Artikel
Elevated Homocysteine level in aqueous humor of patients with pseudoexfoliation glaucoma
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Autoren
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A. Jünemann
- Department of Ophthalmology, University of Erlangen-Nuremberg, Erlangen
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J. Rödl
- Department of Ophthalmology, University of Erlangen-Nuremberg, Erlangen
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U. Reulbach
- Department of Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Erlangen
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U. Schlötzer-Schrehardt
- Department of Ophthalmology, University of Erlangen-Nuremberg, Erlangen
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F. E. Kruse
- Department of Ophthalmology, University of Erlangen-Nuremberg, Erlangen
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J. Kornhuber
- Department of Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Erlangen
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S. Bleich
- Department of Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Erlangen
| Veröffentlicht: | 22. September 2004 |
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Gliederung
Text
Objective
Homocysteine (Hcy) can induce vascular injury, and alterations of extracellular matrix metabolism due to dysregulation of matrix metalloproteinases and their inhibitors, and contributes to neuronal cell death by different mechanisms. Moderate hyperhomocysteinemia has been found in patients with primary and secondary open-angle glaucoma due to pseudoexfoliation (PEXG). This study was performed to determine the homocysteine level in aqueous humor of patients with PEXG.
Methods
Total plasma hcy, vitamins relevant for its metabolism (folate, B12, B6), and total hcy of aqueous humor were determined in 30 patients with PEXG (age:72.8±6.8 years, 17 female, 13 male), and 31 controls with cataract (age: 71.8±9.3 years., 18 female, 13 male) using HPLC. Patients with any commonly known other risk factors for hyperhomocysteinemia were excluded. The control group was matched to the study group by age, gender and concurrent diagnosis of systemic hypertension.
Results
Significantly raised plasma hcy levels were found in patients with PEXG (15.53μmol/l ±7.76, Mann-Whitney-U-test, Z=-2.55, p = 0.01) as compared with the control group (11.82μmol/l ±3.56). Hcy was also identified in all aqueous humor samples. The hcy level was raised twofold in PEXG samples (2.51μmol/l ±1.41, Mann-Whitney-U-test, Z=-5.18, p<0.001) as compared with the control group (1.26μmol/l ±0.80). Plasma and aqueous humor hcy levels were correlated in PEXG patients (Spearman rho, r=0.46, p=0.025), but not in the control patients.
Conclusions
The present study revealed elevated homocysteine plasma levels and aqueous humor levels in patients with PEXG. Therefore, increased levels of homocysteine in patients with PEXG may have important implications for understanding the pathogenesis of PEX glaucoma.
