Publication: Association between aqueous humour level of glutathione peroxidase and reductase among primary glaucoma patients
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Date
2021
Authors
Satar, Huwaina Abdul
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Abstract
Introduction: Glaucoma is the leading cause of irreversible blindness worldwide. Oxidative stress is believed to have a significant role in pathogenesis of glaucoma by trabecular meshwork degeneration leading to aqueous outflow resistance. Subsequently, this condition might lead to IOP elevation, retinal ganglion cell loss and glaucomatous optic neuropathy. Detection of oxidative stress level in ocular tissues may show a role of oxidative stress in pathogenesis of glaucoma that would affect the disease prognosis. Objective: To evaluate the oxidative stress level of glutathione peroxidase and reductase in aqueous humour between primary glaucoma and age-matched controls. Methodology: A cross sectional study was conducted between June 2018 to February 2021 involving patients with confirmed diagnosis of primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) who attended eye clinic in two tertiary hospitals in Malaysia; Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab 11, Kota Bharu, Kelantan. Age-matched non glaucoma patients were recruited as controls. Complete evaluations, detail medical, ocular and drug history such as antioxidant supplement were obtained. Ocular examinations were conducted including intraocular pressure and Humphrey visual field analysis. Aqueous samples collected during cataract surgery, trabeculectomy or triple procedure. Laboratory analysis was performed to test on glutathione peroxidase (GPX) and reductase (GR) levels in aqueous using commercially available immunological kits (ELISA). Statistical analysis was done using Statistical Package for the Social Science (SPSS Inc Version 26.0). Independent t-test was used to compare the level of GPX and GR in aqueous between glaucoma and controls. Result: A total of 70 primary glaucoma patients and 70 controls were recruited. Control subjects were older than glaucoma patients. Predominantly, Malay samples were the highest in both groups. The mean values of glutathione peroxidase (GPX) and reductase (GR) in both groups were slightly higher in control group. There was no significant difference in GPX level (p=0.154) and GR level (p=0.756) between glaucoma and controls using multivariate analysis after adjusting confounding factors. There is significant association between the female patients in primary glaucoma and higher level of glutathione reductase. Conclusion Lower aqueous level of GPX and GR may play a role in pathogenesis of primary glaucoma. Improvement of the levels GPX and GR might help to reduce the risk of primary glaucoma. In the future, perhaps comparing with older adults without ocular disease will provide a better understanding of the role of these antioxidant enzymes.
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