Mudassar Imran Bukhari Syed, Yew Kiu Kwong, Thambiraja Rajasunthari, Sulong Sarina, Ghulam Rasool Aida Hanum, Ahmad Tajudin Liza-Sharmini
Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia.
Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia.
Ther Adv Ophthalmol. 2019 Aug 22;11:2515841419868100. doi: 10.1177/2515841419868100. eCollection 2019 Jan-Dec.
To determine the role of microvascular endothelial dysfunction as risk factor for primary open angle glaucoma.
A cross-sectional study was conducted involving 114 Malay patients with POAG seen at the eye clinic of Hospital Universiti Sains Malaysia. Patients aged between 40 and 80 years who were diagnosed with other types of glaucoma, previous glaucoma filtering surgery or other surgeries except uncomplicated cataract surgery and pterygium surgery were excluded. A total of 101 patients who were followed up for dry eyes, age-related cataracts or post cataracts extraction surgery were recruited as control subjects. Those with family history of glaucoma or glaucoma suspect were excluded. Microvascular endothelial function was assessed using laser Doppler fluximetry and the process of iontophoresis. Iontophoresis with acetylcholine (ACh) and sodium nitroprusside (SNP) was used to measure microvascular endothelium-dependent and endothelium-independent vasodilatations, respectively.
In general, POAG patients demonstrated lower ACh% and ACh values compared with controls. There was significant difference in microvascular endothelial function [ACh%: mean, 95% confidence interval = 503.1 (378.0, 628.3), and ACh: mean, 95% confidence interval = 36.8 (30.2, 43.5)] between primary open angle glaucoma cases ( < 0.001) and controls [ACh%: mean, 95% confidence interval = 1378.4 (1245.4, 1511.3), and ACh: mean, 95% confidence interval = 79.2 (72.1, 86.2)]; this difference remained significant even after controlling for potential confounders. Similar difference was also found in SNP% and SNP between POAG and controls ( < 0.001). Age and diastolic blood pressure were inversely correlated with microvascular endothelial function.
There was an impairment of microvascular endothelial function and endothelial-independent vasodilatation in POAG patients. Microvascular endothelial function is a potential risk factor for POAG.
确定微血管内皮功能障碍作为原发性开角型青光眼危险因素的作用。
进行了一项横断面研究，纳入了马来西亚理科大学医院眼科门诊的114名马来原发性开角型青光眼患者。排除年龄在40至80岁之间、被诊断患有其他类型青光眼、曾接受青光眼滤过手术或除单纯白内障手术和翼状胬肉手术之外的其他手术的患者。总共招募了101名因干眼症、年龄相关性白内障或白内障摘除术后接受随访的患者作为对照对象。排除有青光眼家族史或疑似青光眼的患者。使用激光多普勒血流仪和离子导入法评估微血管内皮功能。分别使用乙酰胆碱（ACh）和硝普钠（SNP）离子导入法测量微血管内皮依赖性和内皮非依赖性血管舒张。
总体而言，原发性开角型青光眼患者的ACh%和ACh值低于对照组。原发性开角型青光眼病例（<0.001）与对照组[ACh%：均值，95%置信区间 = 1378.4（1245.4，1511.3），ACh：均值，95%置信区间 = 79.2（72.1，86.2）]之间的微血管内皮功能存在显著差异[ACh%：均值，95%置信区间 = 503.1（378.0，628.3），ACh：均值，95%置信区间 = 36.8（30.2，43.5）]；即使在控制了潜在混杂因素后，这种差异仍然显著。在原发性开角型青光眼患者与对照组之间，SNP%和SNP也发现了类似差异（<0.001）。年龄和舒张压与微血管内皮功能呈负相关。
原发性开角型青光眼患者存在微血管内皮功能和内皮非依赖性血管舒张受损。微血管内皮功能是原发性开角型青光眼的一个潜在危险因素。
