Cerebral Vascular Disease

As discussed in Dr. Fink’s lecture, high blood pressure can result in retinal damage. This retinal damage can present as hemorrhages, exudates, or with a component of papilledema (CP, 145). According to Lilly, this retinal damage produced by hypertension is termed hypertensive retinopathy. More often than not, the retinopathy can be seen on physical exam but is asymptomatic to the patient. However, the clinical presentation can help to further classify the nature of the patient’s hypertension.

Diabetes is associated with an increased risk of developing primarily vascular complications that contribute to morbidity and mortality of diabetic patients. Poor glycaemic control leads to vascular complications that affect large (macrovascular), small (microvascular) vessels or both. Macrovascular complications include coronary heart disease, peripheral vascular disease and stroke. Microvascular complications contribute to diabetic neuropathy (nerve damage), nephropathy (kidney disease) and retinopathy (eye disease).

Age related macular degeneration (AMD) is the leading cause of blindness in people over the age of 50. Every ten years after the age of 50 the prevalence of this disease increases exponentially. Many different factors contribute to the development of AMD including genetic, environment, and metabolic functions. Aside from smoking, abnormal blood pressure, and an unhealthy diet low in fruits and vegetables, many more studies are concluding that similar inflammatory and oxidative processes seen in other age related diseases are also playing a key role in the development of AMD. This disease affects the central areas of the retina and choroid. In return central vision is impaired while peripheral vision is usually not lost. AMD is seen in two different forms, the earlier nonneovascular (dry) type and the more advanced neovascular (wet) type. Each form has its own specific pathology and unique characteristics that set them apart. Fatty, protein deposits called drusens may be the key risk factor in understanding dry AMD pathology, progression, and treatment. Once the more advanced wet AMD is diagnosed, pathology and treatment are targeted around the formation and destruction of abnormal blood vessels, characteristic of the wet AMD eye. The increasing prevalence of AMD has influenced more investigation into what factors can be modulated to prevent the onset or to stop the progression of AMD. This text will discuss the pathology of drusens and the role of inflammation and

The best intervention for early age-related macular degeneration is observation, which includes regular checkups with an optometrist or ophthalmologist. For intermediate age-related macular degeneration it has been found that dietary interventions are successful in slowing the progression to the more severe stages. These interventions include the use of antioxidants, zinc, vitamin C, and vitamin E. It also includes the increased intake of foods like kale, spinach, broccoli, peas, and brussel sprouts because they contain the carotenoid plant pigments lectin and zeaxanthin which aid in protecting the retina and retinal pigment epithelium from light damage. For advanced age-related macular degeneration the most commonly used interventions are anti–vascular endothelial growth factor (VEGF) therapy, photo-dynamic therapy (PDT; with or without intraocular steroids), thermal laser, and submacular and translocation surgery. Low vision aids and observation may by utilized in the geographic atrophy

These changes typically affect small blood vessels in the eye and compromise the blood-retinal barrier. When viewing the retina with the use of an ophthalmoscope or via retinal imaging, haemorrhages appearing as small red spots can be seen which are leaks in the blood vessels. Overtime these tiny leaks within the affected blood vessels create inflammation within the retina. As a result of these inflammatory processes, the retina releases angiogenic factors. Angiogenic factors include the production of new blood vessels within the eye. These new blood vessels don’t have tight junctions and are therefore extremely leaky. If diabetic retinopathy is not treated it can result in severe scarring on the retina which evidently gives reduction in

Peripheral arterial disease is a circulatory problem that causes narrowed arteries to reduce blood flow to your limbs. When you develop this disease, your lower extremities will not receive enough blood flow

The most frequent ocular complications reported for all the AVM groups, are: vascular occlusions, aneurysm formation, intraretinal haemorrhage, exudation and cystoid macular oedema. Furthermore, neovascular glaucoma and open angle glaucoma have been described as a result of a retinal central vein occlusion [1].

Cerebrovascular circulation is the movement of blood through the central veins and arteries supplying the brain. Blood supply to the brain is very important and with the help of four main arteries that is achieved. Those four main arteries consist of the left and right internal carotid arteries and the left and right vertebral arteries. When there is an area of blockage or plaque formation in these vessels then a problem may occur. Carotid artery disease is common and increases the risk of having a stroke. The collateral circulation is an important aspect affecting the risk of stroke. The cerebral circulation will attempt to maintain constant cerebral perfusion even if there are changes within the system. If one major cerebral artery is occluded,

It has been proved that defective autoregulation has relationship with pathologies like diabetes and glaucoma. Autoregulation in the eye is defined as local vascular constriction or dilation causing vascular resistance to reciprocally increase or decrease, so therefore maintaining a constant nutrient supply in response to ocular perfusion pressure changes [Harris1998]. In the situation with increased IOP, varying blood pressure and changes in normal blood flow figure out a result ocular perfusion pressure decreased and local tissue metabolic pressure increased. Deficiency of stable blood flow autoregulation may lead to ischemic damage of the optic nerve and retinal ganglion cells, which likely contributes to further destruction in vascular regulation. These disadvantages of events might be occur retinal ganglion cell death and structural changes of the optic nerve head

. Overview of processes involved ischemic stroke and high potential therapeutic microRNAs. Cerebral ischemia includes several injurious mechanisms (excitotoxicity, oxidative stress, inflammation and apoptosis) to confer neuronal injury. Potential therapeutic areas to compensate these pathogenic process include promoting angiogenesis, neurogenesis and neuroprotection which they are as recovery and repair

Diabetic retinopathy is a leading cause of adult vision loss world-wide that offers a significant diagnostic challenge. The prevalence of DR increases with duration of diabetes [31]. DR is difficult to prevent and treat. Biochemical mechanisms, such as hyperglycemia, are proposed as possible pathogenic factors in DR, while retinal vasodilation and retinal hyperperfusion, related to hypoxia and the release of nitric oxide, may be key initiating factors in early DR developments [32-35]. Hyperperfusion, is associated with impaired vascular autoregulation, which may lead to increased epithelial wall tension and permeability, and subsequent leakage and microaneurysm development [36]. Disturbances are detected in many aspects of ocular circulation

By 2025, it is estimated that 380 million individuals will be diagnosed with diabetes. With that being said, 4 million of them will lose their sight. Diabetic Retinopathy (DR) is the leading cause of blindness in patients ranging from age 20 to age 74. Development and progression of this disease is closely associated with blood pressure, blood glucose, the type and duration of diabetes, and possibly lipids. Although it has been found true that chronic hyperglycemia causes the development and progression of diabetic retinopathy, the mechanism of how the damage is caused is unclear. To further look into the complexity of DR, the disease can be classified as non-proliferative diabetic retinopathy (NPDR), which is

A few causes of peripheral vascular disease include having a family history of the disease, lack of exercise, smoking, poor diet, and high blood pressure.

Rhegmatogenous retinal detachment (RRD) is a major cause of worldwide vision loss with a rate of 0.012% in the US.1 It is associated with retinal breaks, posterior vitreous detachment (PVD), and vitreoretinal traction.2 During a PVD, the posterior vitreous cortex separates from the internal limiting membrane of the retina. Areas of traction exist at sites of strong vitreo-retinal adhesions and may lead to a retinal tear as the vitreous pulls on the retina. RRD occurs when a tear in the retina leads to subretinal fluid accumulation in the space between the neurosensory retina and the underlying retinal pigment epithelium (RPE).2 Symptoms of RRD may include photopsia, floaters, and a “curtain” over the vision. The greatest risk is found in

Diabetic retinopathy is a disease caused by complications of diabetes, which can eventually results to blindness. It is an advanced step of diabetes, a systemic disease, which affects up to 80 percent of all patients who have had diabetes for 10 years or more. From the observation taken from the result statistics, research indicates that at least 90% of these new cases could be reduced if there were proper and vigilant treatment and monitoring of the eyes routinaly. The longer a person has diabetes, the higher his or her chances of developing diabetic retinopathy. In each year in the United States, diabetic retinopathy accounts for 12% of all new cases of blindness. It is found that it is also the leading cause of blindness for people aged 20 to 65 years.