Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan.
Department of Aging Vision Healthcare, Tohoku University Graduate School of Biomedical Engineering, Miyagi, Japan.
PLoS One. 2023 Feb 24;18(2):e0282047. doi: 10.1371/journal.pone.0282047. eCollection 2023.
To investigate the association of systemic oxidative stress markers and optic nerve head (ONH) blood flow in normal-tension glaucoma (NTG) patients, as well as sex differences in this association.
This was a cross-sectional study of 235 eyes with NTG of 134 patients (56 male, 78 female; mean age, 60.9±14.1 years). Laser speckle flowgraphy (LSFG) was used to measure ONH blood flow (mean blur rate in the tissue area of the ONH; MBR-T) and LSFG pulse-waveform parameters, including flow acceleration index in the tissue area of the ONH (FAI-T). Oxidative stress markers, diacron-reactive oxygen metabolites (d-ROMs), and biological antioxidant potential (BAP) were measured with a free radical elective evaluator. Spearman's rank correlation test and a multivariate linear mixed-effect model were used to investigate factors associated with ONH blood flow.
MBR-T was significantly correlated with age (rs = -0.28, p < 0.001), mean arterial pressure (rs = -0.20, p = 0.002), intraocular pressure (rs = 0.24, p < 0.001), peripapillary retinal nerve fiber layer thickness (rs = 0.62, p < 0.001), and disc area (rs = -0.26, p < 0.001), but not with serum d-ROM level. Separate analyses of the subjects divided by sex showed that BAP was positively correlated to MBR-T (rs = 0.21, p = 0.036) and FAI-T (rs = 0.36, p < 0.001) only in male subjects. Similarly, BAP was significantly associated with MBR-T (β = 0.25, p = 0.026) and FAI-T (β = 0.37, p < 0.001) in male subjects in a multivariate linear mixed-effect model.
A lower serum antioxidant level, as indicated by BAP, was associated with reduced ONH blood flow only in male NTG patients. Our findings suggest that there are sex differences in the involvement of oxidative stress in the pathogenesis of reduced ocular blood flow in NTG.
研究正常眼压性青光眼（NTG）患者的系统性氧化应激标志物与视神经头（ONH）血流之间的关系，以及这种关系的性别差异。
这是一项横断面研究，共纳入了 134 名患者的 235 只 NTG 眼（男 56 只，女 78 只；平均年龄 60.9±14.1 岁）。采用激光散斑血流仪（LSFG）测量 ONH 血流（ONH 组织区域的平均模糊率；MBR-T）和 LSFG 脉搏波参数，包括 ONH 组织区域的血流加速指数（FAI-T）。使用自由基选择性评估器测量氧化应激标志物二氢肌酐反应性氧代谢物（d-ROMs）和生物抗氧化潜能（BAP）。采用 Spearman 秩相关检验和多元线性混合效应模型来研究与 ONH 血流相关的因素。
MBR-T 与年龄（rs=-0.28，p<0.001）、平均动脉压（rs=-0.20，p=0.002）、眼内压（rs=0.24，p<0.001）、视盘周围视网膜神经纤维层厚度（rs=0.62，p<0.001）和视盘面积（rs=-0.26，p<0.001）呈显著相关，但与血清 d-ROM 水平无关。按性别对受试者进行的单独分析显示，仅在男性中，BAP 与 MBR-T（rs=0.21，p=0.036）和 FAI-T（rs=0.36，p<0.001）呈正相关。同样，在多元线性混合效应模型中，BAP 与 MBR-T（β=0.25，p=0.026）和 FAI-T（β=0.37，p<0.001）在男性 NTG 患者中显著相关。
BAP 表示血清抗氧化水平较低与 NTG 男性患者的 ONH 血流减少有关。我们的研究结果表明，氧化应激在 NTG 患者眼血流减少的发病机制中存在性别差异。
