effect of carbon dioxide inhalation or nilvadipine on orbital blood flow in normal-tension glaucoma. J Glaucoma 9：262-267, 2000

12）Huemer KH, Zawinka C, Garhöfer G et al：Effects of dopamine on retinal and choroidal blood flow parameters in humans. Br J Ophthalmol 91：1194-1198, 2007

13）Reitsamer HA, Zawinka C, Branka M：Dopaminergic vasodilation choroidal circulation by D1/D5 receptor activation. Invest Ophthalmol Vis Sci 45：900-905, 2004

. Int J Ophthalmol 11：719-725, 2018

15）Siesky B, Harris A, Brizendine E et al：Literature review and meta-analysis of topical carbonic anhydrase inhibitors and ocular blood flow. Surv Ophthalmol 54：33-46, 2009

16）Polak K, Wimpissinger B, Berisha F et al：Effects of sildenafil on retinal blood flow and flicker-induced retinal vasodilatation in healthy subjects. Invest Ophthalmol Vis Sci 44：4872-4876, 2003

17）Schmetterer L, Polak K：Role of nitric oxide in the control of ocular blood flow. Prog Retin Eye Res 20：823-847, 2001

18）Harris-Yitzhak M, Harris A, Ben-Refael Z et al：Estrogen-replacement therapy：Effects on retrobulbar hemodynamics. Am J Ophthalmol 129：623-628, 2000

19）Belfort MA, Saade GR, Snabes M et al：Hormonal status affects the reactivity of the cerebral vasculature. Am J Obstet Gynecol 172：1273-1278, 1995

20）Polak K, Luksch A, Frank B et al：Regulation of human retinal blood flow by endothelin-1. Exp Eye Res 76：633-640, 2003

21）Resch H, Karl K, Weigert G et al：Effect of dual endothelin receptor blockade on ocular blood flow in patients with glaucoma and healthy subjects. Invest Ophthalmol Vis Sci 50：358-363, 2009

22）Kurashima H, Watabe H, Sato N et al：Effects of prostaglandin F（2α）analogues on endothelin-1-induced impairment of rabbit ocular blood flow：comparison among tafluprost, travoprost, and latanoprost. Exp Eye Res 91：853-859, 2010

23）Polska E, Ehrlich P, Luksch A et al：Effects of adenosine on intraocular pressure, optic nerve head blood flow, and choroidal blood flow in healthy humans. Invest Ophthalmol Vis Sci 44：3110-3114, 2003

24）Portellos M, Riva CE, Cranstoun SD et al：Effects of adenosine on ocular blood flow. Invest Ophthalmol Vis Sci 36：1904-1909, 1995

25）Sugiyama T, Nakamura H：Increased short-term fluctuation in optic nerve head blood flow in a case of normal-tension glaucoma by the use of laser speckle flowgraphy. Vision doi：10. 3390/vision1010005, 2016

26）Yamaguchi T, Nagano H, Yamaguchi M et al：The effects of kallidinogenase on choroidal blood flow in a hypertensive rabbit model. Curr Eye Res 18：417-422, 1999

27）Suh MH, Zangwill LM, Manalastas PI et al：Deep retinal layer microvasculature dropout detected by the optical coherence tomography angiography in glaucoma. Ophthalmology 123：2509-2518, 2016

28）Kiyota N, Kunikata H, Takahashi S et al：Factors associated with deep circulation in the peripapillary chorioretinal atrophy zone in normal-tension glaucoma with myopic disc. Acta Ophthalmol 96：e290-e297, 2018

29）Shinmei Y, Nitta T, Saito H et al：Continuous intraocular pressure monitoring during nocturnal sleep in patients with obstructive sleep apnea syndrome. Invest Opthalmol Vis Sci 57：2824-2830, 2016

30）Lotfi K, Grunwald JE：The effect of caffeine on the human macular circulation. Invest Ophthalmol Vis Sci 32：3028-3032, 1991

31）Steigerwalt RD, Laurora G, Incandela L et al：Ocular and orbital blood flow in cigarette smokers. Retina 20：394-397, 2000

32）Okuno T, Sugiyama T, Kohyama M et al：Ocular blood flow changes after dynamic exercise in humans. Eye 20：796-800, 2006