|Year : 1981 | Volume
| Issue : 2 | Page : 97-99
Effect of antiprostaglandin drugs on human blood-aqueous barrier
SK Mathur, UK Satsangi, GC Jain
Department of Ophthalmology S. P. Medical College, Bikaner, India
U K Satsangi
Department of Ophthalmology, S.P. Medical College, Bikaner 334001, Rajasthan
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mathur S K, Satsangi U K, Jain G C. Effect of antiprostaglandin drugs on human blood-aqueous barrier. Indian J Ophthalmol 1981;29:97-9
Specific biochemical mechanisms for the development of the irritative response caused by trauma to the eye have only recently been investigated. Ambache reported for the first time presence of a smooth muscle stimulating and vasodilating substance in extracts of iris tissue named IRIN. On further investigation prostaglandin E and F were identified as components of irin extracts. Ambache et al reported that prostaglandins are released into aqueous humour of rabbit eve in response to trauma or paracentasis.
More and more evidences are accumulating that prostaglandins are involved in ocular inflammation. Although the elusive goal of delineating the precise involvement of prostaglandins in ocular inflammation has not been attained and individual opinion may differ on such matter but it is of interest to think whether further clinical applications of some anti-inflammatory drugs may be suggested by their antiprostaglandin actions.
The present study was undertaken to study the role of antiprostaglandin drugs like aspirin and indomethacin in patients undergoing intra-ocular surgery, for their effect on bloodaqueous barrier by estimating the protein content of aqueous humour.
| Materials and methods|| |
Patients admitted for cataract extraction were selected and patients having signs of uveitis or inflammation or any contra-indication to administration of aspirin and indomethacin were excluded from the study. Total 30 cases were studied (10 controls without any treatment, 10 each with aspirin and indomethacin treatment). The usual routine preoperative medication were given without any corticosteroids or anti-inflammatory agents. The patients in aspirin and indomethacin groups were given orally 200 mg of aspirin and 50 mg of indomethacin respectively every 4 hourly for approximately 12 hours preceding the operation. The patients were given additional 200 mg of aspirin or 50 mg of indo. methacin orally as they left ward for the operation theatre.
The immediate pre-operative procedures (retrobulbar anaesthesia, pre-operative preparations, lid sutures) and initial operative manoeuvres were routine. After a limbal cataract groove the surgeon extracted 0.1 ml of aqueous humour from the anterior chamber through the groove before the anterior chamber was surgically opened. A sterilized tuberculin syringe with a 27 gauge needle was used to withdraw the samples. Then the aliquot were carefully remeasured by micro pipette and diluted to 1 ml with distilled water. The surgeon halted all the procedures for five minutes so that the aqueous reformation occurred with disturbed blood-aqueous barrier. At the end of five minutes another sample of aqueous humour was obtained and operation proceeded as usual. The second samples were also remeasured and diluted to 1 ml.
Protein estimation was done by Lowry's method of folin phenol ciocaiteu reagent with little modification to suit the measurement of small quantity of protein in aqueous humour. Tyrosin was used as standard solution.
| Observations|| |
In the present study maximum patients (8%) were seen in 56 to 75 years age group in controls, 45 to 65 years in aspirin group and 56 to 75 years in indomethacin group. Male female ratio seen in control group was 3 : 2 and I : I in aspirin and indomethacin groups. Mean protein values in primary and secondary (after 5 minutes of paracentasis) aqueous humour, mean rise and percentage change in protein level in various groups studied is shown in [Table - 1]. Percentage change was 50.81% in control group while 6.76% in aspirin and 11.01% in indomethacin group, thereby indicating their effective antiprostaglandin action.
The mean clinical observations of patients studied is shown in [Table - 2]. The overall clinical observations correlated well with the total protein contents of aqueous humour in various groups. Aspirin was observed to be superior to indomethacin in its antiprostaglandin action.
| Discussion|| |
Increase in prostaglandin level has been reported after trauma and paracentasis with characteristic changes in the eye. Surprisingly the same characteristic changes in eye have been reported after topical application, subconjunctival, anterior chamber and intracameral injections of prostaglandins. The characteristic changes include miosis, vasodilation, increased protein contents of aqueous humour and raised intra-ocular pressure.
Most of the studies available in the literature about the anti-prostaglandin drugs on ocular inflammation have been done on experimental animals. While preliminary human clinical studies have shown aqueous humour prostaglandin elevation in certain diseased states of eye like glaucoma and Uveitis.
In the present study, proteins were raised in secondary aqueous (50.81% in controls) thereby indicating disturbance of blood-aqueous barrier after paracentasis. This disturbance is mediated by prostaglandins as evident from its prevention by antiprostaglandin drugs (Aspirin 6.76% and indomethacin 11.01% rise only). Zimmerman et al showed similar results with aspirin (53% in controls and 7% in aspirin group).
Post-operative observations also correlated well with the total protein contents of aqueous humour in various groups studied. It was seen that aspirin and indomethacin prevented raction of eye and inflammatory response to trauma. Aspirin was found to be relatively superior to indomethacin in its anti-prostaglandin action.
| Summary|| |
Total thirty cases were studied to see the effects of antiprostaglandin drugs on blood aqueous barrier. Total protein rise of 50.81% in secondary aqueous in control group was reduced to 6.76% and 11.01% by antiprostaglandin drugs aspirin and indomethacin respectively. Postoperative anteinflammatory effects were also correlated these. Aspirin was revealed to be superior to indomethacin in its antiprostaglandin action.
| Acknowledgements|| |
We are thankful to Dr. S.N. Misra, Principal, S.P. Medical College and Controller of Attached Hospitals, Bikaner, for providing the facilities to conduct this study.
| References|| |
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[Table - 1], [Table - 2]