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Iwona Grabska-Liberek, Jankowska- Lech Irmina; Does Incidence Of Glaucomatous Optic Neuropathy (GON) Connect With Vascular Dysregulation In Multiple Sclerosis (MS) Patients ?. Invest. Ophthalmol. Vis. Sci. 2012;53(14):259.
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© ARVO (1962-2015); The Authors (2016-present)
A common pathological finding in inflammatory, especially autoimmunological diseases is an increased concentration of endothelin-1 (ET-1) in the circulating blood. It may be connected with incidence of secondary vascular disregulation (SVD syndrome). Vascular disregulation has also been identified as a risk factor for GON. SVD syndrome was observed in patients suffering from multiple sclerosis.Aim of the study: to estimate the incidence of structural glaucomatous optic neuropathy (GON) in multiple sclerosis patients. The second aim of this study was to estimate endothelin-1 (ET-1) plasma level in the same group of patients.
Material: consisted of 39 patients (9 males, 30 females), mean age: 39, range: 22-62 years, suffering from multiple sclerosis, according to McDonalds rule. The healthy controls group consisted of 3 males and 24 females, mean age: 38 years, range: 20-62 years. In all patients scanning laser ophthalmoscopy - HRT (Heidelberg Retina Tomograph), spectral optical coherence tomography of the peripapillary retinal nerve fiber layer (OCT- 3D 1000, Topcon) and clinical stereoexamination were performed to determine the presence of GON. Endothelin-1 (ET-1) plasma levels were determinated by ELISA Test (Immuno-Biological Laboratories Co, Japan with sensivity of 8 fmol/ml). Statistical analyze was performed using nonparametric tau- Kendall test for independent groups.
GON was observed in 16 (26.9%) multiple sclerosis patients in HRT (according to Mikelberg classification). 9 patients (20.5%) with glaucomatous structural changes in HRT had borderline or outside normal results of the nerve fiber layer thickness in OCT. Among these, 5 patients (12.8%) demonstrated the GON lesions in clinical stereoscopic fundus examination. Endothelin-1 (ET-1) plasma levels were significantly decreased in study group (MS patients): P<0.001. Patients receiving immunomodulation therapy showed tendency towards lower ET-1 levels; however, this finding was not statistically significant.
1. The study outcomes indicate higher incidence 12.8% of glaucomatous optic neuropathy structural changes in (MS) patients than in normal population over 40 years old .2. Higher incidence of GON structural changes in (MS) patients may be associated with vascular dysregulation syndrome 3. Significantly decreased ET-1 plasma level in MS patients may be influenced by a/ nonactive MS stage at the time of ET-1 estimation b/ treatment MS patients with immunomodulation drugs, which could blocked activity of lymphocytes but it cannot be excluded that decrease ET-1 plasma level in MS patients may be result of vascular disregulation.
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