IntroductionPrimary open-angle glaucoma (POAG) is one of the most prevalent causes of irreversible blindness and is associated with endothelial dysfunction and arterial stiffness. Pseudoexfoliative ...glaucoma (PEG) is another type of glaucoma observed in pseudoexfoliation syndrome. It is characterized by the deposition of pseudoexfoliative material in several tissues and organs.HypothesisWe evaluate the hypothesis whether inflammation in patients with PEG affect endothelial function and vascular properties.MethodsIn this study we enrolled 25 subjects with PEG, 25 subjects with POAG and 25 control subjects (CL). Endothelial function was evaluated by flow-mediated dilatation (FMD). Carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness and augmentation index (AIx) as a measure of arterial wave reflections. We also measure high sensitivity C-reactive protein (hsCRP).ResultsBetween the three study groups CL, POAG, PEG there was no difference in age (67±10y vs. 68±9y vs. 67±12y, p=0.24) or prevalence of male sex (70% vs. 68% vs. 67%, p=0.55). Importantly, there was a linear impairment of FMD (7.35±2.77% vs. 6.58±3.18% vs. 4.88±3.29%, p=0.006), PWV (7.98±1.56m/sec vs. 9.20±1.84m/sec vs. 9.22±2.16m/sec, p=0.004) and AIx (21.29±8.77% vs. 25.14±5.71% vs. 28.20±8.75%, p=0.002) from CL to POAG and PEG. Interestingly post hoc test after Scheffe correction revealed also that PEG subjects had not only significantly impaired FMD, compared to control subjects, but also compared to POAG subjects (4.88±3.29% vs. 6.58±3.18%, p=0.02). Importantly, hsCRP levels was significantly increased 1.1(0.5-1.7)mg/l vs. 1.0(0.6-1.5)mg/l vs. 1.27 (0.5-3.5)mg/l, p=0.03 form CL to POAG and PEG. Moreover in PEG patients CRP levels were significantly associated with impaired PWV (rho=0.63, p=0.001) and AIx (rho=0.38, p=0.05).ConclusionsEndothelial function arterial stiffness and inflammatory status is significantly impaired in patients with pseudoexfoliative glaucoma. These findings shed some light in the pathophysiology of pseudoexfoliative glaucoma and support the theory that pseudoexfoliative fibrils may precipitate systemic inflammatory response and may also accumulate and damage the arterial wall.
