Status of Systemic Oxidative Stresses in Patients with Primary Open-Angle Glaucoma and Pseudoexfoliation Syndrome

Abstract

BackgroundThe involvement of local and systemic oxidative stress in intraocular pressure (IOP) elevation and optic nerve damage has been hypothesized in the pathogenesis of glaucoma. To test this, we measured the systemic levels of prooxidants and antioxidants by analyzing the blood biochemistry in patients with glaucoma.MethodsPeripheral blood samples were collected from Japanese patients with primary open-angle glaucoma (PG) (n = 206), exfoliation syndrome (EX) (n = 199), and controls (n = 126). Plasma levels of lipid peroxides, ferric-reducing activity, and thiol antioxidant activity were measured by diacron reactive oxygen metabolites (dROM), biological antioxidant potential (BAP), and sulfhydryl (SH) tests, respectively, using a free radical analyzer.ResultsIn the PG, EX, and control groups, the mean ± standard deviation values were 355±63, 357±69, and 348±56 (U. Carr), respectively, for dROM; 1,951±282, 1,969±252, and 2,033±252 (µmol/L), respectively, for BAP (µmol/L); and 614±98, 584±91, and 617±99 (µmol/L), respectively, for SH. The differences in the BAP values were significant between the PG and control groups (p = 0.0062), for SH between the EX and control groups (p = 0.0017), and for SH between the PG and EX groups (p = 0.0026). After adjustment for differences in age and sex among groups using multiple regression analysis, lower BAP values were correlated significantly with PG (p = 0.0155) and EX (p = 0.0049). Higher dROM values with and without glaucoma were correlated with female gender, and lower SH values with older age. There were no significant differences between the higher (≥21 mmHg) and lower (<21 mmHg) baseline IOPs in the PG group or between the presence or absence of glaucoma in the EX group.ConclusionsLower systemic antioxidant capacity that measured by ferric-reducing activity is involved in the pathogenesis of PG and EX.

Higher serum lipids and oxidative stress in patients with normal tension glaucoma, but not pseudoexfoliative glaucoma

“…In our study, we aimed to explore this phenomenon by comparing parameters related to oxidative balance in NTG and PEXG. The oxidant/antioxidant parameters in PEX and PEXG patients has been studied extensively and OS markers were found to have risen, while antioxidants have diminished, resulting in an oxidative balance in favor of oxidants [9][10][11][12][13]. There are fewer studies on NTG, but an increase in OS has been associated with it nonetheless [6,7].…”

“…Pseudoexfoliation glaucoma (PEXG) is also associated with OS, in which abnormal extracellular fibrillar material is accumulated in the eye, obstructing humor drainage [8]. PEX syndrome (PEX) is, in fact, an age-related systemic disorder of the extracellular matrix, also observed in the vascular system and various organs [9][10][11][12][13].…”

Characteristics of the cornea in patients with pseudoexfoliation syndrome

“…The net oxidative burden between the prooxidant and antioxidant systems represents the oxidative stress that damages cellular and tissue macromolecules, such as lipids, proteins, and nucleic acids, and results in cellular and tissue dysfunction and cellular death (9) . The numbers of keratocytes and other cells of the cornea may decline with age in response to cumulative oxidative insults or declining antio xidant protection (10) .…”

Immune protective mechanism of rMOMP protein ophthalmic vaccine regarding intraocular hypertension and retinal optic nerve injury in rats

“…The common pathological basis of glaucoma and optic nerve injury is the irreversible death and difficult regeneration of RGCs, further leading to the atrophy of the optic nerve and loss of function (Tanito et al, 2012;. Therefore, the survival rate of RGCs was taken as the main indicator in this study.…”