Angmo Dewang, Warjri Gazella Bruce, Gowtham L, Velpandian Thirumurthy, Dada Tanuj
Glaucoma Research Facility and Clinical Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Ocular Pharmacology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Eur J Ophthalmol. 2025 Jan;35(1):163-171. doi: 10.1177/11206721241247419. Epub 2024 Apr 13.
To compare the levels of endocannabinoids (EC) in plasma, aqueous humor and tears, cortisol in plasma and aqueous, in primary angle closure glaucoma (PACG) and controls, while comparing the quality of life in both groups.
A total of 60 patients, ≥40years of age, with a diagnosis of PACG or cataract, 30 in each group were recruited. They were subjected to a detailed ophthalmic evaluation, a WHO Quality of Life Brief Version (WHOQOL-BREF) questionnaire answering and collection of tear, aqueous and blood samples. The levels of endocannabinoids-anandamide (AEA), 2-arachidonoylglycerol (2AG) in plasma, aqueous humor and tears; cortisol in plasma and aqueous humor; and WHO-QOL score in each group were noted.
Plasma AEA ( = 0.01) and plasma 2-AG, ( = 0.002) levels were significantly higher in the control group as compared to the PACG group. WHO-QOL score was better in controls ( < 0.001). The EC were in undetectable levels in aqueous. Plasma and aqueous cortisol were significantly higher in PACG and both had the highest Area under the receiver operating characteristics (AUROC) curve value for differentiating PACG from controls. Tear 2AG and tear AEA had a moderately strong positive correlation with plasma 2-AG. Females had insignificantly higher levels of plasma and tear endocannabinoids.
Tear endocannabinoids were determined for the first time in PACG and normal with no difference between the two groups. Plasma and aqueous cortisol levels are a differentiating factor between normal and glaucoma patients with plasma endocannabinoids being remarkably higher in normals. Quality of life in glaucoma patients with high cortisol levels is poorer.
比较原发性闭角型青光眼（PACG）患者与对照组血浆、房水和泪液中内源性大麻素（EC）水平，以及血浆和房水中皮质醇水平，并比较两组的生活质量。
共招募60例年龄≥40岁、诊断为PACG或白内障的患者，每组30例。对他们进行详细的眼科评估、填写世界卫生组织生活质量简表（WHOQOL-BREF）问卷，并采集泪液、房水和血液样本。记录血浆、房水和泪液中内源性大麻素——花生四烯酸乙醇胺（AEA）、2-花生四烯酸甘油酯（2AG）的水平；血浆和房水中皮质醇的水平；以及每组的WHO-QOL得分。
与PACG组相比，对照组的血浆AEA（P = 0.01）和血浆2-AG（P = 0.002）水平显著更高。对照组的WHO-QOL得分更好（P < 0.001）。房水中的EC水平未检测到。PACG组的血浆和房水皮质醇水平显著更高，两者在区分PACG与对照组方面的受试者工作特征曲线下面积（AUROC）值最高。泪液2AG和泪液AEA与血浆2-AG呈中度强正相关。女性的血浆和泪液内源性大麻素水平略高。
首次在PACG患者和正常人中测定泪液内源性大麻素，两组之间无差异。血浆和房水皮质醇水平是正常人与青光眼患者之间的一个区分因素，正常人的血浆内源性大麻素水平显著更高。皮质醇水平高的青光眼患者生活质量较差。
