Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri.
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri.
Am J Ophthalmol. 2019 Jul;203:12-25. doi: 10.1016/j.ajo.2019.02.008. Epub 2019 Feb 15.
The purpose of this study was to investigate correlations of partial pressure of oxygen (pO) in the ocular anterior segment of human eyes and aqueous humor antioxidant levels of ascorbate (AsA) and total reactive antioxidant potential (TRAP) with glaucoma and vitreous status.
This prospective, cross-sectional study stratified patients (n = 288 eyes) by lens and vitreous status and the presence of primary open-angle glaucoma for statistical analyses. Intraocular pO concentrations were measured using a fiberoptic probe in patients at the beginning of planned glaucoma and/or cataract surgery. Aqueous humor specimens were obtained for antioxidant analysis of AsA and TRAP.
Following prior pars plana vitrectomy, pO levels were significantly higher than in the reference group of cataract surgery in the anterior chamber angle (16.2 ± 5.0 vs. 13.0 ± 3.9 mm Hg; P = .0171) and in the posterior chamber (7.6 ± 3.1 vs. 3.9 ± 2.7 mm Hg; P < .0001). AsA and TRAP levels were significantly lower (1.1 ± 0.4 vs. 1.4 ± 0.5 mM, respectively; 403.3 ±116.5 vs. 479.0 ± 146.7 Trolox units, respectively; P = .004 and P = .024, respectively) in patients after vitrectomy. In patients with an intact vitreous, neither pO nor antioxidant status correlated with lens status or glaucoma.
Increased pO and antioxidant depletion following vitrectomy suggests an alteration of the intraocular oxidant-antioxidant balance. Our study links physiologic factors such as increased pO in the anterior chamber angle and the posterior chamber to decreased antioxidant levels in aqueous humor following vitrectomy. Oxidative stress/damage to the trabecular meshwork in such post-vitrectomy cases may contribute to intraocular pressure elevation and increased risk of glaucoma. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
本研究旨在探讨人眼前节氧分压（pO ）与房水抗氧化物抗坏血酸（AsA）和总反应性抗氧化能力（TRAP）水平与青光眼和玻璃体状态的相关性。
本前瞻性、横断面研究根据晶状体和玻璃体状态以及原发性开角型青光眼的存在对患者（n=288 眼）进行分层，以便进行统计学分析。在计划进行青光眼和/或白内障手术的患者中，使用光纤探头测量眼内 pO 浓度。获取房水标本，用于分析 AsA 和 TRAP 的抗氧化剂水平。
在接受经睫状体平坦部玻璃体切割术（PPV）后，前房角（16.2±5.0 比 13.0±3.9mmHg；P=.0171）和后房（7.6±3.1 比 3.9±2.7mmHg；P<.0001）中的 pO 水平显著高于参考组白内障手术。玻璃体切割术后，AsA 和 TRAP 水平明显降低（分别为 1.1±0.4 比 1.4±0.5mM，403.3±116.5 比 479.0±146.7Trolox 单位；P=.004 和 P=.024）。在玻璃体完整的患者中，pO 和抗氧化剂状态均与晶状体状态或青光眼无关。
玻璃体切割术后 pO 增加和抗氧化剂耗竭表明眼内氧化还原平衡发生改变。本研究将前房角和后房的 pO 等生理因素与玻璃体切割术后房水中抗氧化物水平降低联系起来。在这种玻璃体切割术后的情况下，小梁网的氧化应激/损伤可能导致眼压升高和青光眼风险增加。
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