Fluids Hypertension Syndromes: Migraines, Headaches, Normal ...

Fluids Hypertension Syndromes – Dr. Leonardo Izecksohn – page 82
Similarly, low intraocular pressure at the office was found by Nakakura S and others, studying patients
medicated for Glaucoma, who only 33,8% presented maximum 24-hours intraocular pressure at
the office hours, and 66.2% presented it at night, after 9 PM and before 6 AM.
This is similar with the Tajimi Study findings, where “surprisingly, 92% of the Primary Open Angle
Glaucoma patients diagnosed had Intraocular Pressure lower than 22 mmHg at the screening.” (Suzuki
Y, and others).
Hasegawa K and others, studying intraocular pressure in Normal-Tension Glaucoma patients found
that “the peak time was observed outside clinical hours (1800-0800) in 41.4% of the patients, and the
trough time was observed during clinical hours (1000-1600) in 15.9%.”
“Intraocular pressure peaks were thus shown to have an association with the apparent progression of
vision loss independent of the mean intraocular pressure.” (Zeimer R C, and others).
- Deciding to cure or to worsen the Normal Tension Glaucoma with 3 etiologies (in bold):
We had a strong mulatto, 48-year-old, specialized worker, complaining of small blurring of his vision,
weak glasses, and mild occasional right temporal and occipital headaches. He suffered from
asthma but became better years ago. He drank daily coffee 1,000 milliliter (33 fluid ounces) and some
beer at weekends, with hangover at the next morning, which he classified as “normal”. We examined
him and found his old eyeglasses correct, not needing new ones. His intraocular pressures were 14 and
14 mmHg in both eyes (physiologic), but his Optic Nerve’s disks show 0.6/3/3/0.5 and 0.5/4/3/0.5 (Cup
diameter/ cup deepness/ lamina cribosa’s pores visibility/ borders edema), which we configure as suspicion
of glaucoma and Cerebrospinal Fluid Hypertension, both occurring at different hours. This is a
patient beginning the glaucomatous damage, presenting simultaneously Ocular and Cerebrospinal
Fluids Hypertension Syndromes, all caused by his ethnology, beer and coffee daily drinks. He presented
few symptoms because he is a man and has 48 years. As most of the alcoholic drinkers, he consider
hangover as “normal”.
We can not change his ethnology. He may decide: or he stops his drinks of beer and coffee and his
Optic Nerve damage stabilize at its actual reasonable level, or he continues his pleasant drinks, and
after some years, one physician will diagnose Normal (Peak) Tension Glaucoma at an irreversible
phase. The only treatment to stop this evolution and prevent the Normal (Peak) Tension Glaucoma is
his resolution to stop the beer and coffee drinks now.
In rats, the “Low-tension” glaucoma pathophysiology already was demonstrated: “The intraocular
pressure was transiently elevated for 1 hour, 6 days weekly over 6 weeks... the mean baseline Intraocular
pressure of 14.9+/-1.8 mm Hg increased to 35.3+/-2.6 mm Hg during 1-hour... the Optic nerve fiber
layer thinning (22-25%) corresponded with a decrease (7-10%) in soma number in the ganglion cell
layer. Optic nerves displayed axonal degeneration with a modest axon loss of 6%.” (Joos K M, and others).
So, the wrong name “Low-tension” glaucoma should correctly be “Peak-tension” glaucoma.
VII – B - Posner-Schlossman Syndrome (Glaucomatocyclitic crisis) – It is caused by the caffeine.
The caffeine was ever the etiology of this disease in our patients. This already was proven by other
physicians:
In “Twelve patients with Glaucomatocyclitic crisis...The Flow-mediated vasodilation was much lower
in the glaucomatocyclitic crisis group than in the control groups (mean 4.81% vs. 7.89%)... which implies
peripheral vascular endothelial dysfunction.”(Shen S C, and others). As “coffee exerts an acute
unfavorable effect on the endothelial function in healthy adults, lasting for at least 1 h after intake. This
effect might be attributed to caffeine, given that decaffeinated coffee was not associated with any
change in the endothelial performance.”(Papamichael C M, and others).