I’m seeking to gain a deeper understanding of the interplay between blood clotting factors and their potential effects on the microvasculature of the eye. Specifically, I’d like to explore how these factors may impact blood flow, taking into account the presence of elevated intraocular pressure and its potential contribution to optic nerve damage in the context of this eye condition. Your insights into this complex relationship would be greatly appreciated.
The answer to your question is not simple, because multiple factors are involved in regulating microvascular blood flow, tissue perfusion, and tissue oxygenation. The first thing to understand is that there is a capillary gate mechanism that is primarily regulated by carbon dioxide levels in tissues, and secondarily controlled by autonomic balance.
All cells continuously produce carbon dioxide. Carbon dioxide production increases in accord with cellular metabolism in tissues and organs. For example, muscle tissues produce more carbon dioxide during exercise. Rising levels of carbon dioxide release nitric oxide (NO) from capillary walls, which consist of a single layer of specialized cells called the “vascular endothelium.” Nitric oxide opens the capillary gate and increases microvascular perfusion. In the research literature this is called “nitrergic neurogenic vasodilation” because parasympathetic nervous activity also releases nitric oxide from the capillary endothelium. Sympathetic nervous activity releases von Willebrand Factor from the capillary endothelium, which closes the capillary gate by increasing microvascular flow resistance. Thus, microvascular perfusion is regulated by combinations of CO2 partial pressure and autonomic balance.
The next thing to understand is that blood pressure is NOT the “driving force” of blood flow and tissue perfusion. You can find a detailed explanation of hemodynamic pathophysiology in my book called “50 Years Lost in Medical Advance: The Discovery of Hans Selye’s Stress Mechanism” that is sold via Amazon.com.
For research purposes, if you want to optimize tissue perfusion and tissue oxygenation, you will need a combination of anesthesia, analgesia, and hypercarbia. This applies to all organs and tissues.
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