The trabecular meshwork (TM) of patients with primary open-angle glaucoma (POAG) is characterized by specific morphologic and biochemical changes such as loss of TM cells, accumulation of extracellular matrix (ECM), and accelerated senescence.
1 2 It is assumed that these TM changes lead to an increased outflow resistance and thus to elevated intraocular pressure (IOP). The reasons for these changes are not clear. Various factors may play an elementary role in the pathologic course of the disease, such as genetic factors, increased levels of glutamate, changes in nitric oxide metabolism, and vascular changes.
3 4 5 One factor, which is increasingly important in the pathogenesis of POAG, is oxidative stress.
6 Abu-Amero et al.
7 in patients with POAG demonstrated the occurrence of mutations in the mitochondrial genome and a reduced mitochondrial respiratory activity in comparison to control subjects. Moreover, it has been ascertained that the antioxidative capacity in the aqueous humor of patients with POAG is markedly reduced compared to nonglaucomatous eyes.
8 In another study, it has been shown that oxidative damage in the TM is correlated with visual field defects.
9 10 Based on these observations, it can be postulated that POAG is a degenerative disease and may be promoted, among other factors, by oxidative stress. In various cellular systems, oxidative stress is able to induce a broad number of biological changes. It is known that oxidative stress can induce cell death,
11 ECM production,
12 and accelerated senescence.
12 13 14 All these changes can be found in several age-related diseases (e.g., in atherosclerosis as a systemic disease),
15 16 17 but also in diseases of the human eye, such as age-related macular degeneration (AMD)
18 19 and POAG.
1 2 20 Therefore, in this study we hypothesized that oxidative stress may be responsible for the TM changes in POAG.