Clinical and Ocular Histopathological Findings in a Patient With Normal-Pressure Glaucoma

Abstract

To study the histopathological changes of eyes from a patient with normal-pressure glaucoma whose clinical and laboratory findings were well documented.Methods: Postmortem histopathological findings in a patient with normal-pressure glaucoma who had monoclonal gammopathy and serum immunoreactivity to retinal proteins were examined in comparison with those of an age-matched control subject. Clinicopathological correlations to laboratory findings were examined.Results: Clinical and histopathological findings of the patient, including cavernous degeneration of optic nerve and characteristic optic nerve cupping, were similar to those in patients with glaucoma who had high intraocular pressure. In addition, we found immunoglobulin G and immonuglobulin A deposition in the ganglion cells, inner and outer nuclear layers of the retina, and evidence of apoptotic retinal cell death using terminal deoxynucleotidyltransferasemediated deoxyuridine triphosphate nick end labeling technique.Conclusions: Serum antibodies to retinal proteins and retinal immunoglobulin deposition constitute novel findings in a patient with normal-pressure glaucoma and may contribute to better understanding of the mechanisms underlying glaucomatous optic neuropathy in this disorder.

Induced Autoimmunity to Heat Shock Proteins Elicits Glaucomatous Loss of Retinal Ganglion Cell Neurons via Activated T-Cell-Derived Fas-Ligand

“…similar to that which occurs in brain (Bauer et al, 1998). This likely provides a native protection mechanism against potential cytotoxicity from a broad array of immune responses that may be injurious to retinal neurons and vision In accordance with our findings of early and transient T cell appearance after immunization, in many neurodegenerative diseases including glaucomatous optic nerve degeneration, virtually no T cell invasion is detected at later time points in the retina (Wax et al, 1998; Schwartz and Kipnis, 2001). …”

Induced Autoimmunity to Heat Shock Proteins Elicits Glaucomatous Loss of Retinal Ganglion Cell Neurons via Activated T-Cell-Derived Fas-Ligand

“…similar to that which occurs in brain (Bauer et al, 1998). This likely provides a native protection mechanism against potential cytotoxicity from a broad array of immune responses that may be injurious to retinal neurons and vision In accordance with our findings of early and transient T cell appearance after immunization, in many neurodegenerative diseases including glaucomatous optic nerve degeneration, virtually no T cell invasion is detected at later time points in the retina (Wax et al, 1998; Schwartz and Kipnis, 2001). …”

Serum Autoantibodies to Optic Nerve Head Glycosaminoglycans in Patients With Glaucoma

“…Information about the laboratory findings could also be obtained from one of the patients with normal-pressure glaucoma, which included the presence of a monoclonal gammopathy and aberrant serum antibodies to extractable nuclear proteins and retinal proteins. 4 The level of optic nerve damage was similar in glaucomatous eyes as identified by previous clinical records and microscopic findings of the optic nerve heads. All eyes were enucleated within 4 hours of death and processed within 12 hours.…”

Untitled

“…Similar elevated autoantibodies to HSP in normotensive and highpressure glaucoma patients vs controls were made in U.S and Japanese populations [198][199][200].…”

Induced Autoimmunity to Heat Shock Proteins Elicits Glaucomatous Loss of Retinal Ganglion Cell Neurons via Activated T-Cell-Derived Fas-Ligand

“…similar to that which occurs in brain (Bauer et al, 1998). This likely provides a native protection mechanism against potential cytotoxicity from a broad array of immune responses that may be injurious to retinal neurons and vision In accordance with our findings of early and transient T cell appearance after immunization, in many neurodegenerative diseases including glaucomatous optic nerve degeneration, virtually no T cell invasion is detected at later time points in the retina (Wax et al, 1998; Schwartz and Kipnis, 2001). …”

Serum Autoantibodies to Optic Nerve Head Glycosaminoglycans in Patients With Glaucoma

“…Information about the laboratory findings could also be obtained from one of the patients with normal-pressure glaucoma, which included the presence of a monoclonal gammopathy and aberrant serum antibodies to extractable nuclear proteins and retinal proteins. 4 The level of optic nerve damage was similar in glaucomatous eyes as identified by previous clinical records and microscopic findings of the optic nerve heads. All eyes were enucleated within 4 hours of death and processed within 12 hours.…”

Untitled

“…Similar elevated autoantibodies to HSP in normotensive and highpressure glaucoma patients vs controls were made in U.S and Japanese populations [198][199][200].…”

Induced Autoimmunity to Heat Shock Proteins Elicits Glaucomatous Loss of Retinal Ganglion Cell Neurons via Activated T-Cell-Derived Fas-Ligand

“…similar to that which occurs in brain (Bauer et al, 1998). This likely provides a native protection mechanism against potential cytotoxicity from a broad array of immune responses that may be injurious to retinal neurons and vision In accordance with our findings of early and transient T cell appearance after immunization, in many neurodegenerative diseases including glaucomatous optic nerve degeneration, virtually no T cell invasion is detected at later time points in the retina (Wax et al, 1998; Schwartz and Kipnis, 2001). …”

Serum Autoantibodies to Optic Nerve Head Glycosaminoglycans in Patients With Glaucoma

“…Information about the laboratory findings could also be obtained from one of the patients with normal-pressure glaucoma, which included the presence of a monoclonal gammopathy and aberrant serum antibodies to extractable nuclear proteins and retinal proteins. 4 The level of optic nerve damage was similar in glaucomatous eyes as identified by previous clinical records and microscopic findings of the optic nerve heads. All eyes were enucleated within 4 hours of death and processed within 12 hours.…”

Untitled

“…Similar elevated autoantibodies to HSP in normotensive and highpressure glaucoma patients vs controls were made in U.S and Japanese populations [198][199][200].…”