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G. L. Yoo, Y. Shaikh, F. Yu, A. L. Coleman; Serum IgE and Glaucoma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5827.
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Historically, there have been several case reports regarding the improvement in eye pressures of glaucoma patients with systemic control of allergies. A potential link between an altered immune environment, as indicated by IgE levels, and glaucoma may exist. We evaluated the association of serum IgE antibodies in glaucoma patients in the National Health and Nutrition Examination Survey (NHANES).
In the 2005-2006 NHANES survey, 2934 subjects had frequency doubling perimetry testing (N30-5 FDT) and optic disc photographs. Glaucoma was defined as having 2 or more abnormal points on the N30-5 FDT on two tests in the same eye along with a cup-to-disc ratio (CDR) or CDR asymmetry between eyes of the same subject of ≥ 97.5th percentile for the normal NHANES population. Analysis of serum samples was conducted using the Pharmacia Diagnostics ImmunoCAP 1000 System. Participants were considered to be ‘positive’ for allergen-specific antibodies if their serum IgE levels were greater than 0.35kU/L. Additionally, participant values of total IgE greater than 119kU/L were considered ‘positive’.
A total of 2372 participants were included in this analysis, and the overall prevalence of glaucoma was 1.71% (95% CI: 1.1;2.3). After controlling for age, study participants with glaucoma had higher odds of testing positive for specific IgE antibodies to D. Farinae (OR 3.16; 95% CI: 1.7; 5.9), D. Pteronyssinus (OR 2.51; 95% CI: 1.3; 5.0), cat (OR 2.09; 95% CI: 1.0; 4.2), cockroach (OR 4.38; 95% CI: 1.8; 10.6), peanuts (OR 3.50; 95% CI: 1.8; 6.8), ragweed (OR 2.29; 95% CI: 1.3; 4.1), rye grass (OR 1.95; 95% CI: 1.1; 3.4), bermuda grass (OR 229; 95% CI: 1.3; 4.2), oak (OR 2.38; 95% CI: 1.2; 4.8), thistle (OR 3.44; 95% CI: 1.5; 7.9), and mouse (OR 9.78; 95% CI: 1.3; 72.9). After including all IgE antibodies into a single model to correct for immune cross-reactivity in addition to age, participants with glaucoma had higher odds of testing positive for D. Farinae (OR: 4.5; 95% CI: 1.3, 15.5) and cockroach (OR: 2.77; 95% CI: 1.02, 7.52) antibodies than those without glaucoma.
In NHANES, participants with glaucoma had significantly higher odds of having positive serum levels of IgE antibodies to the ubiquitous dust mite (D. Farinae) and cockroach allergens than those without glaucoma. IgE stimulates B-cell/humoral immunity through several cytokines including IL 4 and 6, which have recently been reported to be increased in glaucoma patients. Further research is needed to determine whether these findings are spurious or indicate that a changed immune environment may contribute to optic nerve damage.
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