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Editors Selection IGR 7-2

Clinical glaucoma: NPG

Thomas Yorio

Comment by Thomas Yorio on:

13736 Altered endothelin-1 vasoreactivity in patients with untreated normal-pressure glaucoma, Henry E; Newby DE; Webb DJ et al., Investigative Ophthalmology and Visual Science, 2006; 47: 2528-2532


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Vascular dysregulation has been considered as a mechanism associated with normal-pressure glaucoma (NPG). Henry et al. (451) tested the hypothesis that ET-1 mediated endothelium-dependent relaxation is impaired in patients with NPG. Despite a small patient population of eight normal and eight NPG patients, the authors were able to demonstrate an impaired vasodilation response to an ET-A receptor antagonist using forearm blood flow measurements. The authors concluded that the decreased response to the ET-A antagonist was a result of decreased endothelium ET-B receptor mechanism that results in the release of nitric oxide (NO). The authors also showed that there was no difference in the vasoconstrictor response to exogenously administered ET-1 in normal versus NPG patients, suggesting that the vasoconstrictor effects of ET-1 were not altered. In addition, the plasma concentrations for ET-1 were not significantly different, although the variance and sample size was probably limiting. Some studies have shown some differences in plasma ET levels in NPG,1 while others agree with these observations.2,3 Overall, the study is consistent with previous findings that suggests that in NPG there may be a vascular imbalance and this study supports others that NO and ET activity may be the mechanisms contributing to this imbalance.

References

  1. Sugiyama T, Moriya S, Oku H, et al. Association of endothelin-1 with normal tension glaucoma: clinical and fundamental studies. Surv Ophthalmol 1995; 30: S49-S56.
  2. Kaiser HJ, Flammer J, Wenk M, et al. Endothelin-1 plasma levels in normal-tension glaumcoma: abnormal response to postural changes. Graefes Arch Clin Exp Ophthalmol 1995; 233: 484-488.
  3. Nicolela MT, Ferrier SN, Morrison CA, et al. Effects of cold-induced vasospasm in glaucoma: the role of endothelin-1. IOVS 2003; 44: 2565-2572.


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