Reactive oxygen species promote localized DNA damage in glaucoma-iris tissues of elderly patients vulnerable to diabetic injury.

Glaucoma is typically an insidious-onset disease with serious visual consequences that has been positively linked to diabetes mellitus (DM). Glaucoma is more often present in the elderly. Important prognostic factors of glaucoma may be oxidative stress resulting from the toxic effects of glucose, and diabetes-associated vascular complications. Fifty-five patients and control subjects aged 71.0+/-10.1 yrs were enrolled in this study. Iris-tissue samples from DM type-2 patients, primary open-angle glaucoma-positive and -negative DM patients, and from healthy subjects were examined by use of the alkaline comet assay. We measured the DNA damage as numbers of strand breaks (SBs), oxidized purines as glycosyl-formamido-glycosylase (Fpg)-susceptible sites, and oxidized pyrimidines as endonuclease III (Nth)-susceptible sites. It was found that the level of oxidative damage in iris tissue was statistically higher in DM and glaucoma patients than that in healthy controls (oxidized purines: 38.0% and 34.7% vs 15.4%; oxidized pyrimidines: 43.3% and 39.0% vs 23.3%; P<0.001). Interestingly, we found strongly elevated levels of oxidized purines and pyrimidines in glaucomatous patients who also had DM, in comparison with healthy controls (oxidized purines: 55.7% vs 15.4%; oxidized pyrimidines: 61.8% vs 23.3%; P<0.001). Our observations suggest that the generation of reactive oxygen species may promote localized DNA damage in glaucoma-iris tissues of elderly patients vulnerable to diabetic injury.