Apoptosis markers and progression of glaucomatous optic neuropathy after surgical treatment of primary open-angle glaucoma
Keywords:primary open-angle glaucoma, glaucomatous optic neuropathy, surgical treatment, tumor necrosis factor α, Fas-ligand, sFas/APO-1
Background. The mechanisms of apoptosis of optic nerve neurons in primary open-angle glaucoma (POAG) continue to be studied. It was found that markers of this process are tumor necrosis factor α (TNFα), Fas-ligand (FasL) and soluble form of Fas-receptor (sFas/APO-1). The purpose of the study was to investigate the relationship of apoptosis markers (TNFα, FasL and sFas/APO-1) with the progression of glaucomatous optic neuropathy after surgical treatment for primary open-angle glaucoma. Materials and methods. Sixty-nine patients (69 eyes) with POAG stages I–III were examined, they underwent trabeculectomy with Ex-Press shunt implantation. The content of specified markers in the intraocular fluid was determined by enzyme-liked immunoassay. Repeated ophthalmologic examination was performed in 3 and 6 months and after one year. The control group consisted of 25 patients (25 eyes) who underwent surgery for age-related cataracts. The content of apoptosis markers in the intraocular fluid was also studied in these patients. Statistical analysis was performed using the software packages SPSS 11.0, MedStat. Results. The intraocular pressure did not differ 3 months after surgery in the presence or absence of postoperative progression of optic neuropathy. The content of TNFα was highest in POAG stage III and exceeded that of in the control group by 2.3 times (p < 0.001). Similar differences are noted for the FasL content, which was maximal in stage III and 1.9-fold higher than in controls (p < 0.001). The level of sFas/APO-1 according to POAG stage was lower (p < 0.001). The content of TNFα and FasL in the intraocular fluid was higher with the progression of optic neuropathy, while the level of sFas/APO-1 was lower (p < 0.001). The maximum absolute difference is observed for sFas/APO-1 (2.5 times), it was smaller for TNFα (1.7 times) and FasL (1.6 times). Conclusions. Comparison of the obtained data with literature indicates an important pathogenic role of apoptosis markers and may indicate the possibility of their use to predict the development and progression of glaucomatous optic neuropathy in POAG and after its surgical treatment.
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