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L.E. Pillunat, E. Spoerl, M.F. Mueller–Holz, P. Rommeck, M. Bauer, A.G. Boehm; Uric Acid Serum Concentrations in POAG and Normals . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5531.
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Purpose: There is evidence that a disturbed uric acid (UA) pathway could be involved in the pathogenesis of primary open angle glaucoma (POAG). The aim of the study was to elucidate whether serum concentrations of uric acid are different in POAG patients in comparison with non–POAG subjects. Methods: In a prospective, masked clinical study 86 patients with POAG (36 male, 50 female; mean age: 66.8 years) and 45 healthy subjects without history of or medication against hyperuricaemia (27 male, 18 female; mean age: 68.6 years) were included. The study was proven by the ethics committee and all patients gave their written consent. All subjects had a complete ophthalmological examination (visual acuity, IOP, anterior eye segment biomicroscopy, funduscopy) including visual field threshold test [Humphrey 30–2; SITA–Standard], HRT of optic nerve head (Heidelberg Engineering, Software Version 2.02) and pulsatile ocular blood flow assessment (OBF–System). Venous blood samples were obtained for UA serum determination and systemic parameters blood pressure (BP) and heart rate (HR) were recorded. Statistical analysis was performed using ANOVA and Pearsons linear regression analysis. Results:Both groups were not significant different regarding age, BP and HR. UA concentrations in the POAG group and controls were 314 µmol/l vs. 356 µmol/l (P<0.01). Dividing the groups regarding the gender only UA concentrations in the male subgroups were statistically significantly different (339 µmol/l POAG vs. 398 µmol/l controls; p<0.05). The female subgroups did not show a significant difference of UA concentrations (295 µmol/l vs. 294 µmol/l). Pulsatile ocular blood flow (pOBF) and pulse amplitudes (PA) were decreased in POAG patients (731 vs. 806 µl/min; P>0.05 and 2.64 vs. 2.35 mmHg; P>0.05). Regression analysis did not show correlations between UA concentrations and age, pOBF, PA, disc area, cup area or rim volume of the optic nerve head. Conclusions:Contrary to previous investigations no elevated UA concentrations were present in POAG patients compared with age matched controls. There was even a significant lower concentration of UA in the male POAG group compared to the corresponding controls. Therefore, increased systemic UA levels seem to play no major role in the pathogenesis of glaucoma.
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