About this book
- Decisive guidance on the practical aspects for early diagnosis and treatment of ocular and cerebral diseases for clinicians in ophthalmology, neurology, medicine, optometry and geriatrics
- Brings together 50 years of research on the physiology of intraocular pressure, ocular blood flow and their relation to early diagnosis and therapy of vascular diseases of the eye and brain
- Presents evidence that ischemia and loss of autoregulation of blood flow are associated with the onset of the major ocular and cerebral diseases including macular degeneration, diabetic retinopathy, low and normal tension open angle glaucoma, stroke and Alzheimer’s disease
Ischemia and Loss of Vascular Autoregulation in Ocular and Cerebral Diseases: A New Perspective presents evidence that ischemia and loss of autoregulation of blood flow are associated with the onset of the major ocular and cerebral diseases including macular degeneration, diabetic retinopathy, low and normal tension open angle glaucoma, stroke and Alzheimer’s disease. Recognition of these vascular changes underline the critical need for clinicians to monitor blood flow and autoregulation to improve early diagnosis and to optimize therapies of ocular and cerebral vascular diseases. The text brings to clinicians in Ophthalmology, Neurology, Medicine, Optometry and Geriatrics decisive guidance on the practical aspects for early diagnosis and treatment of ocular and cerebral diseases.
The author brings together in a concise form the progress made over the span of his career and provides new perspectives and understanding of the fluid circulations of the eye and the brain. In addition, he explains the new analytical technologies that made the new concepts possible. The physiological and functional importance of blood flow autoregulation in the eye and in the brain in minimizing the progression of pathology, including the ischemia resulting from stenosis of the internal carotid artery and stroke, are also presented .
ABOUT THE AUTHOR: Dr. Langham was born in London, England. In 1947, he joined the Ophthalmological Research Unit, newly formed by the Medical Research Council of the United Kingdom under the direction of Sir Stewart Duke-Elder. In 1956, the author enjoyed a research fellowship at Harvard University. After returning to England for a time, he accepted a position of Associate Professor of Ophthalmology and Director of Research at the Wilmer Ophthalmological Institute of the Johns Hopkins Hospital and Medical school in 1959. There he initiated a program in which all residents spent time engaged in research. This productive interaction between the disciplines led to many important clinical diagnostic and therapeutic advances.
Ophthalmologists, ophthalmology residents and fellows, clinical neurologists, neuroscientists, vision researchers, and vascular medicine investigators
cerebrovascular blood flow
Table of contents
“In vivo” manometric measurements of the steady state Intraocular pressure and the IOP pulse in animals and man.- The rate of formation of the aqueous humor.- The steady state IOP/flow relations in dead and living animal and human eyes.- Homeostasis, autoregulation and relative ischemia.- The pressure/volume relation in eyes of dead and living animal and human eyes.- The ocular perfusion pressure and its influence on the IOP pulse.- Direct and indirect measurements of ocular blood flow in anesthetized and conscious animals and humans.- The morphology and hydrodynamics of the chamber angle.- The sympathetic nerve innervation of the eye and the actions of the adrenergic transmitter norepinephrine on IOP and ocular blood flow.- Manometric studies on the IOP and the vascular circulation in ophthalmic disease.- Indirect measurements of the IOP and the IOP pulse.- The effect of posture and corneal thickness on the IOP.- The Langham analogue and digitized pneumatic tonometers.- The calibration of the IOP and the IOP pulse using the Langham pneumatic tonometer.- The theory of the Langham tonometer.- The IOP/pulse amplitude relation in healthy animal and human eyes.- The IOP/PA relation and loss of autoregulation in ocular diseases including open angle glaucoma, low tension glaucoma, age related macular degeneration, diabetic retinopathy, and occlusion of the central retinal vein.- Autoregulation of the IOP and the ocular blood flow.- The evaluation of ocular ischemia and the loss of autoregulation for the early detection of ocular vascular diseases.- The action of ocular hypotensive drugs on ocular blood flow and on the IOP/PA relation.- The confluence and integration of therapies based on modulation of the IOP and ocular blood flow.- Longitudinal therapeutic studies.- The ophthalmic arterial pressure, the IOP/PA relations, and their association to the ocular and cerebral circulations.- Opthalmodynamometry.- Autoregulation of the IOP and blood flow in the human eye.- Objective measurements of the diastolic and systolic ophthalmic arterial pressures in man.- The ophthalmic arterial pressure in healthy subjects.- The relation between the ophthalmic arterial pressure and the IOP/PA relation.- Modulation of the IOP/PA relation in subjects with stenosis of the internal carotid artery.- Alzheimer’s disease and the eye.- The ocular perfusion pressure and the visual threshold.- Concepts and new perspectives.- References.