Brooks A M, Gillies W E
Glaucoma Investigation and Research Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.
Br J Ophthalmol. 1988 Apr;72(4):270-3. doi: 10.1136/bjo.72.4.270.
A series of 474 mixed cases of glaucoma was assessed to determine whether there were any genetic differences between different types of glaucoma. A careful distinction was made between chronic open angle glaucoma (COAG), acute and chronic angle closure glaucoma, ocular hypertension, low tension glaucoma, patients with large cup disc ratios, and various types of secondary glaucoma including pseudoexfoliation of the lens capsule, uveitic and traumatic glaucoma. Using ABO blood groups, Rhesus groups, ABH secretion or non-secretion, and phenylthiourea tasting we identified certain differences. The differences from normal were significant decrease in Rh-negative patients in chronic closed angle glaucoma (p less than 0.05), a decrease in ABH secretors in ocular hypertension (p less than 0.01), and fewer HB secretors in patients with COAG (p less than 0.02). There was a significant decrease in AH secretors and increase in HB secretors in both pseudoexfoliation with raised intraocular pressure compared with COAG (p less than 0.01) and in secondary glaucomas as a group compared with COAG (p less than 0.01). Tasters of phenylthiourea were more common in traumatic and uveitic glaucoma than in normal controls (p less than 0.05). These results suggest that secondary glaucoma develops in different subjects from COAG, while patients who develop a rise in intraocular pressure proceed to cupping and field loss if they have a certain genetic constitution. The groups of patients are too small for the differences to be of great prognostic value.
对474例混合型青光眼病例进行了评估,以确定不同类型青光眼之间是否存在基因差异。对慢性开角型青光眼(COAG)、急慢性闭角型青光眼、高眼压症、低眼压性青光眼、杯盘比大的患者以及包括晶状体囊假性剥脱、葡萄膜炎性和外伤性青光眼在内的各种继发性青光眼进行了仔细区分。通过ABO血型、恒河猴血型、ABH分泌或非分泌以及苯硫脲味觉测试,我们发现了某些差异。与正常情况相比,差异在于慢性闭角型青光眼中Rh阴性患者显著减少(p<0.05),高眼压症中ABH分泌者减少(p<0.01),COAG患者中HB分泌者较少(p<0.02)。与COAG相比,眼压升高的假性剥脱患者以及作为一个整体的继发性青光眼患者中,AH分泌者显著减少,HB分泌者增加(p<0.01)。苯硫脲味觉者在创伤性和葡萄膜炎性青光眼中比正常对照组更常见(p<0.05)。这些结果表明,继发性青光眼与COAG发生于不同个体,而眼压升高的患者如果具有某种基因构成,则会发展为视盘凹陷和视野缺损。这些患者组规模太小,差异尚无重大预后价值。