|Year : 1979 | Volume
| Issue : 4 | Page : 111-112
Plasma catecholamines in primary glaucoma
Banaras Hindu University, Varanasi, India
H V Nema
2, Medical Enclave, B.H.U.. Varanasi.
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Nema H V. Plasma catecholamines in primary glaucoma. Indian J Ophthalmol 1979;27:111-2
Glaucoma is a common eye disease with an obscure etiology. Several predisposing factors are well known in the causation of glaucoma. An imbalance of the autonomic nervous system has been suggested as a possible cause of rise in intraocular pressure. However, available experimental and clinical evidences are not sufficient to justify the acceptance of neuro-vegetative hypothesis of glaucoma. With the advancement of biochemistry, the influence of the sympathetic nervous system on the intraocular pressure can be better assessed by estimation of neuro-humours. Surprisingly, no attempts have been made in this direction. It is therefore, the present work has been undertaken and plasma catecholamines estimated.
| Materials and Methods|| |
40 proved cases of primary glaucoma, (consisting of 25 cases of open angle and 15 cases of narrow angle) were selected from the out patient department of Bhuwalka eye hospital. Additional 15 normal cases in the age range of glaucomatous patient were selected, so as to act as controls. All the selected cases were subjected for the record of visual acuity, visual field, ocular tension by Schiotz and grading of the angle of anterior chamber by gonioscopy. Care was taken to exclude the cases showing any ocular inflamation. Plasma catechol amines was estimated by the fluorometry method of Griffith et al (1970). Results obtained were subjected to statistical analysis.
Plasma catecholamine in normal subjects: Plasma catecholamine in random normal subjects (non-glaucomatous) ranged between 22 ng/ml and 432 ng/ml with a mean of 289.33 ng/ml + 71.56 ng/ml.
Plasma catecholamines in primary glaucoma: The catecholamines levels in the group of primary glaucoma ranged from 198 ng/ml to 508.8 ng/ml. The mean leve was 367.01% ±119.54 ng/ml.
Plasma catecholamines in simple and congestive glaucoma: The mean plasma catecholamines level in 25 patients of simple glaucoma was found to be 347.76 + 124.24 ng/ml while the mean level in congestive glaucoma patients was 412.39% + 135.75 ng/ml.
| Discussion|| |
The aetiology of glaucoma is an unsolved problem of modern ophthalmology, which poses a great challenge to the research workers. The role of central nervous system in the maintenance of intra ocular pressure has been studied in the past and there is some evidence to suggest that hypothalamus exerts such control.
The results obtained in the present study indicate that the mean plasma catecholamines in a glaucoma patient is significantly higher as compared to the mean of normal subjects (t= 2.96, p<0.01). The circulation of catecholamines is an indication of over activity of sympathetics, which may be interpreted in terms of an enhanced emotional state associated with the stresses inherent in every day life.
Taking the two groups of glaucomas separately and comparing each of them with the control, it was found that the mean plasma catecholamines level in chronic simple glaucoma did not differ significantly (t=1.88, p=0.05) from the mean of the control. However, the mean plasma catecholamines in the congestive glaucoma group, showed very significant higher values than that of the mean of control (t=3.10, p<0.01). Such a finding suggests that congestive glaucoma patients are very labile and possess sympathetonic personality. The psychic trauma may cause a rapid change in neurohumour system resulting in release of catecholamines in the blood and consequent alteration in aqueous dynamics in an already glaucoma predisposed eye.
Plasma catecholamine levels in simple and congestive glaucoma were statistically compared with rise of ocular tension. It was found that there was no correlation between plasma catecholamme and ocular tension in simple glaucomas (t=.19 p>.1) however, a correlation was found between ocular tension and plasma catecholamines in the congestive group (t== .60 p<.05). This observation is very important and plotting of the scatterogram further indicates that the two are linearly dependent but readings of ocular tension and plasma catecholamines in simple glaucoma are so scattered that they do not seem linearly dependent.