effects of CCSVI on the vascular fundus of the eye

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.
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Cece
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effects of CCSVI on the vascular fundus of the eye

Post by Cece »

http://clinicaltrials.gov/ct2/show/NCT0 ... svi&rank=4
Primary Outcome Measures:

•Fundus: venous engorgement/beading

Abnormal vessel appearance in fundi may include venous engorgement and beading, abnormal A/V ratio, blurred disc margins, papilledema, dot hemorrhages or exudates
.
Detailed Description:

Chronic Cerebrospinal Venous Insufficiency (CCSVI) has been proposed as the cause of numerous neurodegenerative diseases of the brain. CCSVI is the result of poor drainage of blood (and cerebral spinal fluid to some degree) from weakened or stenosed veins usually located in the cervical area (most notably the internal jugular veins). Although current focus and treatment of CCSVI is on multiple sclerosis, CCSVI has also been implicated as a potential cause of Alzheimer's disease and Parkinson's Disease. Additionally, patients with Ehlers-Danlos Syndrome (EDS) -- a disorder of connective tissue -- are more prone to developing multiple sclerosis than the general population. Many EDS patients are known to have weakened and abnormal blood vessels and 40 - 70% of EDS patients develop autonomic dysfunction in addition to numerous other symptoms found in patients with CCSVI. In the small subset of EDS and multiple sclerosis patients seen at Total Eye Care, the investigators have noticed a vascular irregularity (using the optomap® and examining the results under high magnification) which offers credence to the theory of CCSVI. Such objective data has been elusive, excepting for fMRI, ultrasound (to a limited degree) and venous angioplasty results. Current treatment of CCSVI involves the ballooning and sometimes stenting, of abnormally stenosed veins. The treatment of CCSVI offers hope to many patients suffering from multiple sclerosis. Although CCSVI research is in its infancy, many doctors believe that CCSVI is a significant portion of the solution to patients with neurodegenerative diseases of the brain. Because CCSVI is a vascular disorder, the investigators hypothesize that the investigators are able to screen candidates for CCSVI via the optomap®.
Are the answers in our eyes?

This may be quantifiable evidence of vascular abnormality in CCSVI in MS. Very happy if it is so.
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1eye
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Post by 1eye »

Didn't I tell you that eyeball veins are all little Starling Resistors? I don't get red eyes except from THC and allergic reactions though, far as I know. What's an optomap?
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Cece
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Post by Cece »

As much as I love the term 'Starling Resistors' (with connotations of science fiction and birds all in one), I forget what it means. :(
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1eye
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Post by 1eye »

Ohm's law describes a resistance to a current caused by a pressure. It can describe a carbon resistor in an electrical circuit where copper conducts a current or flow of one fluid called electricity, or a narrowing in a vein where heart pressure pumps blood. The math is the same. Voltage is the analog of pressure. Flow is the analog of current. Resistance to blood flow is the analog of resistance to electrical current.

Ohm's law is V= IR. Voltage or pressure equals resistance times current or flow. V is potential energy. I is movement of fluid per second. R is a measurement of the carbon resistor or the narrowing's resistance to the movement of the fluid (electricity or blood). In electricity the units of R are Ohms. I don't know what they are for blood.

With a Starling resistor the analogy breaks down because the vein is flexible and surrounded by a different fluid under a different pressure which presses in on the vein walls. Since they are flexible the viscosity of the fluid inside increases (this is like resistance). The math gets far less linear. The vein is now a kind of Starling Resistor, named after a guy who built one in a box to model the lung.

Things get exceedingly more complex because the pressure (and flow, and also the Starling fluid pressure/resistance: spinal or eyeball) are not always constant. They pulsate, and sometimes even alternate between negative and positive. One guy even used wave mechanics to describe them.

Clear as mud?
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HappyPoet
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Post by HappyPoet »

We've talked about Optomaps before. I'll look for the link.

Hopefully, Dr. Diana will post soon. Has she posted yet about her busy weekend of giving presentations?

Edit -- to add the link: http://www.thisisms.com/ftopicp-166124.html#166124
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Motiak
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Post by Motiak »

It would be nice to not have a constant black haze over the vision in my left eye. Maybe this is related.
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Post by Cece »

It's clearer, 1eye, although I am not yet ready for the pop quiz.....
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Post by 1eye »

An odd thing: a narrowing, if fixed, can be a fixed resistance. But Starling pressure modulates not diameter, which would be really powerful, but viscosity. There still might be a gain value greater than 1. So if there is negative feedback, great! You have the biological equivalent of a negative feedback amplifier. A transistor-like or vacuum tube-like apparatus inside the human body. Errors in the amount of pressure or flow from input to output would be corrected by the feedback. But if the gain ever got to be positive, greater than +1, you would have oscillation, and the system would become unstable and self-destructive. What influences that gain? The density and viscosity of blood and spinal fluid. The compliance of the vein walls. Heat. Temperature. Perhaps the temperature above which I melt is the one where my internal amplifiers' (Starling resistors') feedback goes positive!

Maybe I should ask Dr. Beggs about this one.
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thisisalex
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Post by thisisalex »

it sounds VERY interesting. an operator independent diagnosis tool for ccsvi!

more information at their homepage:

http://www.totaleyecare.com/Vascular-Fu ... -CCSVI.htm
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