38In primary open angle glaucoma, decrease of hyaluronic acid level is related to extracellular matrix deposition of trabecular meshwork. Extracellular matrix deposition will increase humor aqueous outflow resistance which in turn increase the intraocular pressure. Key words : hyaluronic acid, primary open angle glaucoma, MMP-9Penurunan kadar asam hialuronat pada trabekular meshwork pasien glaukoma sudut terbuka primer diduga mempunyai korelasi dengan peningkatan deposit matriks ekstraselular sehingga menyebabkan peningkatan resistensi outflow humor akuos yang pada akhirnya akan meningkatkan tekanan intra okuli. Salah satu famili matriks metaloproteinase (MMP) yang mempunyai kemampuan degradasi tinggi terhadap matriks ekstra selular adalah MMP-9. Ekspresi MMP-9 diduga dapat diaktivasi oleh asam hialuronat melalui ikatannya dengan reseptor utamanya yaitu CD44. Penelitian ini bertujuan untuk mengetahui apakah paparan asam hialuronat dapat meningkatkan ekspresi MMP-9 kultur sel trabekular meshwork pasien glaukoma sudut terbuka primer dengan metode imunohistokimia. Setelah dilakukan pemaparan asam hialuronat selama 24 jam pada 4 konsentrasi yang berbeda terhadap kultur sel trabekular meshwork yaitu 0 mg/ml sebagai kelompok kontrol dan 1mg/ml, 3mg/ml serta 6 mg/ml sebagai kelompok perlakuan, didapatkan hasil bahwa terdapat perbedaan yang signifikan antara ekspresi MMP-9 kelompok kontrol dibandingkan dengan kelompok perlakuan. Didapatkan korelasi yang signifikan antara paparan asam hialuronat dengan ekspresi MMP-9 kultur sel trabekular meshwork, dan paparan asam hialuronat dapat mempengaruhi ekspresi MMP-9 kultur sel trabekular meshwork. Peningkatan ekspresi MMP-9 seiring dengan peningkatan konsentrasi asam hialuronat yang diberikan. Hal ini menunjukkan bahwa asam hialuronat dapat menurunkan resistensi humor akuos outflow di trabekular meshwork dengan mengaktivasi ekspresi MMP-9 sehingga terjadi peningkatan degradasi matriks ekstra seluler.

Most glaucoma drugs lower the intraocular pressure (IOP) by decreasing the aqueous humor production and increasing the outflow through uveoscleral pathway. None of these drugs work mainly on increasing outflow through the trabecular pathway. Consequently, the experiment to develop glaucoma drugs directly target at the trabecular outflow pathway is highly required. The purpose of this study is to reveal the effect of rho-kinase inhibitor Y-27632 on the thickness of trabecular meshwork in juvenile rats model injected with sodium hyaluronate. This study was an experimental study with posttest only control group design. Twenty-four rats were included in this study. Each eye of the rat would be considered as one sample. Samples were divided into 6 groups, negative control group, positive control I group with intracameral sodium hyaluronate injection, positive control II group with topical Y-27632 10 mM, and three experimental groups with intracameral injection of sodium hyaluronate and Y-27632 10-1 mM, 1 mM, and 10 mM respectively. After the procedures all rats were sacrificed and enucleated. Trabecular meshwork tissue was stained with Hematoxilene-Eosin and evaluated under 400× microscopic magnification. Quantitative measurements were taken using computerized image analysis with dot slide program. There were significant statistic differences among the positive control I group and the experimental groups (p-value < 0.05) as well as the positive control II group and the experimental groups (p-value < 0.05). The highest mean of decreasing trabecular meshwork thickness was noted in the group given by sodium hyaluronate and Y-27632 10 mM with value of 118.42 µm. There was decreasing thickness of trabecular meshwork due to the effect of rho-kinase inhibitor Y-27632 in juvenile rats injected with sodium hyaluronate.