How does stress affect trabecular meshwork integrity/structure? Is there a reason to think that psychological or mental stress may alter trabecular meshwork leading to elevation of intraocular pressure?
Thank you for this very important question . In theory , yes emotional stress may have an impact on the trabecular meshwork as high level of cortisol is produced by the renal glands. This may , in theory , activate the gene expression in the trabecular meshwork --- and may lead on to glaucoma. Any additional comments from others will be most welcomed .
This is a vital question that is not being addressed today, with the increasing stress in our society. However this needs to assessed both holistically and scientifically.
- Do go through the classical paper by Klauza and Maurer attached below. However they couldn't demonstrate the effect of relaxation techniques on this elevation of IOP in the short term follow up study that they carried out. (J Behav Med. 1996 Dec;19(6):587-98. Stress reactivity of intraocular pressure after relaxation training in open-angle glaucoma patients. Kaluza G1, Strempel I, Maurer H.) This shows that simply an interplay of IOP increase is not the sole reason of stress related increase in glaucoma incidence and instead is a complex interplay of emotional, neuro-endocrine and biochemical modulation cascade activation that involves several systems.
- Additionally try going through Am J Optom Physiol Opt. 1987 Nov;64(11):866-70. Psychophysiological stress, elevated intraocular pressure, and acute closed-angle glaucoma. Shily BG. This article again discusses the various theories that can explain stress related activation of angle closure glaucoma.
- I would also suggest you to go through Liton, P. B., & Gonzalez, P. (2008). Stress Response of the Trabecular Meshwork. Journal of Glaucoma, 17(5), 378–385. http://doi.org/10.1097/IJG.0b013e31815f52a8 . They discuss other types of dynamic stress that the TM has to endure and highlight the biochemical modulation that occurs due to these changes.
Overall its a very engaging subject that needs active intervention of researchers to identify new avenues of monitoring and managing glaucoma activation and progression.
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