|Year : 1965 | Volume
| Issue : 4 | Page : 127-129
Primary glaucoma and blood groups
MP Garg, JM Pahwa
Eye Hospital, Sitapur, India
|Date of Web Publication||25-Feb-2008|
M P Garg
Eye Hospital, Sitapur
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Garg M P, Pahwa J M. Primary glaucoma and blood groups. Indian J Ophthalmol 1965;13:127-9
In 1853 Von Arlt drew the attention of the ophthalmic world to the heredity of primary glaucoma, but it is only in recent years that several workers Biro (1951), Kellerman and Posner (1955), have stressed its importance. Familial incidence in glaucoma has been seen and studied even upto 6 generations [Francois and collaberators (1950, 1961)]. Recent studies carried out by Patterson (1961) on the siblings of patients with simple glaucoma and by Miller and Patterson (1962) on their descendants sufficiently signifies that there is a marked hereditary factor in primary glaucoma. The fact that there might be only a single case in a family does not rule out heredity, because it is possible that it may be passed on as a recessive. Moreover mutation of genes has also to he taken into consideration. The genetic factor of glaucoma is confirmed by study of monozygotic twins. Westerlund (1947) and Agarwal (1964) In simple primary glaucoma, the first sign of the disease is the increased resistance to outflow of the aqueous due to trabecular obstruction diagnosed by means of tonography with the water drinking test, whereas in congestive glaucoma it is the narrowness of the irido-corneal angle seen by gonioscopy coupled with a positive response to the provocative test to darkness, which determines the early stages.
Vol Dungern and Herszfeld (1910) first proved the hereditary nature of blood groups, when they found that agglutinogens A and B are inherited as Mandelian dominants.
Studies of blood groups have been carried out for malignant diseases, anemias, peptic ulcers, diabetes and even tuberculosis in order to establish a hereditary factor. Thus it has been found that the incidence of peptic ulcer is highest amongst group 0 whilst those carrying the agglutinogen A are more prone to cancer of the stomach (Aird et al 1953, 1954).
Besides the blood group, about 85 per cent of persons possess a group- specific A substance in their tissues which is secreted in the saliva, urine, tears, semen, gastric juice and milk. The remainder do not possess this ability. Persons in the two catagories are designated as 'secretors' and non-secretors.' The ability to secrete the group-specific substance is inherited as a simple Mendelian dominant character, independent of the inheritance of blood groups or types. The chemical basis for the difference between the secretors and nonsecretors is due to the occurence of the group-specific substance in two forms. A lipoidal fraction is present in the body cells of all persons in the blood group. An additional water-soluble form occurs in the body fluids of secretors only and their secretions contain this substance.
| Aim and Objects|| |
This study has been undertaken in order to find the existence of any relationship between the blood groups and the incidence of primary glaucoma and their association if any, between secretors and non- secretors. Provided with evidence of the presence of a specific hereditary factor, help may thus be obtained to screen siblings and immediate descendents of these to suspect a glaucomatous tendency. (Dr. Gowin, Hardin and Alsever).
| Method and Material|| |
100 cases of primary glaucoma (both open angle and narrow angle in various stages) who attended the glaucoma clinic in the Eye Hospital, Sitapur, were studied for their blood group and secretors nonsecretors types. No case of secondary glaucoma was included in this study.
The blood groups were done with the high titre grouping sera of A and B blood groups. The secretors and non secretors were classified after collecting the saliva of the patients. The saliva was put in a test tube with equal quantity of normal saline and the mixture was kept in boiling water for 20 minutes and then one drop of grouping sera and a drop of blood of the same patient was also placed and was examined for any agglutination. For classifying the secretors and non secretors of blood group 'O'-anti 'H' substance was used.
| Observations|| |
All the cases of primary glaucoma examined were chiefly between 3rd and 6th decades of life. The youngest one was 31 years and eldest one 76 years while 62 were males and 38 females.
They were of following varieties:-
1. Simple primary wide angle glaucoma: ... 56 cases.
2. Narrow angle glaucoma: ... 39 cases.
3. Could not be classified: 5 cases.
Out of 100 cases of primary glaucoma 45 belonged to group A, 30 belonged to group B, 19 belonged to group 0, while 6 were of group AB.[Table - 1]
Further it was noticed that amongst 100 cases 69 belonged to non secretors type and 31 were secretors. It was also observed that the percentage of non-secretors was highest in the blood group A and B and least in Blood group AB.
From these findings it is apparent that primary glaucoma is more common in secretors than in non secretors, the normal ratio being 15:85. This leads to a tentative conclusion which lends support to the theory that glaucoma is inherited as a Mendelian dominant.
Westerlund (1947) Posner and Schlossman (1949) accept a dominant heredity, but recent authors such as Waardenburg, (1950) Biro (1951), Robert (1952) Weekers et al (1955) and others have found a percentage of cases which showed recessive characteristics also.
The clue to these conflicting reports may well be in the nature of glaucoma itself. In the case of the narrow angle type, Barkan, Sugar and Tornquist have shown that the depth of the anterior chamber and the iridocorneal angles are inherited as genetic factors, thus we may be dealing with two different types of inheritance. Von Graefe, (1869)
Groenowe (1904), Bell (1938), Posner and Schlossman (1949) have drawn attention to the fact that within any family, glaucoma is generally of the same type; if one member has open glaucoma the other siblings, parents or children will also suffer from the the same type. Similarly for closed angle glaucoma.
Further we know that blood group substances are mucopolysaccharides and may be that persons with group substance A and B, have an increased amount of, or an altered form of, mucopolysaccharide in their trabecular tissue, which may account for the raised intra ocular tension in primary simple open angle glaucoma.
We must admit that this is just a preliminary report and we have extended our study to examine blood groups in siblings and immediate descendants and relations of known glaucoma patients, and we think that this may be an additional source of help in our screening programme of early diagnosis of primary glaucoma. Similarly it may also help in differentiating some cases of primary and secondary glaucoma which clinically look similar.
| Summary|| |
Primary glaucoma is very common in blood group A and B less common in group O and AB. It is also noted that the incidence of this disease is high in non secretors rather than secretors. It is hoped that determination of such groups may help in the early diagnosis of primary glaucoma cases.
| References|| |
Agarwal L. P. Madan Mohan, Malik S. R. and Gupta A.K. (1964) J. All. India Ophthal Soc. 12, 132.
Aird T. (1953) B.M.J. 1, 759.
(1954) B.M.J. 11, 315.
von. Ant C.G. (1853) Die Krankheiten des Auges fiir praktische Arzte. Vo. 12, p. 199 (as cited in 10).
Bell Julia, (1933) The Treasury of Human Inheritance, Cambridge University Press London.
Biro I. (1951), Ophthalmologica, 122, 228.
von Dungern and Herszfeld (1910) Z. Immunoforsh., 6, 284.
De Gowin, Hardin and Alsever ( ) Blood Transfusion p. 58.
Frangoise J. (1961). Heredity in Ophthalmology, p. 225 C. V. Mosby Co. St. Louis.
Frangoise J. Deweer T. P. and Vandenburghe (1950) 1. Bull. Soc. beige Opht. 96, 665. (as cited in 10)
Groenouw (1904); Graefe - Saemisch's Hdb. des Augenh. 11, 464. (as cited in 10)
Kellerman L. and Posner A. (1955) Amer. J. of Ophthal. 40, 681.
Miller S. (1961), Trans Ophthal Soc. U.K. 81, 577.
Miller S. J. H., and Patterson G. D. (1962). Brit. J. Ophthal. 46, 513.
Patterson G. (1961). Trans Ophthal Soc. U.K. 81, 561
Posner A. and .
Schlossman A. (1949) Arch. of Ophthal 41, 125.
Waardenburg P. J. (1950) Ophthalmologica, 119, 250.
Weekers R. Gougnard-Rion C. and Gougnard L. (1955) Bull Soc. Beige Opht. 110, 255 (cited in 10)
Westerlund E. (1947) Clinical and Genetic Studies on Primary Glaucomas (cited in 10)
[Table - 1]