Chan, Fhun Lai
(2016)
Comparison of oxidative stress levels among patients with primary open angle glaucoma(POAG) and primary angle closure glaucoma (PACG) closure glaucoma (PACG).
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction:
Oxidative stress has been postulated to cause retinal ganglion cells death, trabecular
meshwork degeneration leading resistance of aqueous outflow. Subsequently, it may lead to
IOP elevation and glaucomatous optic neuropathy. Thus, it is worthwhile to look for the
oxidative stress level in glaucoma patients. Detection of oxidative stress level in ocular tissue
may perhaps provide insight into a role of oxidative stress in pathogenesis of glaucoma.
Objective:
Our objective was to compare the oxidative stress level in tears between glaucoma and agematched
controls. The comparison of SOD, catalase and MDA level between POAG and
PACG patients were also conducted.
Methods:
A cross sectional study was conducted between May 2014 and November 2015 involving
patients with confirmed diagnosis of POAG and PACG attending eye clinic of two tertiary
hospitals in Malaysia; Hospital Universiti Sains Malaysia and Hospital Raja Permaisuri
Bainun. Age-match non glaucoma patients were recruited as controls. The detail medical
history, ocular history and drug history such as antioxidant supplement were obtained
through direct questioning from patients and medical record. Complete ophthalmic
evaluations were conducted including Humphrey visual field analysis. Tear samples collected
by using schirmer paper. Laboratory analysis was performed to test on SOD, catalase and
MDA level of tears using commercially available immunological kits. Statistical analysis was
done using Statistical Package for the Social Science (SPSS Inc Version 20). Independent ttest was used to compare the SOD, catalase and MDA level in tears between glaucoma and
controls.
Results:
A total of 62 POAG patients, 57 PACG patients and 72 controls were recruited. Patients with
glaucoma were older. Mean SOD and catalase level were slightly higher in glaucoma patients
as compared to controls. Meanwhile mean MDA level was slightly lower in glaucoma
patients compared with controls. However, there was no significant difference of SOD level
(p=0.191), catalase level (p=0.259) and MDA level (p=0.309) between glaucoma and
controls using multivariate analysis. There was no significant difference of SOD, catalase and
MDA level between POAG and PACG patients. However, mean SOD activity was
statistically significant higher in patients with POAG compared to controls after adjusting
confounding factors (351.67 U/ml vs 315.12 U/ml), p=0.006) .
Conclusions
Quantification of oxidative stress level in tears is non invasive and easy. Catalase and MDA
may not a play role in oxidative stress in glaucoma. SOD is a potential oxidative stress
marker for POAG.
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