Systemic dysfunction in glaucoma

The most important risk factors for the development of glaucoma is increased intraocular pressure. There is, however, evidence that systemic facts pay a role as well. As such it has been shown that patients with primary open angle glaucoma show signs of endothelial dysfunction as well as signs of systemic autonomic dysfunction. The latter is supported by data showing abnormal heart rate variability in glaucoma, particularly in normal tension glaucoma. In addition, studies have shown that glaucoma patients exhibit an abnormal systemic and ocular vascular response to warm-cold stimulation. The consequences of systemic autonomic dysfunction in glaucoma may be wide including abnormal diurnal fluctuations of intraocular pressure, blood pressure and ocular blood flow.