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December 1983

Effects of Elevated IOP on Blood Flow-Reply

Arch Ophthalmol. 1983;101(12):1949-1950. doi:10.1001/archopht.1983.01040020950029

In Reply.  —We are pleased by Dr Hayreh's interest in our two articles and were especially interested to hear that his experimentally induced renovascular arterial hypertension, in which circulating vasoconstrictors abound, produced anterior ischemic optic neuropathy. We had wondered1 if a deficient autoregulation, perhaps produced by a diffusion of vasoconstrictors from the choroid into the optic nerve, might participate in the pathogenic mechanisms of ischemic optic neuropathy and low-tension glaucoma (including shock-induced optic neuropathy), in addition to glaucoma.We share Dr Hayreh's uncertainty about which vessels govern the autoregulation of the optic nerve head. It is not clear how the posterior ciliary artery would become informed that the optic disc was suffering and that the artery should relax its tone. Nor is it clear how the artery should respond if one of its territories (the optic disc) required more perfusion while its other territory did not. Therefore, it has

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