Rusmayani Emma, Artini Widya, Sasongko Muhammad Bayu, Viona Viona
Glaucoma Department, Jakarta Eye Center Hospitals and Clinics, Jakarta, Indonesia.
Ophthalmology Department, Faculty of Medicine University Gadjah Mada, Yogyakarta, Indonesia.
Clin Ophthalmol. 2022 Dec 10;16:4075-4087. doi: 10.2147/OPTH.S388382. eCollection 2022.
To analyze ischemia-modified albumin (IMA) levels in aqueous humor and serum, and their correlation to RNFL thinning in primary glaucoma patients.
Cross-sectional study.
Patients were divided into the control and glaucoma groups. The control group was patients with senile cataracts. The glaucoma group consisted of patients diagnosed for the first time as primary open-angle glaucoma (POAG) or primary angle closure glaucoma (PACG). Exclusion criteria were secondary glaucoma and patients with systemic disease. A complete cataract examination was done for all patients, and glaucoma examinations for the glaucoma group. In both groups, the IMA aqueous humor was obtained during cataract and glaucoma procedure. Serum levels of IMA, malondialdehyde (MDA), and tumor necrosis factor alpha (TNF-α) were examined during preoperative examinations.
Control group comprised 33 participants, and glaucoma group 41 patients (21 PACG and 20 POAG). Mean IMA aqueous humor (AQH) levels found in cataract group 6.039±3.16 ng/mL, glaucoma group 14.89±6.08 ng/mL, PACG group 12.69±6.25 ng/mL and POAG group 17.33±4.988 mg/mL. Mean IMA serum levels in cataract group 14.75±6.53 ng/mL, glaucoma group 13.89±6.53 ng/mL, PACG group 12.79±6.46 ng/mL± and POAG group 14.93±10.74 ng/mL. Glaucoma group had significant higher level of IMA in aqueous humor compared to control group, but opposite findings in serum IMA levels between groups. POAG patients had a higher aqueous IMA level compared to PACG group and correlated significantly with IOP. IMA AQH also negatively correlated to the RNFL thickness in both POAG and PACG group. Cut off 9.5 ng/mL was considered as a normal limit value to differentiate between control and glaucoma group.
Primary glaucoma patients showed a significantly increased level of IMA AQH as a local ischemic biomarker compared to the control group. Systemic oxidative activity is not a representation of local ocular oxidative stress in both cataract and glaucoma group.
分析原发性青光眼患者房水和血清中缺血修饰白蛋白（IMA）水平及其与视网膜神经纤维层（RNFL）变薄的相关性。
横断面研究。
将患者分为对照组和青光眼组。对照组为老年性白内障患者。青光眼组由首次诊断为原发性开角型青光眼（POAG）或原发性闭角型青光眼（PACG）的患者组成。排除标准为继发性青光眼和患有全身性疾病的患者。对所有患者进行了全面的白内障检查，对青光眼组进行了青光眼检查。两组患者均在白内障和青光眼手术过程中获取房水IMA。术前检查血清IMA、丙二醛（MDA）和肿瘤坏死因子α（TNF-α）水平。
对照组33例，青光眼组41例（21例PACG和20例POAG）。白内障组房水IMA平均水平为6.039±3.16 ng/mL，青光眼组为14.89±6.08 ng/mL，PACG组为12.69±6.25 ng/mL，POAG组为17.33±4.988 mg/mL。白内障组血清IMA平均水平为14.75±6.53 ng/mL，青光眼组为13.89±6.53 ng/mL, PACG组为12.79±6.46 ng/mL，POAG组为14.93±10.74 ng/mL。与对照组相比，青光眼组房水中IMA水平显著更高，但两组血清IMA水平结果相反。POAG患者房水IMA水平高于PACG组，且与眼压显著相关。POAG组和PACG组中房水IMA均与RNFL厚度呈负相关。截断值9.5 ng/mL被视为区分对照组和青光眼组的正常限值。
与对照组相比，原发性青光眼患者房水IMA水平显著升高，可作为局部缺血生物标志物。白内障组和青光眼组全身氧化活性均不能代表局部眼部氧化应激。
