Matrix metalloproteinases and their inhibitors in the chamber angle of normal eyes and patients with primary open-angle glaucoma and exfoliation glaucoma

Background In glaucoma, extensive pathological changes occur in the trabecular meshwork (TM) and juxtacanalicular tissue of the chamber angle. Aqueous humor drainage is disturbed due to the accumulation of extracellular matrix (ECM) material in the outflow system. Matrix metalloproteinases (MMPs) remodel ECM material and, thus, they may have a role in regulating outflow facility and intraocular pressure (IOP). This study examined the expression of MMPs and tissue inhibitors of MMPs (TIMPs) in the chamber angle of normal eyes and in primary open-angle glaucoma (POAG) and in exfoliation glaucoma (ExG). Methods TM tissues were isolated from healthy donor eyes for corneal transplantation. Specimens of the inner wall of Schlemm’s canal and the juxtacanalicular tissue were collected from patients with POAG or ExG during deep sclerectomy operation. Monoclonal antibodies against MMPs (MMP-1, -2, -3, and -9) and antibodies against TIMPs (TIMP-1, -2, and -3) were used for immunohistochemical staining Results Immunoreactivity for MMP-2, TIMP-2, or TIMP-3 was observed in human normal TM and in the inner wall of Schlemm’s canal. In general, immunoreactions for all of the tested MMPs were more intense in POAG samples than in ExG samples or in the control group. The only exception was the MMP-2 level, which was the highest in the control group. The staining intensity of MMP-1 or MMP-3 was significantly higher in POAG when compared to ExG. TIMP-1 was significantly increased in POAG compared with ExG and there were no marked differences in the levels of TIMP-2 or TIMP-3 between POAG and ExG. The ratios of MMP-1/TIMP-1 and MMP_1+2+3+9 and TIMP₁₊₂₊₃ were significantly higher in samples from POAG compared to those of ExG. Conclusions Our results reveal an expression imbalance between MMPs and their endogenous tissue inhibitors in tissue samples from patients with POAG and ExG. Differences in immunohistochemical reactions reflect discrete local pathogenic mechanisms involved in POAG and ExG. With respect to the proposed role of MMPs in the remodeling of ECM material, this may point to a weaker reactivity to the accumulation of ECM material in TM in ExG than POAG eyes.     

原发性青光眼合并2型糖尿病患者房水及血液中MMP-2及TIMP-2的表达

目的　探讨基质金属蛋白酶２（ｍａｔｒｉｘｍｅｔａｌｌｏｐｒｏｔｅｉｎａｓｅ-２,ＭＭＰ-２）及金属蛋白酶２组织抑制因子（ｔｉｓｓｕｅｉｎｈｉｂｉｔｏｒｏｆｍｅｔａｌｌｏｐｒｏｔｅｉｎａｓｅ-２,ＴＩＭＰ-２）与原发性青光眼合并２型糖尿病的关系。方法　研究对象分Ａ组、Ｂ组、Ｃ组、Ｄ组、Ｅ组、Ｆ组６组,每组３０眼。Ａ组为原发性开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎａｎｇｌｅｇｌａｕｃｏｍａ,ＰＯＡＧ）组,Ｂ组为原发性闭角型青光眼（ｐｒｉｍａｒｙａｎｇｌｅｃｌｏ-ｓｕｒｅｇｌａｕｃｏｍａ,ＰＡＣＧ）组,Ｃ组为ＰＯＡＧ合并２型糖尿病组,Ｄ组为ＰＡＣＧ合并２型糖尿病组,Ｅ组为糖尿病性白内障组,Ｆ组为年龄相关性白内障组。采用酶联免疫吸附试验检测各组房水及血清中ＴＩＭＰ-２及ＭＭＰ-２的含量,并计算ＴＩＭＰ-２／ＭＭＰ-２值。结果　在６组研究对象的房水中,ＭＭＰ-２浓度在Ａ组为（２４．９２±６．６２）μｇ?Ｌ－１、Ｂ组为（３６．８０±１５．０７）μｇ?Ｌ－１、Ｄ组为（２８.４４±５．７８）μｇ?Ｌ－１,均较Ｆ组的（２２．８７±３.５４）μｇ?Ｌ－１显著升高（均为Ｐ＜０．０５）;同时房水中ＴＩＭＰ-２浓度在Ａ组为（４３.９２±１９．５７）μｇ?Ｌ－１、Ｂ组为（７６．１３±２７．６７）μｇ?Ｌ－１、Ｄ组为（６１．９２±６．５１）μｇ?Ｌ－１,也均较Ｆ组的（２２.４８±３．５６）μｇ?Ｌ－１显著升高（均为Ｐ＜０．０５）。Ａ、Ｂ、Ｃ、Ｄ组房水中ＴＩＭＰ-２／ＭＭＰ-２值较Ｅ组和Ｆ组显著提高,约为其２倍,但Ａ组、Ｂ组、Ｃ组、Ｄ组间ＴＩＭＰ-２／ＭＭＰ-２值无显著性差异。在６组研究对象的血清中,Ａ组ＭＭＰ-２和ＴＩＭＰ-２浓度最高,分别为（３９６．７５±４９．３０）μｇ?Ｌ－１和（３３７．６７±６２．７８）μｇ?Ｌ－１,其余各组间ＭＭＰ-２和ＴＩＭＰ-２浓度无显著性差异。６组研究对象血清中ＴＩＭＰ-２／ＭＭＰ-２值无明显差异。结论　原发性青光眼患者中ＴＩＭＰ-２／ＭＭＰ-２值均存在失衡,说明ＭＭＰ-２的活性变化及ＴＩＭＰ-２／ＭＭＰ-２值与ＰＯＡＧ和ＰＡＣＧ的发病密切相关,但２型糖尿病对原发性青光眼的病程进展无明显影响。     

Aqueous humor erythropoietin levels in patients with primary open-angle glaucoma

PURPOSE: To evaluate the levels of erythropoietin (EPO) in the aqueous humor in eyes with primary open-angle glaucoma (POAG) and without glaucoma. METHODS: Levels of EPO were measured using a sandwich enzyme-linked immunosorbent assay kit in aqueous humor aspirates taken during anterior segment surgery from 45 patients, of whom 20 had POAG and 25 had senile cataract only. RESULTS: The mean aqueous humor EPO concentration in eyes with POAG (10.91+/-4.32 mU/mL) was significantly higher than that from eyes with cataract (8.24+/-1.77 mU/mL, P=0.008). There was no significant difference between the serum EPO concentrations of POAG (26.46+/-10.36 mU/mL) and the control group (24.50+/-7.59 mU/mL, P=0.468). There was no correlation (P=0.165) between the EPO aqueous humor concentration and the EPO serum concentration while there was no correlation between the EPO aqueous humor concentration and the EPO serum concentration in the control group (P=0.819). CONCLUSIONS: The aqueous humor EPO level is increased in eyes with POAG.     

Combined phacoemulsification and goniotrephination in primary open-angle glaucoma and pseudoexfoliation glaucoma - a retrospective analysis

BACKGROUND: During the last few years combined cataract and glaucoma surgery is an established method to control intraocular pressure (IOP) and visual rehabilitation in patients with cataract and glaucoma. Despite this, there are currently only few data concerning the results of combined surgery for primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG). PATIENTS AND METHODS: To study the course of PEXG and POAG with respect to IOP regulation and visual acuity, 100 eyes with POAG (72 patients) and 22 with PEXG (19 patients) were evaluated which underwent a combined phacoemulsification and goniotrephination between 1993 and 1997. All patients had no glaucoma or other ocular surgery before. The mean follow up after operation was 39.5 (range 16 - 72) months. RESULTS: The mean preoperative IOP in PEXG (31.8 +/- 10.3 mm Hg) was significantly higher than in the POAG group (25.3 +/- 6.4 mm Hg) (p=0.0004). At follow up IOP decreased to 16.7 +/- 2.8 mm Hg (POAG) and 15.1 +/- 4.0 mm Hg (PEXG) (p < 0.0001). The absolute IOP lowering effect was significantly better for PEXG than for POAG (p=0.0003). All patients received medical treatment before surgery, whereas at follow up 59.0 % (POAG) and 81.8 % (PEXG) were untreated. The median preoperative visual acuity for the POAG was 0.32 (PEXG 0.25), visual outcome 0,63 (PEXG 0.5). CONCLUSION: The combined cataract and glaucoma surgery is a successful method of IOP control and visual rehabilitation. It seems that there is a tendency for a better efficiency and an untreated IOP regulation after surgery for PEXG. Thereby early surgical intervention could be an advantage for this glaucoma entity.     

兔眼人工晶状体植入后房水基质金属蛋白酶及其抑制因子活性的动态变化

目的 探讨白内障囊外摘出及人工晶状体植入术后房水中基质金属蛋白酶(MMPs)活性及其抑制因子(TIMPs)的动态变化。 方法20只健康成年家兔,均1眼行晶状体囊外摘出及人工晶状体植入术,另一未手术眼作为对照组。每4只兔为一组,分别于术后第1、3、7、14、30 d抽取房水,用酶谱分析法和反向酶谱分析法检测各标本中的MMPs的活性及TIMPs量的变化。 结果 正常对照组兔眼内有MMP-2、-7的表达,而MMP-1、-9的表达甚微;术后第1d,房水中MMP-1、-2、-7、-9、TIMP-1和TIMP-2的活性明显升高,这种高水平可持续到术后第14 d,并有显著性差(P<0.05),但在术后第30d其活性仍高于正常对照组(P<0.05)。 结论 MMPs可能是白内障术后眼内炎症的重要炎症介质之一;MMPs/TIMPs平衡的破坏可能影响了白内障囊外摘出及人工晶状体植入术后细胞外基质的降解,表明TIMPs可能是后囊膜混浊的形成和纤维化的重要原因之一。     

Oxidative stress in primary open-angle glaucoma

PURPOSE: To analyze oxidative stress in primary open-angle glaucoma (POAG). MATERIAL AND METHODS: A case-control study including 90 eyes of 90 patients who needed antiglaucomatous surgery in the course of POAG (glaucoma group, n=50) and from patients who were operated of nonpathologic cataracts (cataract group, n=40). Free radical formation via lipid peroxidation by malondialdehyde-thiobarbituric acid reactive substances (MDA-TBARS) test and total antioxidant status in the aqueous humor samples of both groups were determined. Statistical analyses were carried out in relation to MDA-TBARS and total antioxidant status and their correlations with glaucoma risk factors. RESULTS: Significantly higher MDA-TBARS were detected in the POAG with respect to the comparative group of cataract subjects (P<0.001). Antioxidant activity was significantly lower in the POAG than in the cataract group (P<0.001). CONCLUSIONS: Aqueous humor samples may be used for determining oxidative and antioxidant status in pathologic processes. Glaucomatous eyes had a significant increase in oxidative status and decreased antioxidant activity in the aqueous humor than the cataract eyes. Oxidative stress may play a pathogenical role in the POAG.     

Evaluation of serum and aqueous humor klotho levels in pseudoexfoliation syndrome,pseudoexfoliation and primary open-angle glaucoma

International Ophthalmology - The aim of our study was to compare klotho in the serum and aqueous humor of patients with primary open-angle glaucoma (POAG), pseudoexfoliation glaucoma (PEXG) and...     

基质金属蛋白酶2、基质金属蛋白酶抑制剂2和可溶性CD44在高度近视眼合并原发性开角型青光眼患者房水中的定量研究

目的研究房水中可溶性白细胞分化抗原44(sCD44)、基质金属蛋白酶2(MMP-2)、基质金属蛋白酶抑制剂2(TIMP-2)的水平及MMP-2与TIMP-2比值的变化与高度近视眼(HM)合并原发性开角型青光眼(POAG)发病的相关性。 方法收集2015年7月至2016年12月期间就诊于解放军总医院第三医学中心的HM、POAG和年龄相关性白内障(CAT)患者47例，根据诊断分为4组，HM合并POAG患者12例(12只眼)作为HMG组；POAG组患者15例(15只眼)作为POAG组；HM患者12例(12只眼)作为HM组；CAT患者8例(8只眼)作为CAT组。以A型超声检查测定眼轴长度。采用双抗体夹心法酶联免疫吸附实验方法测定各组房水中MMP-2、TIMP-2及sCD44的水平。采用单因素方差分析比较各组房水样本之间sCD44、MMP-2、TIMP-2的水平及MMP-2与TIMP-2比值的差异，组间两两比较采用方差分析。采用Pearson相关性检验分析sCD44、MMP-2和TIMP-2之间的相关性及sCD44、MMP-2、TIMP-2与眼轴长度的相关性。 结果HMG组、HM组、POAG组及CAT组房水中sCD44水平分别为(229.86±14.23) ng/l、(227.96±17.91) ng/l、(187.80±14.14) ng/l及(149.74±19.18) ng/l，MMP-2水平分别为(7.83±1.28) ng/ml、(7.78±0.91) ng/ml、(6.10±0.85) ng/ml及(5.42±0.72) ng/ml，TIMP-2水平分别为(128.08±11.41) ng/ml、(115.20±7.44) ng/ml、(91.89±8.26) ng/ml及(63.22±8.69) ng/ml，TIMP-2/MMP-2比值分别为(16.65±2.44)、(14.95±1.55)、(15.32±2.30)及(11.67±0.49)，比较差异均有统计学意义(F＝53.88，16.05，95.41，9.98；P<0.05)。其中，HMG组、HM组及POAG组房水中sCD44水平较CAT组升高，差异有统计学意义(t＝10.75，9.31，5.12；P<0.05)；HMG组及HM组房水样本中MMP-2的水平较CAT组升高，差异有统计学意义(t＝4.81，6.15；P<0.05)；POAG组房水中MMP-2的水平与CAT组比较，差异无统计学意义(t＝1.86，P>0.05)；HMG组、HM组及POAG组房水中TIMP-2的水平较CAT组升高，差异有统计学意义(t＝13.62，14.33，7.45；P<0.05)；HMG组、HM组及POAG组中TIMP-2/MMP-2的比值均高于CAT组，差异有统计学意义(t＝5.65，5.75，4.39；P<0.05)。相关性分析显示，房水中MMP-2的水平与TIMP-2的水平呈较高度正相关(r＝0.75，P<0.05)。房水中MMP-2的水平与sCD44的水平呈较高度正相关(r＝0.67，P<0.05)。房水中TIMP-2的水平与sCD44的水平呈高度正相关(r＝0.83，P<0.05)；房水中sCD44、MMP-2及TIMP-2的水平与眼轴长度呈正相关(r＝0.90，0.70，0.81；P<0.05)。 结论HM合并POAG患者、HM患者和POAG患者房水中的sCD44、MMP-2及TIMP-2的水平显著升高，TIMPs/MMPs比例失衡。房水中sCD44、MMP-2及TIMP-2可作为HM合并POAG的早期预警指标。     

维吾尔族假性剥脱综合征患者角膜内皮形态学分析

目的：对比分析维吾尔族假性剥脱综合征（PEX）、剥脱综合征性青光眼（PEXG）、原发性开角型青光 眼（POAG）及年龄相关性白内障（ARC）角膜内皮形态学差异。方法：回顾性病例对照研究。选取 2019年7月至2020年8月在中国人民解放军新疆军区总医院全军眼科中心就诊治疗的维吾尔族PEX 患者76例（76眼）,PEXG患者82例（82眼）,POAG患者64例（64眼）以及ARC患者76例（76眼）分别作为PEX组、PEXG组、POAG组及ARC组。收集各组患者角膜内皮细胞密度（ECD）、六角型细胞 比例（HEX）、变异系数（CV）、角膜中央厚度（CCT）（眼前节OCT）等资料。多组间比较采用单因素方差分析,组间两两比较采用LSD-t检验。结果：ARC组、PEX组、PEXG组及POAG组ECD分别为 （2 565±202）/mm2 、（2 286±178）/mm2 、（2 104±376）/mm2 、（2 206±206）/mm2。PEX组、PEXG组及 POAG组ECD低于ARC组,差异有统计学意义（t=5.16、6.19、6.58,均P<0.001）;PEXG组ECD低于 PEX组、POAG组,但差异无统计学意义;与ARC组相比,PEX组、PEXG组以及POAG组CV较高, HEX较低,差异均有统计学意义（均P<0.001）;PEX组CCT与ARC组相比差异无统计学意义;PEXG 组CCT较PEX组薄,差异有统计学意义（t=2.25,P=0.02）,较POAG组也薄,但差异无统计学意义。 结论：维吾尔族PEX患者ECD减少,PEXG患者CCT变薄,提示在对PEX、PEXG患者行手术治疗时应更注意对角膜的保护。     

Long-term results of viscocanalostomy in pseudoexfoliative and primary open angle glaucoma

Purpose: To document the outcome of viscocanalostomy (VC) alone or combined with phacoemulsification (phaco‐VC) in eyes with pseudoexfoliation glaucoma (PEXG) and primary open angle glaucoma (POAG). Methods: A prospective, comparative study of 314 eyes undergoing VC in two centres over 6 years was conducted. Main outcome measures were: (i) intraocular pressure (IOP) control (complete success was IOP ≤ 18 mmHg without medication and failure IOP > 18 mmHg); and (ii) requirement for Nd:YAG laser goniopuncture (YAG‐GP) if IOP > 21 mmHg. Results: In the POAG group, 174 eyes underwent phaco‐VC and 104 VC. In the PEX group, 20 eyes underwent phaco‐VC and 16 VC. At final follow up, complete success rate (CSR) was 76% for POAG phaco‐VC, 67% for POAG VC, 95% for PEXG phaco‐VC and 63% for PEXG VC with mean IOP reduction of 29.9%, 40%, 42.5% and 51%, respectively. Without YAG‐GP, by 3 years postoperatively the failure rate was 100% for PEXG eyes and 21% for POAG eyes undergoing VC alone, but PEXG eyes undergoing phaco‐VC were 100% successful. CSR for YAG‐GP was 92% in PEXG VC eyes and 55% in POAG VC eyes. Conclusions: In phakic eyes with PEXG undergoing VC, an absolute requirement for long‐term success was YAG‐GP. This was not the case in POAG eyes or PEXG eyes undergoing phaco‐VC. Late IOP rise in phakic PEXG eyes and restoration of IOP control following YAG‐GP suggests that continued release of PEX material from the lens capsule with time blocks the outflow through the trabecular‐Descemetic window created by VC.     

Aqueous humor and serum concentration of hydroxyproline in pseudoexfoliation syndrome

PURPOSE: To determine the concentration of hydroxyproline (Hyp) in aqueous humor and serum samples of patients with and without pseudoexfoliation (PEX). PATIENTS AND METHODS: Aqueous humor and serum Hyp levels were measured in cataract patients. Patients were divided into PEX and control groups. Samples were obtained from 27 cataract patients with PEX and 25 cataract patients without PEX. Patients had no elevated intraocular pressure or glaucoma. Hyp concentration was determined spectrophotometrically. RESULTS: Mean Hyp concentration in the PEX aqueous (0.86+/-0.27 mg/L) and serum (40.8+/-6.14 mg/L) samples was significantly higher than that measured in the control aqueous (0.56+/-0.2 mg/L) and serum (34.51+/-6.82 mg/L) samples, respectively (P<0.001, P=0.001). No significant correlation could be found between aqueous humor and serum Hyp concentrations. CONCLUSIONS: The higher levels of Hyp could be a sign of increased collagen turnover in PEX syndrome.     

Endothelin-1-mediated signaling in the expression of matrix metalloproteinases and tissue inhibitors of metalloproteinases in astrocytes

PURPOSE: Endothelin (ET)-1 levels are increased in aqueous and vitreous humor in patients with glaucoma and animal models of glaucoma. Whether the elevated ET-1 induces extracellular matrix (ECM) remodeling in the optic nerve head is still unknown. In the present study, the regulation of matrix metalloproteinases/tissue inhibitors of matrix metalloproteinases (MMPs/TIMPs) and ECM remodeling in ET-1-activated human optic nerve head astrocytes (hONAs) were determined. METHODS: Primary hONAs were exposed to ET-1 for 1 day and 4 days. Incubation media were subjected to zymography and Western blot to detect activity and expression of MMPs and TIMPs. Fibronectin (FN) was monitored by Western blot and immunofluorescent staining. RESULTS: ET-1 increased the activity of MMP-2 and the expression of TIMP-1 and -2 in hONAs. The expression of TIMP-1 and -2 induced by ET-1 was abolished by application of inhibitors of mitogen-activated protein kinase (MAPK) or PKC, leading to enhanced activity of MMP-2. Knockdown of MMP-2, by using small interfering (si)RNA, not only decreased the activity of MMP-2 but also decreased the expression of TIMP-1 and -2. ET-1 increased the soluble (s)FN expression as well as FN matrix formation. However, the accumulation of sFN did not enhance FN matrix formation. Unlike ET-1's effects on MMP-2, blockade of MAPK and PKC did not alter the expression and deposition pattern of FN in hONAs. CONCLUSIONS: ET-1 increased the expression and activity of MMP-2 and TIMP-1 and -2. The ERK-MAPK and PKC pathways are involved in the regulation of expression of MMP-2 and TIMP-1 and -2. ET-1's effects on MMPs/TIMPs may be important, not only in regulating the expression of MMPs and TIMPs, but also in influencing ECM remodeling.     

Increased levels of<Emphasis Type="Italic"> Helicobacter pylori</Emphasis> IgG antibodies in aqueous humor of patients with primary open-angle and exfoliation glaucoma

Purpose A prospective, nonrandomized, comparative study was carried out to investigate the levels of anti-H. pylori-specific IgG antibodies in the aqueous humor and serum of patients with primary open-angle glaucoma (POAG) and patients with exfoliation glaucoma (XFG), and to compare them with those in age-matched cataract patients.Methods Aqueous humor was aspirated at the beginning of glaucoma surgery from 26 eyes of 26 patients with POAG, 27 eyes of 27 patients with XFG, and at the beginning of phakoemulsification cataract surgery from 31 eyes of 31 age-matched normotensive cataract patients. Serum samples were obtained the day before surgery from all patients. Anti-H. pylori IgG concentration in the aqueous humor and serum was measured by means of an enzyme-linked immunosorbent assay.Results The mean concentration (± SE) of anti-H. pylori-specific IgG was significantly greater in the aqueous humor samples from patients with POAG (14.27±3.86 U/ml) and XFG (14.25±3.39 U/ml) than in those from age-matched control cataract patients (4.67±1.07 U/ml); (P=0.006 and P=0.003, respectively). No difference was observed in the levels of H. pylori-specific IgG antibodies between POAG and XFG aqueous humor samples (P=0.5). Similarly, the serum concentration of anti-H. pylori antibodies was significantly greater in patients with POAG (69.96±9.69 U/ml; P=0.013) and XFG (81.37±10.62 U/ml; P=0.002) than in the cataract controls (44.16±6.48 U/ml). The mean vertical cupping correlated significantly with the titer of anti-H. pylori-specific IgG in the aqueous humor in the POAG patients.Conclusion H. pylori-specific IgG antibody levels are significantly increased in the aqueous humor and serum of patients with POAG and XFG. Moreover, the titer of anti-H. pylori antibody in the aqueous humor might reflect the severity of glaucomatous damage in POAG patients. These findings support a role for H. pylori infection in the pathobiology of these two common glaucomas.Financial support: noneCommercial interests: none     

Transforming growth factor-β2 levels in aqueous humor of glaucomatous eyes

PURPOSE: To determine whether clinical characteristics are correlated with increased levels of transforming growth factor-beta 2 (TGF-beta 2) in aqueous humor in glaucomatous eyes. METHODS: Aqueous humor samples were collected from 91 glaucomatous eyes. Included were samples from primary open-angle glaucoma (POAG) in 40 eyes, (pseudo)exfoliation syndrome (EXS) in 18 eyes, primary angle-closure glaucoma (PACG) in 26 eyes and uveitis-related secondary glaucoma (SG) in 7 eyes. TGF-beta 2 in aqueous humor was assessed with a specific-capture ELISA. RESULTS: The mean concentration (+/- standard error) of mature (biologically active) TGF-beta 2 in the aqueous humor of eyes with POAG was 293.6 +/- 33.6 pg/ml, significantly higher than that in eyes with PACG, EXS and SG: 147.5 +/- 28.1, 135.8 +/- 30.2 and 41.0 +/- 10.7 pg/ml, respectively (P = 0.0006, P = 0.0010 and P = 0.0003; analysis of variance). The mean concentration (+/- standard error) of total TGF-beta 2 in the aqueous humor of eyes with POAG was 1647.6 +/- 124.5 pg/ml, not significantly different from that in eyes with PACG, EXS and SG: 1482.9 +/- 148.2, 1442.7 +/- 187.8 and 1929.0 +/- 367.6 pg/ml, respectively. A multivariate analysis using logistic regression showed significant correlations between mature TGF-beta 2 concentration and history of cataract surgery (P = 0.0225) and the use of carbonic anhydrase inhibitors (P = 0.0143). CONCLUSIONS: Our results indicate that increased levels of TGF-beta 2 may play an important role in the pathogenesis of POAG.     

家兔晶状体机械性损伤后虹膜和房水中组织金属蛋白酶抑制物活性的改变

目的　探讨家兔晶状体机械性损伤后 ,基质金属蛋白酶抑制物 (TIMPs)在虹膜组织和房水中的动态变化及其意义。方法　建立单眼晶状体机械性损伤的家兔模型 ,应用反向酶谱法检测并定量分析损伤后 1、3、7和 15d眼内虹膜组织和房水中两种主要的TIMPs (TIMP 1、2 )的活性 ,并应用蛋白酶谱法检测TIMPs的作用底物基质金属蛋白酶 (MMPs)的活性。结果　健康家兔眼和实验家兔未损伤眼的虹膜组织和房水中 ,均未检测到TIMP 1、2的相应蛋白活性条带。伤后 1d家兔损伤眼的虹膜组织中的TIMP 1、2活性显著增加 (P <0 0 5 ) ,而MMP 2的活性受抑制 ;伤后 1d损伤眼的房水中 ,TIMP 1、2的活性均显著增加 (P <0 0 5 ) ;此后逐渐减少 ,至伤后 7d与健康家兔比较无差异 (P值分别为 0 0 97和 0 777) ;酶谱分析结果显示MMP 2活性的改变与此对应 ,即在损伤后 1d受到抑制 ,此后逐渐恢复。结论　TIMPs参与家兔晶状体机械性损伤后的眼内急性反应 ,对抑制炎性反应、促进创伤修复可能具有重要意义。     

剥脱性青光眼患者视网膜神经纤维层厚度变化分析

目的：比较维吾尔族假性剥脱综合征(PEX)患者、剥脱性青光眼(PEXG)患者视网膜神经纤维层(RNFL)厚度,为早期诊断剥脱性青光眼提供理论依据。

方法：回顾性病例对照研究。选取2018-04/ 2020-06在我院就诊治疗的维吾尔族假性剥脱综合征患者70例70 眼,剥脱性青光眼患者 80例80 眼,按照视野缺损分期分为早中期剥脱性青光眼患者56眼、晚期剥脱性青光眼患者24眼,选取同期本院收治的维吾尔族年龄相关性白内障病例60例60 眼作为对照组。比较四组患者视盘不同位置RNFL厚度。

结果：对照组、假性剥脱综合征组及剥脱性青光眼组患者视野缺损(MD)逐渐加重且剥脱性青光眼组患者MD显著高于假性剥脱综合征组(P<0.01); 假性剥脱综合征组、早中期剥脱性青光眼组及晚期剥脱性青光眼组视盘不同位置RNFL厚度较对照组均变薄(均P<0.01); 假性剥脱综合征组患者视盘平均RNFL、下方、上方RNFL厚度均低于对照组(均P<0.01)); 晚期剥脱性青光眼组患者视盘各个位置RNFL厚度明显低于早中期剥脱性青光眼患者(均P<0.01)。

结论：维吾尔族假性剥脱综合征患者早期RNFL厚度较未患有剥脱综合征人群开始变薄,早期对于假性剥脱综合征患者RNFL进行检测有助于剥脱性青光眼疾病诊断并进行治疗。     

Quantification of blood--aqueous barrier breakdown after trabeculectomy: pseudoexfoliation versus primary open-angle glaucoma

PURPOSE: Impairment of the blood-aqueous barrier in unoperated eyes with pseudoexfoliation syndrome has been demonstrated by fluorescein angiography, fluorophotometry, measurement of aqueous flare, and determination of aqueous protein. We performed noninvasive quantification of aqueous flare using the laser flare-cell meter to compare blood-aqueous barrier breakdown after trabeculectomy in eyes with primary open-angle glaucoma (POAG) and in eyes with pseudoexfoliative glaucoma (PEX). METHODS: Twenty eyes with PEX and 20 eyes with POAG were included in the study. Trabeculectomy was performed by two surgeons according to a standard trabeculectomy technique. Intra- and postoperative treatments were identical in both groups. Aqueous flare was quantitatively determined using the laser flare-cell meter FC-1000 (Kowa, Tokyo, Japan) before and 3, 5, 7, and 9 days after trabeculectomy. Absolute flare and difference between post- and preoperative flare values were statistically analyzed using the Mann-Whitney U-Test for independent samples. RESULTS: Before surgery, aqueous flare values were significantly higher in PEX than in POAG. On days 3, 5, 7 and 9 after surgery, flare values were significantly higher in eyes with PEX than in eyes with POAG. Absolute differences between post- and preoperative flare values also were significantly higher in eyes with PEX, but this was not true for percentage values. CONCLUSION: These results show that substantial blood-aqueous barrier breakdown occurs in eyes with PEX after trabeculectomy. These alterations may contribute to early or late complications of trabeculectomy and indicate the need for close postoperative follow-up evaluation in eyes with PEX.     

Glaukom und oxidativer Stress

BACKGROUND: Primary open-angle glaucoma (POAG) is a multifactorial disease, in which aging, race, genetic disposition, vascular status, probably inflammation, and maybe oxidative stress may play a specific role. We wanted to know if by using a common test for a specific oxidative stress product differences would be found in the aqueous humor and serum of patients with POAG, cataract without pseudoexfoliation, cataract with pseudoexfoliation, and volunteers without ocular disease. PATIENTS AND METHODS: We examined the aqueous humor of 33 patients with POAG, 111 patients with cataract without pseudoexfoliation, 39 patients with cataract and pseudoexfoliation syndrome and the serum of all three groups plus of 43 volunteers without ocular disease. Malondialdehyde as an oxidative stress product of peroxidation of lipids was proven by thiobarbituric acid-reacting substances (TBARS). RESULTS: The amount of TBARS is given in micromol/l: (1) in the serum of the group with cataract 1.176, with cataract and pseudoexfoliation 1.019, with POAG 0.992, and with healthy eyes 0.983; (2) in the aqueous humor of the group with cataract 0.279, with cataract and pseudoexfoliation 0.274, and with POAG 0.298. There were no statistically significant differences of TBARS (p<0.05) in either the aqueous humor or in the serum of patients with POAG in comparison to those patients without POAG. However, there was a significantly positive correlation between the values in the serum and the aqueous humor. CONCLUSION: For the first time malondialdehyde as a product of lipid peroxidation was determined in the aqueous humor of glaucomatous eyes. With the TBARS method used in our study, it was not possible to detect statistically significant differences of the lipid peroxidation product malondialdehyde between patients with or without POAG. It has to be taken into account that the cataract of the patients in the control group might be a disease per se caused by at least a certain amount of oxidative stress and that these subjects might therefore not be ideal as a control group.