I've wondered about the connection between increased venous pressure created by CCSVI and the eyes. Especially what might happen when pwCCSVI lie down at night, and intraocular pressure might increase if they do not have gravity, nor open jugular veins, to normalize blood flow through out the head.
I'm wondering if we have any eye specialists who would like to comment on the potential affects of increased intraocular pressure....and if we have any means of measuring intraocular pressure while someone is lying down???.....here's why:
New research on how the compression of the jugular veins increases pressure inside the eyeball of dogs.
Objective-To determine the effect of eyelid manipulation and manual jugular compression on intraocular pressure (IOP) measurement in clinically normal dogs. Design-Randomized clinical trial. Animals-30 dogs (57 eyes) without diseases or medications that affect IOP. Procedures-An applanation tonometer was used to measure IOP during eyelid manipulation or jugular compression.
Results-The 2 manipulations that caused the greatest significant increase in mean IOP were lateral eyelid extension with compression of both jugular veins (difference from baseline IOP, 17.6 mm Hg; 95% confidence interval [CI], 15.7 to 19.5 mm Hg) and lateral eyelid extension alone (16.5 mm Hg; 95% CI, 14.6 to 18.4 mm Hg). Dorsoventral eyelid extension (6.42 mm Hg; 95% CI, 4.5 to 8.3 mm Hg) and compression of both jugular veins alone (3.0 mm Hg; 95% CI, 1.1 to 5.0 mm Hg) significantly increased mean IOP, compared with baseline. Compression of the ipsilateral jugular vein increased mean IOP (0.3 mm Hg; 95% CI, -1.6 to 2.2 mm Hg) from baseline, but not significantly. Conclusions and Clinical Relevance-Traction on the eyelids or pressure on both jugular veins can significantly increase IOP values as measured by use of applanation tonometry in clinically normal dogs.
http://www.ncbi.nlm.nih.gov/pubmed/21568774
Why is this important? Why would measuring intraocular pressure in pwMS or CCSVI be relevant? One of the first areas affected in pwMS is vision. My husband lost his peripheral vision as a child. He now has bilateral tunnel vision. He had bilateral jugular occlusions. Although he has drusen (fatty deposits) on his optic nerve, this does not normally create vision loss. Why did his drusen create vision loss? The eye doctors never had an answer, since his intraocular pressure, when measured in the seated position and upright, seems normal. But what was happening at night??? What was happening all those years when he would lie down with two occluded jugular veins. Why do many with MS show optic neuritis? Is there a connection to CCSVI?
Normal intraocular pressure is a range (10-20 mmHg). Everyone experiences variations within this range throughout the day and night. For example, a person's intraocular pressure might be 16 mmHg in the morning, drop to 14 mmHg in the afternoon, and then rise to 15 mmHg at night. This represents a 3 mmHg variation. Ideally, fluctuations should not exceed 6 mmHg.
The most common disease associated with a rise in intraocular pressure in glaucoma...
The optic neuropathy in multiple sclerosis and glaucoma neuropathy are very common ophthalmological diseases. Multiple sclerosis (MS) is a chronic inflammatory central nervous system demyelinisation disease with an autoimmunological ethiology. The lastest investigations of multiple sclerosis indicate the molecular and cellular auto-immune aspects. The role of vasoactive factors is underlines in its pathogenesis which also suggests the common elements of glaucoma and MS pathogenesis. The over expressed vasoconstrictive mechanisms in both diseases can create optic nerve injury. The aim of this study is evaluation of the optic disc morphological changes in multiple sclerosis patients with or without neuritis optica in anamnesis in glaucoma "remodeling" aspects. MATERIAL AND METHODS: We present two patients with coexistant MS and glaucoma neuropathy, which underwent retrobulbar neuritis. CONCLUSION: Coexistance of glaucoma neuropathy and multiple sclerosis neuropathy may indicate common elements of glaucoma and SM pathogenesis. The authors recommend precise morphological optic disc evaluation in multiple sclerosis patients because glaucoma neuropathy may appear.
http://www.ncbi.nlm.nih.gov/pubmed/18260288
Anterior ischaemic optic neuropathy is a stroke syndrome of the distal optic nerve, characterised by disc oedema and optic nerve dysfunction--loss of central vision, loss of colour vision, a relative afferent pupillary defect, and nerve fibre layer field loss. We prospectively evaluated the changes of intraocular pressure throughout the day in 16 patients with non-arteritic anterior ischaemic optic neuropathy and 15 normal control subjects of similar age and race. The peak intraocular pressure exceeded 21 mm Hg in five of the ischaemic optic neuropathy patients but none of the controls. The mean peak intraocular pressure was 19.9 mm Hg for the ischaemic optic neuropathy group versus 17.6 mm Hg for controls (p = 0.034). The range of intraocular pressure was also greater for the ischaemic optic neuropathy group (p = 0.030). Eight of 16 ischaemic optic neuropathy patients had a range of intraocular pressure of 6 mm Hg or more, compared with three of 15 control subjects. The intraocular pressure exceeded 21 mm Hg during a subsequent visit in two additional patients in whom the hourly determined intraocular pressure peaked at less than 21 mm Hg. Thus, seven of 16 of our ischaemic optic neuropathy group had an intraocular pressure exceeding 21 mm Hg during the study period. Raised intraocular pressure may be a predisposing factor in some patients who develop anterior ischaemic optic neuropathy.
So, do we have an eye doctor in the house who might care to comment? Is there any way to monitor intraocular pressure in a supine patient? Inquiring minds continue to wonder....
thanks!
Joan