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Flammer syndrome

Abstract

The new term Flammer syndrome describes a phenotype characterized by the presence of primary vascular dysregulation together with a cluster of symptoms and signs that may occur in healthy people as well as people with disease. Typically, the blood vessels of the subjects with Flammer syndrome react differently to a number of stimuli, such as cold and physical or emotional stress. Nearly all organs, particularly the eye, can be involved. Although the syndrome has some advantages, such as protection against the development of atherosclerosis, Flammer syndrome also contributes to certain diseases, such as normal tension glaucoma. The syndrome occurs more often in women than in men, in slender people than in obese subjects, in people with indoor rather than outdoor jobs, and in academics than in blue collar workers. Affected subjects tend to have cold extremities, low blood pressure, prolonged sleep onset time, shifted circadian rhythm, reduced feeling of thirst, altered drug sensitivity, and increased general sensitivity, including pain sensitivity. The plasma level of endothelin-1 is slightly increased, and the gene expression in lymphocytes is changed. In the eye, the retinal vessels are stiffer and their spatial variability larger; the autoregulation of ocular blood flow is decreased. Glaucoma patients with Flammer syndrome have an increased frequency of the following: optic disc hemorrhages, activated retinal astrocytes, elevated retinal venous pressure, optic nerve compartmentalization, fluctuating diffuse visual field defects, and elevated oxidative stress. Further research should lead to a more concise definition, a precise diagnosis, and tools for recognizing people at risk. This may ultimately lead to more efficient and more personalized treatment.

About the Authors

Katarzyna Konieczka
University of Basel
Russian Federation


Robert Ritch
Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai
Russian Federation


Carlo Enrico Traverso
Clinica Oculistica, Di.N.O. G.M.I., University of Genova
Russian Federation


Dong Myung Kim
Seoul National University
Russian Federation


Michael Scott Kook
University of Ulsan
Russian Federation


Augusto Gallino
Department of Internal Medicine and Cardiology, Ospedale San Giovanni
Russian Federation


Olga Golubnitschaja
Friedrich-Wilhelms-University of Bonn
Russian Federation


Carl Erb
Eye Clinic Wittenbergplatz
Russian Federation


Herbert Reitsamer
SALK/Paracelsus Medical University
Russian Federation


Teruyo Kida
Osaka Medical College
Russian Federation


Natalia Kurysheva
The Ophthalmological Center of the Federal Medical and Biological Agency, Clinical Hospital No. 86
Russian Federation


Ke Yao
Eye Center of Second Affiliated Hospital, Zhejiang University College of Medicine
Russian Federation


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Review

For citations:


Konieczka K., Ritch R., Traverso C.E., Kim D.M., Kook M.S., Gallino A., Golubnitschaja O., Erb C., Reitsamer H., Kida T., Kurysheva N., Yao K. Flammer syndrome. National Journal glaucoma. 2016;15(4):3-11. (In Russ.)

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ISSN 2078-4104 (Print)
ISSN 2311-6862 (Online)