Treatment of Ocular Hypertension

Sommer, Alfred

doi:10.1001/archophthalmol.2010.13

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…But approximately 30% of the patients don't show an elevated IOP (normal tension glaucoma (NTG)) [2]. Additionally 4–7% of people over the age of 40 have ocular hypertension (OHT) [3] but per year only 1% develop glaucoma [4], [5]. Therefore, although still a major risk factor, the presumption that an elevated IOP is the only cause for glaucoma is long out-dated.…”

Section: Introductionmentioning

confidence: 99%

Serum and Antibodies of Glaucoma Patients Lead to Changes in the Proteome, Especially Cell Regulatory Proteins, in Retinal Cells

et al. 2012

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PurposePrevious studies show significantly specifically changed autoantibody reactions against retinal antigens in the serum of glaucoma and ocular hypertension (OHT) patients in comparison to healthy people. As pathogenesis of glaucoma still is unknown the aim of this study was to analyze if the serum and antibodies of glaucoma patients interact with neuroretinal cells.MethodsR28 cells were incubated with serum of patients suffering from primary open angle glaucoma (POAG), normal tension glaucoma (NTG) or OHT, POAG serum after antibody removal and serum from healthy people for 48 h under a normal or an elevated pressure of 15000 Pa (112 mmHg). RGC5 cells were additionally incubated with POAG antibodies under a normal pressure. Protein profiles of the R28 cells were measured with Seldi-Tof-MS, protein identification was performed with Maldi-TofTof-MS. Protein analysis of the RGC5 cells was performed with ESI-Orbitrap MS. Statistical analysis including multivariate statistics, variance component analysis as well as calculating Mahalanobis distances was performed.ResultsHighly significant changes of the complex protein profiles after incubation with glaucoma and OHT serum in comparison to healthy serum were detected, showing specific changes in the cells (e.g. Protein at 9192 Da (p<0.001)). The variance component analysis showed an effect of the serum of 59% on the cells. The pressure had an effect of 11% on the cells. Antibody removal led to significantly changed cell reactions (p<0.03). Furthermore, the incubation with POAG serum and its antibodies led to pro-apoptotic changes of proteins in the cells.ConclusionsThese studies show that the serum and the antibodies of glaucoma patients significantly change protein expressions involved in cell regulatory processes in neuroretinal cells. These could lead to a higher vulnerability of retinal cells towards stress factors such as an elevated IOP and eventually could lead to an increased apoptosis of the cells as in glaucoma.

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Section: Introductionmentioning

confidence: 99%

Serum and Antibodies of Glaucoma Patients Lead to Changes in the Proteome, Especially Cell Regulatory Proteins, in Retinal Cells

et al. 2012

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Argumente gegen eine drucksenkende Behandlung der okulären Hypertension

Stürmer

2011

Ophthalmologe

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The main argument against a pressure-lowering treatment for patients with ocular hypertension (OHT) is the principle of "first do no harm". The imprecision of intraocular pressure (IOP) measurements and the fact that increased IOP is only a risk factor for glaucoma raise major doubts on a clinical definition of OHT. The use of IOP-lowering treatment in the absence of functional or morphological glaucomatous changes should only be initiated if the IOP is very high (>32 mmHg). If the IOP is between 21 and 32 mmHg the glaucoma conversion risk of the individual patient should be estimated. The risk factors as proven in major prospective trials (OHTS/EGPS) should be assessed using the risk calculator. Only patients with a high risk (>13%) of conversion profit from prophylactic IOP-lowering treatment. For all patients with intermediate or low risk of conversion the potential side-effects (local and systemic) of the treatment outweigh the possible benefit, so that the principle of "watchful waiting" is the best for patients with OHT. If morphological or functional progression is observed IOP-lowering treatment should be started immediately.

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Treatment of Ocular Hypertension

Cited by 2 publications

References 7 publications

Serum and Antibodies of Glaucoma Patients Lead to Changes in the Proteome, Especially Cell Regulatory Proteins, in Retinal Cells

Serum and Antibodies of Glaucoma Patients Lead to Changes in the Proteome, Especially Cell Regulatory Proteins, in Retinal Cells

Argumente gegen eine drucksenkende Behandlung der okulären Hypertension

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