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C-H Hong, RS Ayyala, RN Patel; Assessment of Chlamydia pneumoniae as Possible Risk Factor for Open-Angle Glaucoma . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3385.
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Purpose: Epidemiological and case-controlled studies have identified Chlamydia pneumoniae infection as a risk factor for coronary artery disease. Furthermore, Chlamydia pneumoniae antigen has been demonstrated in atherosclerotic tissue, and it is postulated that this may be the inciting factor for the development of atherosclerosis. Recent studies have shown a 50% reduction in the incidence of second heart attacks in patients treated with azithromycin, an antibiotic that targets Chlamydia pneumoniae. One of the postulated theories of open-angle glaucoma is the vascular theory in which disturbance of autoregulation of tone and interference with blood flow to the optic nerve can lead to optic nerve damage. Chronic, low-grade infection of the arterial walls of the ophthalmic and ciliary arteries can potentially induce both disturbance in autoregulation and atherosclerosis, leading to optic nerve head ischemia and development of glaucoma. In this study, we present the incidence of Chlamydia pneumoniae infection in patients with primary open-angle glaucoma (POAG). Methods: A prospective study in which 35 consecutive patients with established diagnosis of primary open-angle glaucoma from the Tulane University Glaucoma Service were enrolled. Serologic microimmunofluorescent tests were performed to detect levels of IgM and IgG for Chlamydia pneumoniae, Chlamydia trachoma, and Chlamydia psittaci on each patient. Five patients who demonstrated cross-reactivity among the various chalmydial species were excluded from the study. Results: 19 of 30 (63%) patients with POAG demonstrated a significant level of IgG antibody titers to Chlamydia pneumoniae. Conclusion: Chlamydia pneumoniae infection can potentially cause chronic low-grade infection and inflammation and contribute to optic nerve head ischemia. Larger studies are required to further study this association between Chlamydia pneumoniae and open-angle glaucoma.
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