青光眼与神经心理
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摘要
青光眼视力丢失常在患者日常生活中引发诸如人脸识别障碍、阅读困难、行动不便等严重后果。尤其当视力丢失不可逆,同时患者经受持续的心理压力如担忧、焦虑、恐惧时会引发抑郁症和社交孤立。而持续的心理压力和升高的皮质醇水平引起自主神经系统(交感神经)失衡、血管调节异常进而对眼和大脑造成不良影响。因此,心理压力可能也是青光眼视神经病变的一个重要病因。本文的目的是理清青光眼视力丧失与神经心理之间的关系。
Loss of vision due to retinal, optic or brain damage leads to serious consequences in patients' daily life, such as facial recognition disorders, reading difficulties, and mobility problems. Because vision loss is irreversible and progressive, patients experience sustained mental stress such as worry, anxiety and fear that can lead to depression and social isolation. In fact, sustained stress and elevated cortisol level cause an imbalance in the autonomic nervous system(sympathetic) and abnormal vascular regulation, which can negatively affect the eyes and brain. Therefore, stress may also be a major cause of visual system diseases such as glaucoma and neuropathy. Although stress is a known risk factor, its pathogenic role in the occurrence and progression of visual system diseases has not been widely recognized. This review is to clarify the relationship between glaucoma visual loss and neuropsychology.
Loss of vision due to retinal, optic or brain damage leads to serious consequences in patients' daily life, such as facial recognition disorders, reading difficulties, and mobility problems. Because vision loss is irreversible and progressive, patients experience sustained mental stress such as worry, anxiety and fear that can lead to depression and social isolation. In fact, sustained stress and elevated cortisol level cause an imbalance in the autonomic nervous system(sympathetic) and abnormal vascular regulation, which can negatively affect the eyes and brain. Therefore, stress may also be a major cause of visual system diseases such as glaucoma and neuropathy. Although stress is a known risk factor, its pathogenic role in the occurrence and progression of visual system diseases has not been widely recognized. This review is to clarify the relationship between glaucoma visual loss and neuropsychology.
引文
1 Flammer J,Mozaffarieh M.What is the present pathogenetic concept of glaucomatous optic neuropathy?[J].Surv Ophthalmol,2007,52(Suppl 2):S162-S173.
2 Sabel BA,Gudlin J.Vision restoration training for glaucoma:a randomized clinical trial[J].JAMA Ophthalmol,2014,132(4):381-389.
3 Tang YY,Holzel BK,Posner MI.The neuroscience of mindfulness meditation[J].Nat Rev Neurosci,2015,16(4):213-225.
4 Tham YC,Li X,Wong TY,et al.Global prevalence of glaucoma and projections of glaucoma burden through 2040:a systematic review and meta-analysis[J].Ophthalmology,2014,121(11):2081-2090.
5 Nageeb N,Kulkarni UD.Glaucoma Awareness and Self-Care Practices among the Health Professionals in a Medical College Hospital[J].J Clin Diagn Res,2015,9(12):NC01-NC04.
6 Van Nispen RM,Vreeken HL,Comijs HC,et al.Role of vision loss,functional limitations and the supporting network in depression in a general population[J].Acta Ophthalmol,2016,94(1):76-82.
7 Lim NC,Fan CH,Yong MK,et al.Assessment of Depression,Anxiety,and Quality of Life in Singaporean Patients With Glaucoma[J].J Glaucoma,2016,25(7):605-612.
8 Rozanski C,Haythornthwaite JA,Dagnelie G,et al.Applying theories and interventions from behavioral medicine to understand and reduce visual field variability in patients with vision loss[J].Med Hypotheses,2014,83(2):190-195.
9 Bechetoille A,Arnould B,Bron A,et al.Measurement of healthrelated quality of life with glaucoma:validation of the Glau-QoL 36-item questionnaire[J].Acta Ophthalmol,2008,86(1):71-80.
10 Bramley T,Peeples P,Walt JG,et al.Impact of vision loss on costs and outcomes in medicare beneficiaries with glaucoma[J].Arch Ophthalmol,2008,126(6):849-856.
11 Kong XM,Zhu WQ,Hong JX,et al.Is glaucoma comprehension associated with psychological disturbance and vision-related quality of life for patients with glaucoma?A cross-sectional study[J].BMJOpen,2014,4(5):e004632.
12 Jeong AR,Kim CY,Kang MH,et al.Psychological Aspects of Glaucoma[J].J Nerv Ment Dis,2016,204(3):217-220.
13 Diniz-Filho A,Abe RY,Cho HJ,et al.Fast Visual Field Progression Is Associated with Depressive Symptoms in Patients with Glaucoma[J].Ophthalmology,2016,123(4):754-759.
14 Sabel BA,Wang J,Cardenas-Morales L,et al.Mental stress as consequence and cause of vision loss:the dawn of psychosomatic ophthalmology for preventive and personalized medicine[J].Epma j,2018,9(2):133-160.
15 Kong X,Yan M,Sun X,et al.Anxiety and Depression are More Prevalent in Primary Angle Closure Glaucoma Than in Primary OpenAngle Glaucoma[J].J Glaucoma,2015,24(5):e57-63.
16 Flammer J,Konieczka K,Bruno RM,et al.The eye and the heart[J].Eur Heart J,2013,34(17):1270-1278.
17 Flammer J,Konieczka K,Flammer AJ.The primary vascular dysregulation syndrome:implications for eye diseases[J].Epma j,2013,4(1):14.
18 Flammer J.Glaucomatous optic neuropathy:a reperfusion injury[J].Klin Monbl Augenheilkd,2001,218(5):290-291.
19 Wang J,Li T,Sabel BA,et al.Structural brain alterations in primary open angle glaucoma:a 3T MRI study[J].Sci Rep,2016,6:18969.
20 Faiq MA,Dada R,Kumar A,et al.Brain:The Potential Diagnostic and Therapeutic Target for Glaucoma[J].CNS Neurol Disord Drug Targets,2016,15(7):839-844.
21 Gupta N,Yucel YH.Glaucoma as a neurodegenerative disease[J].Curr Opin Ophthalmol,2007,18(2):110-114.
22 Sena DF,Lindsley K.Neuroprotection for treatment of glaucoma in adults[J/CD].Cochrane Database Syst Rev,2017,1:CD006539.
23 Gupta N,Yucel YH.What changes can we expect in the brain of glaucoma patients?[J].Surv Ophthalmol,2007,52(Suppl 2):S122-S126.
24 Torriglia A,Valamanesh F,Behar-Cohen F.On the retinal toxicity of intraocular glucocorticoids[J].Biochem Pharmacol,2010,80(12):1878-1886.
25 Ventura LM.Psychoneuroimmunology:application to ocular diseases[J].J Ocul Biol Dis Infor,2009,2(2):84-93.
26 Mabuchi F,Yoshimura K,Kashiwagi K,et al.Risk factors for anxiety and depression in patients with glaucoma[J].Br JOphthalmol,2012,96(6):821-825.
27 Pop-Jordanova N,Ristova J,Loleska S.Depression in ophthalmological patients[J].Pril(Makedon Akad Nauk Umet Odd Med Nauki),2014,35(2):53-58.
28 Konieczka K,Choi HJ,Koch S,et al.Relationship between normal tension glaucoma and Flammer syndrome[J].EPMA J,2017,8(2):111-117.
29 Konieczka K,Koch S,Binggeli T,et al.Multiple sclerosis and primary vascular dysregulation(Flammer syndrome)[J].EPMA J,2016,7:13.
30 Grieshaber MC,Mozaffarieh M,Flammer J.What is the link between vascular dysregulation and glaucoma?[J].Surv Ophthalmol,2007,52(Suppl 2):S144-S154.
31 Schmetterer L,Polak K.Role of nitric oxide in the control of ocular blood flow[J].Prog Retin Eye Res,2001,20(6):823-847.
32 Kurysheva NI,Tomilova IK,Kadykova EL,et al.Nitrogen oxide in the pathogenesis of glaucoma and cataract[J].Vestn Oftalmol,2001,117(5):34-37.
33 Bola M,Gall C,Moewes C,et al.Brain functional connectivity network breakdown and restoration in blindness[J].Neurology,2014,83(6):542-551.
34 Lim SA,Siatkowski RM,Farris BK.Functional visual loss in adults and children patient characteristics,management,and outcomes[J].Ophthalmology,2005,112(10):1821-1828.
35 Raison CL,Miller AH.When not enough is too much:the role of insufficient glucocorticoid signaling in the pathophysiology of stressrelated disorders[J].Am J Psychiatry,2003,160(9):1554-1565.
36 Rosenkranz MA,Lutz A,Perlman DM,et al.Reduced stress and inflammatory responsiveness in experienced meditators compared to a matched healthy control group[J].Psychoneuroendocrinology,2016,68:117-125.
37 Iwata M,Ota KT,Li XY,et al.Psychological Stress Activates the Inflammasome via Release of Adenosine Triphosphate and Stimulation of the Purinergic Type 2X7 Receptor[J].Biol Psychiatry,2016,80(1):12-22.
38 Madrigal JL,Moro MA,Lizasoain I,et al.Stress-induced increase in extracellular sucrose space in rats is mediated by nitric oxide[J].Brain Res,2002,938(1-2):87-91.
39 Konieczka K,Ritch R,Traverso CE,et al.Flammer syndrome[J].EPMA J,2014,5(1):11.
40 Bojinova RI,Konieczka K,Todorova MG.Unilateral Loss of Vision after Spinal Surgery in a Patient with Flammer Syndrome[J].Klin Monbl Augenheilkd,2016,233(4):429-431.
41 Konieczka K,Frankl S,Todorova MG,et al.Unstable oxygen supply and glaucoma[J].Klin Monbl Augenheilkd,2014,231(2):121-126.
42 Mozaffarieh M,Flammer J.New insights in the pathogenesis and treatment of normal tension glaucoma[J].Curr Opin Pharmacol,2013,13(1):43-49.
2 Sabel BA,Gudlin J.Vision restoration training for glaucoma:a randomized clinical trial[J].JAMA Ophthalmol,2014,132(4):381-389.
3 Tang YY,Holzel BK,Posner MI.The neuroscience of mindfulness meditation[J].Nat Rev Neurosci,2015,16(4):213-225.
4 Tham YC,Li X,Wong TY,et al.Global prevalence of glaucoma and projections of glaucoma burden through 2040:a systematic review and meta-analysis[J].Ophthalmology,2014,121(11):2081-2090.
5 Nageeb N,Kulkarni UD.Glaucoma Awareness and Self-Care Practices among the Health Professionals in a Medical College Hospital[J].J Clin Diagn Res,2015,9(12):NC01-NC04.
6 Van Nispen RM,Vreeken HL,Comijs HC,et al.Role of vision loss,functional limitations and the supporting network in depression in a general population[J].Acta Ophthalmol,2016,94(1):76-82.
7 Lim NC,Fan CH,Yong MK,et al.Assessment of Depression,Anxiety,and Quality of Life in Singaporean Patients With Glaucoma[J].J Glaucoma,2016,25(7):605-612.
8 Rozanski C,Haythornthwaite JA,Dagnelie G,et al.Applying theories and interventions from behavioral medicine to understand and reduce visual field variability in patients with vision loss[J].Med Hypotheses,2014,83(2):190-195.
9 Bechetoille A,Arnould B,Bron A,et al.Measurement of healthrelated quality of life with glaucoma:validation of the Glau-QoL 36-item questionnaire[J].Acta Ophthalmol,2008,86(1):71-80.
10 Bramley T,Peeples P,Walt JG,et al.Impact of vision loss on costs and outcomes in medicare beneficiaries with glaucoma[J].Arch Ophthalmol,2008,126(6):849-856.
11 Kong XM,Zhu WQ,Hong JX,et al.Is glaucoma comprehension associated with psychological disturbance and vision-related quality of life for patients with glaucoma?A cross-sectional study[J].BMJOpen,2014,4(5):e004632.
12 Jeong AR,Kim CY,Kang MH,et al.Psychological Aspects of Glaucoma[J].J Nerv Ment Dis,2016,204(3):217-220.
13 Diniz-Filho A,Abe RY,Cho HJ,et al.Fast Visual Field Progression Is Associated with Depressive Symptoms in Patients with Glaucoma[J].Ophthalmology,2016,123(4):754-759.
14 Sabel BA,Wang J,Cardenas-Morales L,et al.Mental stress as consequence and cause of vision loss:the dawn of psychosomatic ophthalmology for preventive and personalized medicine[J].Epma j,2018,9(2):133-160.
15 Kong X,Yan M,Sun X,et al.Anxiety and Depression are More Prevalent in Primary Angle Closure Glaucoma Than in Primary OpenAngle Glaucoma[J].J Glaucoma,2015,24(5):e57-63.
16 Flammer J,Konieczka K,Bruno RM,et al.The eye and the heart[J].Eur Heart J,2013,34(17):1270-1278.
17 Flammer J,Konieczka K,Flammer AJ.The primary vascular dysregulation syndrome:implications for eye diseases[J].Epma j,2013,4(1):14.
18 Flammer J.Glaucomatous optic neuropathy:a reperfusion injury[J].Klin Monbl Augenheilkd,2001,218(5):290-291.
19 Wang J,Li T,Sabel BA,et al.Structural brain alterations in primary open angle glaucoma:a 3T MRI study[J].Sci Rep,2016,6:18969.
20 Faiq MA,Dada R,Kumar A,et al.Brain:The Potential Diagnostic and Therapeutic Target for Glaucoma[J].CNS Neurol Disord Drug Targets,2016,15(7):839-844.
21 Gupta N,Yucel YH.Glaucoma as a neurodegenerative disease[J].Curr Opin Ophthalmol,2007,18(2):110-114.
22 Sena DF,Lindsley K.Neuroprotection for treatment of glaucoma in adults[J/CD].Cochrane Database Syst Rev,2017,1:CD006539.
23 Gupta N,Yucel YH.What changes can we expect in the brain of glaucoma patients?[J].Surv Ophthalmol,2007,52(Suppl 2):S122-S126.
24 Torriglia A,Valamanesh F,Behar-Cohen F.On the retinal toxicity of intraocular glucocorticoids[J].Biochem Pharmacol,2010,80(12):1878-1886.
25 Ventura LM.Psychoneuroimmunology:application to ocular diseases[J].J Ocul Biol Dis Infor,2009,2(2):84-93.
26 Mabuchi F,Yoshimura K,Kashiwagi K,et al.Risk factors for anxiety and depression in patients with glaucoma[J].Br JOphthalmol,2012,96(6):821-825.
27 Pop-Jordanova N,Ristova J,Loleska S.Depression in ophthalmological patients[J].Pril(Makedon Akad Nauk Umet Odd Med Nauki),2014,35(2):53-58.
28 Konieczka K,Choi HJ,Koch S,et al.Relationship between normal tension glaucoma and Flammer syndrome[J].EPMA J,2017,8(2):111-117.
29 Konieczka K,Koch S,Binggeli T,et al.Multiple sclerosis and primary vascular dysregulation(Flammer syndrome)[J].EPMA J,2016,7:13.
30 Grieshaber MC,Mozaffarieh M,Flammer J.What is the link between vascular dysregulation and glaucoma?[J].Surv Ophthalmol,2007,52(Suppl 2):S144-S154.
31 Schmetterer L,Polak K.Role of nitric oxide in the control of ocular blood flow[J].Prog Retin Eye Res,2001,20(6):823-847.
32 Kurysheva NI,Tomilova IK,Kadykova EL,et al.Nitrogen oxide in the pathogenesis of glaucoma and cataract[J].Vestn Oftalmol,2001,117(5):34-37.
33 Bola M,Gall C,Moewes C,et al.Brain functional connectivity network breakdown and restoration in blindness[J].Neurology,2014,83(6):542-551.
34 Lim SA,Siatkowski RM,Farris BK.Functional visual loss in adults and children patient characteristics,management,and outcomes[J].Ophthalmology,2005,112(10):1821-1828.
35 Raison CL,Miller AH.When not enough is too much:the role of insufficient glucocorticoid signaling in the pathophysiology of stressrelated disorders[J].Am J Psychiatry,2003,160(9):1554-1565.
36 Rosenkranz MA,Lutz A,Perlman DM,et al.Reduced stress and inflammatory responsiveness in experienced meditators compared to a matched healthy control group[J].Psychoneuroendocrinology,2016,68:117-125.
37 Iwata M,Ota KT,Li XY,et al.Psychological Stress Activates the Inflammasome via Release of Adenosine Triphosphate and Stimulation of the Purinergic Type 2X7 Receptor[J].Biol Psychiatry,2016,80(1):12-22.
38 Madrigal JL,Moro MA,Lizasoain I,et al.Stress-induced increase in extracellular sucrose space in rats is mediated by nitric oxide[J].Brain Res,2002,938(1-2):87-91.
39 Konieczka K,Ritch R,Traverso CE,et al.Flammer syndrome[J].EPMA J,2014,5(1):11.
40 Bojinova RI,Konieczka K,Todorova MG.Unilateral Loss of Vision after Spinal Surgery in a Patient with Flammer Syndrome[J].Klin Monbl Augenheilkd,2016,233(4):429-431.
41 Konieczka K,Frankl S,Todorova MG,et al.Unstable oxygen supply and glaucoma[J].Klin Monbl Augenheilkd,2014,231(2):121-126.
42 Mozaffarieh M,Flammer J.New insights in the pathogenesis and treatment of normal tension glaucoma[J].Curr Opin Pharmacol,2013,13(1):43-49.