Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Curr Eye Res. 2013 Sep;38(9):983-8. doi: 10.3109/02713683.2013.800889. Epub 2013 Jun 14.
The objective of this study was to investigate the association between systemic oxidative stress and visual field defect progression in normal-tension glaucoma (NTG).
The subjects were 40 consecutive patients with NTG who were admitted to Keio University Hospital for 24-h intraocular pressure (IOP) evaluation; all subjects underwent six or more visual field tests in either eye and were followed up for >5 years. Spot samples of morning urine were collected during admission from all participants to determine the levels of urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) by ELISA kit. A linear regression line was calculated with the least squares method. Those subjects whose regression lines were negative and the p value <0.05 were classified as progressive, while all others were defined as non-progressive. Urinary 8-OHdG/creatinine level was compared between the two groups. Adjusted odds ratio and 95% confidence intervals for the progression were estimated with logistic regression models.
Seventeen subjects showed visual field defect progression (age: 59.9 ± 9.5 years, untreated IOP in the right eye: 15.8 ± 2.1 mmHg), and 23 subjects showed no progression (age: 57.4 ± 10.4 years, untreated IOP in the right eye: 16.0 ± 2.6 mmHg). Urinary 8-OHdG/creatinine level was significantly higher in the progressive group than in the non-progressive group (progressive group: 9.0 ± 2.4 ng/mg creatinine, non-progressive group: 7.3 ± 1.8 ng/mg creatinine, p = 0.02). Multivariable analysis revealed that higher urinary 8-OHdG/creatinine level was a significant risk factor for the progression (odds ratio 1.54, 95% confidence interval 1.03-2.29).
Increased urinary 8-OHdG/creatinine was associated with glaucomatous visual field progression in subjects with NTG.
本研究旨在探讨正常眼压性青光眼（NTG）患者全身氧化应激与视野缺损进展的关系。
连续纳入 40 例因 24 小时眼压（IOP）评估而入住庆应义塾大学医院的 NTG 患者；所有患者均至少在一眼进行了 6 次以上的视野检查，并随访时间超过 5 年。所有患者在入院期间采集晨尿标本，采用 ELISA 试剂盒检测尿 8-羟基-2'-脱氧鸟苷（8-OHdG）水平。采用最小二乘法计算线性回归线。以回归线为负且 p 值<0.05 的患者为进展组，其余患者为非进展组。比较两组患者的尿 8-OHdG/肌酐水平。采用 logistic 回归模型估计进展的调整优势比和 95%置信区间。
17 例患者出现视野缺损进展（年龄：59.9±9.5 岁，右眼未治疗 IOP：15.8±2.1mmHg），23 例患者无进展（年龄：57.4±10.4 岁，右眼未治疗 IOP：16.0±2.6mmHg）。进展组患者的尿 8-OHdG/肌酐水平明显高于非进展组（进展组：9.0±2.4ng/mg 肌酐，非进展组：7.3±1.8ng/mg 肌酐，p=0.02）。多变量分析显示，较高的尿 8-OHdG/肌酐水平是视野进展的显著危险因素（优势比 1.54，95%置信区间 1.03-2.29）。
在 NTG 患者中，尿 8-OHdG/肌酐水平升高与青光眼视野进展相关。
