Ascorbic acid concentration is reduced in the aqueous humor of patients with exfoliation syndrome

PURPOSE: To investigate whether there is a role for ascorbic acid in the development of exfoliation syndrome (XFS). DESIGN: A case-control study was undertaken that included consecutive patients with and without XFS in whom cataract surgery was indicated. Patients with ophthalmic conditions other than XFS and conditions that may influence ascorbic acid levels were excluded. METHODS: A prospective institutional study was undertaken. A small volume of aqueous humor was aspirated at the beginning of phacoemulsification cataract surgery. Eighty aqueous samples, 40 samples from 40 eyes of 40 cataract patients with XFS and 40 samples from 40 eyes of 40 age matched cataract patients without XFS, were collected and analyzed. Ascorbic acid concentration was evaluated in the aqueous samples with a microplate assay method. RESULTS: The mean +/- SD concentration of ascorbic acid in the aqueous from patients with XFS (0.86 +/- 0.43 mM; range, 0.12 to 1.7 mM) was significantly lower than the concentration of ascorbic acid found in the aqueous of age-matched control patients (1.15 +/- 0.50 mM; range 0.42 to 3.1 mM; P =.0068). Total mean protein concentration was found to be significantly higher in the XFS group (481.1 +/- 196.8 pg/dl versus 336.3 +/- 86.4 pg/dl in the controls; P <.0001). Nevertheless, no correlation could be established between ascorbic level and protein concentration. CONCLUSIONS: A significantly reduced mean level of ascorbic acid was observed in the aqueous humor of patients with XFS. In view of the fact that ascorbic acid is a major protective factor against free radical action, a role for free radical action is possible in the pathobiology of XFS.     

Antirecoverin antibody in the aqueous humor of a patient with cancer-associated retinopathy

PURPOSE: To describe a patient with cancer-associated retinopathy (CAR) in whom antirecoverin antibody was found in the aqueous humor.DESIGN: Interventional case report.METHODS: A 65-year-old man underwent resection of adenocarcinoma of the lung in June 1991 and noted deterioration of vision 10 months later. Goldmann perimetry revealed a ring-like scotoma in each eye, and the electroretinogram was nonrecordable. Aqueous humor and peripheral venous blood were collected for Western blot analysis from this patient and three other patients during surgery for age-related cataract.RESULTS: We found antirecoverin antibody within the aqueous humor and serum in the patient with CAR. In contrast, such imunoreactivities were not observed in specimens from the control patients.CONCLUSION: These observations strongly suggest that antirecoverin antibody penetrates into the aqueous humor and vitreous cavity beyond the blood-retina barrier in CAR.     

Increased interleukin-6 in aqueous humor of a patient with lung-metastatic intraocular adenocarcinoma

PURPOSE: We report increased interleukin (IL)-6 level in aqueous humor of a case of lung adenocarcinoma with metastasis to iris and anterior chamber. DESIGN: Interventional case report. METHODS: In one case and 11 healthy cataract patients as controls, we checked the levels of IL-6, IL-2, and tumor necrosis factor (TNF)-alpha in aqueous humor and serum by enzyme-linked immunosorbent assay. RESULTS: Levels of these three cytokines in serum were almost the same as with the levels in aqueous humor in the control group. The IL-6 concentrations ranged from 12.6 to 27.0 pg/ml (mean, 23.5 pg/ml) in serum and 15.0 to 43.1 pg/ml (mean, 22.4 pg/ml) in aqueous humor. There was no statistically significant difference between them. Compared with the control, the IL-6 concentration in aqueous humor of this patient, 282.0 pg/ml, increased more than 10-fold. CONCLUSION: This is a report describing elevated IL-6 level in the aqueous humor of a patient with intraocular metastasis from lung adenocarcinoma.     

房水检测在青光眼睫状体炎综合征诊断中应用的临床研究

目的观察青光眼睫状体炎综合征(PSS)的临床表现特点,评估应用房水检测在PSS早期诊断中的效果。 方法回顾性分析2019年5月至2021年7月于北京首都医科大学附属北京朝阳医院眼科确诊PSS患者41例(41只眼)和老年性白内障患者30例(30只眼)的病例资料。其中,男性38例(38只眼),女性33例(33只眼);年龄15~86岁,平均年龄(54.4±10.3)岁。患有PSS者定义为PSS组;老年性白内障患者定义为对照组。使用非接触式眼压计检查患者的眼压;使用光学相干断层扫描仪检查患者的视盘杯盘比;使用裂隙灯显微镜观察房水的性状,包括羊脂状角膜后沉着物(KP)、Tyndall征及前房浮游细胞。采集所有患者的房水,检测其病毒载量、病毒抗体及细胞因子浓度。病毒包括巨细胞病毒(CMV)、单纯疱疹病毒(HSV)、带状疱疹病毒(VZV)及EB病毒(EBV);细胞因子包括白细胞介素(IL)-6、IL-8、IL-10、血管内皮生长因子(VEGF)、血管细胞黏附分子(VCAM)及碱性成纤维细胞生长因子(bFGF)。对患者的年龄和以房水为标本检测的HSV、VZV、CMV、EBV、IL-6、IL-8、IL-10、VEGF、VCAM及bFGF等指标的检测结果行正态性分布检验,符合正态分布的计量资料以±s表示,组间比较采用独立样本t检验;偏态分布的计量资料以中位数和上下四分位数表示,组间比较采用Mann-Whitney秩和检验。房水病原体阳性率以例数和百分比表示,组间比较采用Mcnemar配对卡方检验。 结果PSS组患者行房水生物显微镜观察羊脂状KP、Tyndall征及前房浮游细胞者分别为33例、32例及29例;行眼压测量者33例;行光学相干断层扫描检查杯盘比者32例。其中,羊脂状KP(+)者24例,占72.7%;Tyndall征(+)者12例,占37.5%;前房浮游细胞(+)者5例,占17.2%;眼压增高(>21 mmHg)(1 mmHg＝0.133 kPa)者15例,占45.5%;杯盘比≥0.6者7例,占21.9%。PSS组患者行HSV、VZV、CMV及EBV核酸检测者分别为22例、22例、38例及25例。其中,CMV(+)者9例,占23.7%,其余均为阴性。PSS组患者行HSV、VZV、CMV及EBV的免疫球蛋白(Ig)G抗体检测者分别为23例、21例、31例及20例。其中,HSV-IgG(+)、VZV-IgG(+)及CMV-IgG(+)抗体者分别为2例、1例及16例,分别占8.7%、4.8%及51.6%。其余均为阴性。对照组30例HSV、VZV、CMV及EBV核酸和IgG抗体检测阳性者均为0。PSS组患者中同一病例同时检测CMV核酸与CMV-IgG抗体者29例。PSS患眼房水CMV的核酸检测阳性检出率为24.1%,CMV-IgG抗体的阳性检出率为48.3%,高于前者。经Mcnemar配对卡方检验,组间比较的差异无统计学意义(P>0.05)。PSS患眼房水IL-6、IL-8、IL-10、VEGF、VCAM及bFGF的含量分别为22.5(5.1,212.7)pg/ml、18.1(8.4,54.1)pg/ml、3.6(0.5,9.0)pg/ml、20.2(14.7,28.0)pg/ml、1212.4(369.9,3617.9)pg/ml及5.9(0.0,7.3)pg/ml。对照组患眼分别为9.9(3.7,34.9)pg/ml、9.6(2.0,24.2)pg/ml、1.6(1.0,5.2)pg/ml、20.5(11.2,24.5)pg/ml、116.4(83.8,178.5)pg/ml及7.1(1.0,15.6)pg/ml。经Mann-Whitney秩和检验,两组患者IL-8、VCAM及bFGF比较的差异有统计学意义(Z＝-2.57,-4.77,-2.07;P<0.05);两组患者IL-6、IL-10及VEGF比较的差异无统计学意义(Z＝-1.56,-1.18,-0.25;P>0.05)。 结论PSS的主要临床表现为羊脂状KP(+)、眼压升高。房水中CMV核酸阳性、IgG抗体阳性、细胞因子IL-8升高及VCAM升高在诊断PSS时灵敏度高,对PPS的辅助诊断有临床价值。     

Uric acid in the aqueous humor and tears of retinoblastoma patients

PURPOSE: Malignancy can be associated with high levels of catabolic products. We performed a two-part study. Part 1 measured levels of uric acid and xanthine in the aqueous humor of eyes with malignant and nonmalignant diagnoses. Part 2 measured the levels of uric acid in tears of retinoblastoma patients. If compounds in high concentrations inside the eye could be detected outside the eye, via diffusion, in high concentrations in the tears, then a tear screening test for retinoblastoma could be developed. METHODS: High-performance liquid chromatography measured levels of uric acid and xanthine in aqueous humor samples of patients with retinoblastoma, melanoma, Coats' disease, adult cataract, and congenital cataract. Tear sampling was performed on patients with retinoblastoma and on normal eyes, and samples were assayed for uric acid. RESULTS: Part 1--Uric acid was elevated in the aqueous humor of eyes with retinoblastoma, melanoma, and Coats' disease compared with eyes with cataracts. Xanthine was elevated in retinoblastoma and Coats' disease and was lower in adult and congenital cataracts and melanoma. Part 2-No significant difference was found in the concentrations of uric acid in the tears of patients with retinoblastoma and those of normal patients. CONCLUSIONS: High levels of uric acid and xanthine present in the aqueous humor of patients with malignancy are consistent with the destructive nature of these conditions. Although uric acid was not elevated in the tears of retinoblastoma patients, continued investigation into substances that might be measurably different in the tears may yield a useful screening test in the future.     

Glaucoma related with photoreceptor outer segments in aqueous humor. Schwartz-Matsuo syndrome

CASE REPORT: We present the case of a patient who was initially diagnosed of hypertensive uveitis with marked fluctuation that was resistant to the common treatment. After a systematic examination, retinal detachment of the ora serrata in the inferotemporal quadrant was diagnosed. The sample of aqueous humor showed melanic pigment and degenerated photoreceptor outer segments. After retinal detachment surgery, the intraocular pressure returned to normal levels without antiglaucoma medication. DISCUSSION: The presence of photoreceptor outer segments in aqueous humor confirms the diagnosis of Schwartz-Matsuo syndrome, which should be considered as a differential diagnosis of iritis and glaucoma.     

Ascorbic acid as a free radical scavenger in porcine and bovine aqueous humour

AIM: To study the antioxidant activity, UV absorption, concentration and stability of ascorbic acid (AA) in porcine and bovine aqueous humour (AH). METHODS: Porcine and bovine AH was taken within 5 min after death and frozen at -70 degrees C. The characteristic UV absorption band of AA and the concentration of AA in AH was determined by UV spectrophotometry. The antioxidant activity of AA to serve as a free radical scavenger in AH has been determined by using a novel fluorescent probe for antioxidants, the azoalkane 2,3-diazabicyclo[2.2.2]oct-2-ene (DBO). The fluorescence lifetime and intensity of this probe reflect the concentration of dissolved antioxidants. The time-resolved fluorescence of DBO (laser excitation at 351 nm) in AH and in a neutral phosphate-buffered saline (PBS) solution containing only the natural amount of AA as an additive were measured. RESULTS: The characteristic UV absorption band of AA has its maximum at 266 nm in AH. The concentration of AA in porcine and bovine AH was found to be 0.547 +/- 0.044 and 1.09 +/- 0.16 mM, respectively, by spectrophotometry. The fluorescence lifetime of the probe DBO was reduced from 320 +/- 5 ns in pure aerated PBS to 205 +/- 5 ns in porcine AH and 165 +/- 3 ns in bovine AH. A detailed kinetic analysis of the lifetime shortening suggests that AA contributes approximately 75 and 85% to the antioxidant activity of porcine and bovine AH, respectively. CONCLUSIONS: Our experiments suggest that AA is the major contributor to the antioxidant activity of porcine and bovine AH. The role of AA to serve as an antioxidant in AH is discussed. In addition, UV spectrophotometry is established as an alternative method to determine the concentration of AA in AH.     

青光眼睫状体炎综合征房水前列腺素 E2含量的变化

目的：探讨青光眼睫状体炎综合征（青睫综合征）房水前列腺素E2（ PGE2）含量的变化。方法青睫综合征患者21例（21只眼）,分别在给予非甾体类消炎药治疗前后采用放射免疫法测量房水PGE2浓度,拟行超声乳化联合人工晶状体植入术的年龄相关性白内障患者21例（21只眼）设为对照。结果应用非甾体类消炎药治疗前试验组房水PGE2平均浓度为（45．39±5．82）ng/L ,对照组房水中PGE2平均浓度为（12．46±2．87）ng/L,差异有显著性意义（ P ＜0．05）;试验组经非甾体类消炎药治疗后,房水PGE2浓度下降至（23．78±3．67） ng/L（ P＜0．05）。结论青睫综合征房水PGE2浓度升高。     

Concentration of hyaluronic acid in primary open-angle glaucoma aqueous humor

We compared the concentration of hyaluronic acid in the aqueous humor of primary open-angle glaucoma (POAG) patients and non-glaucomatous patients. Aqueous humor samples were obtained from 22 patients just before trabeculectomy for clinically uncontrolled POAG (POAG group). Aqueous humor (0.1 mL) was aspirated by inserting a 26-gauge needle into the anterior chamber. The same procedure was performed for 22 non-glaucomatous patients just before cataract surgery (control group). Immediately after collection, the aqueous humor was stored at -20 degrees C. The concentration of hyaluronic acid was determined by a sensitive, noncompetitive and nonisotopic fluoroassay. The median (range) concentrations of hyaluronic acid of the POAG and control groups were 298.4 microg L(-1) (99.0-743.7 microg L(-1)) and 545.1 microg L(-1) (145.0-2366.0 microg L(-1)), respectively. The difference in concentrations of hyaluronic acid between the groups was statistically significant (P<0.001). In conclusion, the concentration of hyaluronic acid in the aqueous humor in POAG patients is lower than in non-glaucomatous patients. Further studies are necessary to determine the role of hyaluronic acid in the pathophysiology of POAG.     

Cytological and immunological study of the aqueous humor in acute retinal necrosis syndrome

We experienced 4 cases of acute retinal necrosis syndrome, and performed anterior chamber paracentesis as a diagnostic aid in their acute and convalescent phases. The aqueous humor obtained by it was used for measuring antibody titers to herpes group virus and electron microscopic observation. One case showed elevated titer to herpes simplex virus type 1 in the convalescent phase, while the other to varicella-zoster virus, suggesting that these 2 viruses could cause this disease. Electron microscopy showed persistent lymphocytes and macrophages throughout the course, while plasma cells appeared at the height of the inflammation corresponding to the locally elevated antibody titers. There was no electron microscopic evidence of viral infection in the aqueous cells examined.     

假性剥脱综合征患者房水生物活性物质的变化

假性剥脱综合征是一种可以导致开角型青光眼的系统性疾病.关于患者前房中为何会出现剥脱物及剥脱物的来源问题,至今尚有各种不同的学说,但并无确切定论.为探求前房剥脱物的成因,进而分析假性剥脱综合征的发病原因及机制,有必要就近年来研究者利用不同手段测定房水中各种物质变化的结果进行综述.

Abstract：

Pseudoexfoliation syndrome, which represents the most commonly identified specific cause of open-angle glaucoma, is a kind of clinically systemic disease. Why there are so much xfoliative material deposited in the anterior chamber? Where did xfoliative material come from? The pathogenesis is never be confirmed exactly, though there are so many theories described by investigators. In recent years, in order to survey and evaluate the changes of the materials of the aqueous humor of patients with the Pseudoexfoliation syndrome, many investigators had done more works. This review will give a summarization of these findings.     

UV absorption by uric acid in diurnal bird aqueous humor

PURPOSE: To analyze the components responsible for the UV absorbance in diurnal bird aqueous humor. METHODS: The absorbance studies were carried out using a Hitachi spectrophotometer (U 2000). Uric acid was determined by high-performance liquid chromatography (LC-10 system; Shimadzu, Kyoto, Japan). Chicken and turkey eyes were examined. RESULTS: The UV absorbance in chicken aqueous was largely accounted for by the presence of protein, tryptophan, tyrosine, ascorbic acid, and uric acid. Ascorbic acid was low (23 micromol/l). Uric acid was, on the other hand, remarkably high (151 micromol/l) compared with that in mammals (cattle, 16 micromol/l). Principally the same results were obtained in chicken and turkey. CONCLUSIONS: Uric acid is a significant UV-absorbing substance in the aqueous humor of diurnal birds with its peak absorbance at 292 nm. The hypothesis that the aqueous humor acts as a UV filter seems to be valid also for the avian eye. However, in these eyes uric acid fulfills the role that ascorbic acid does in mammals.