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Uludağ Üniversitesi Tıp Fakültesi Öğretim Üyesi, Göz Hastalıkları A.D., Bursa, Prof Dr. The etiology of primary open angle glaucoma (POAG) is influenced by multipl risk factors. Among them intraocular pressure is the leading one and it is followed by vascular diseases. These factors may lead to ischemia of retinal nevre fibers and optic nevre head . In vascular endothelial disorders , vasoactive factors contribute to ischemic proccess by altering vascular tonus and flexibilty. Nitric oxide (NO) and endothelin- 1 (ET-1) are the most prominent vasoactive factors. Recent clinical studies about POAG and pseudoexfoliation have clearly set up that ; aqueous levels of NO and vasoendothelial factor (VEGF) tend to decrease while ET-1 levels increase. These findings suggest that blood flow reduction contributes to the pathogenesis of glaucoma . As a results of these developments it is thought that; management of glaucoma, in the future, will depend on the idea of regulating ocular blood flow and maintaining the NO/ET-1 balance as a new treatment parameters. Keywords : POAG, vascular endothelial dysfunction , nitric oxide, endothelin-1