Indian Journal of Ophthalmology

ARTICLES
Year
: 1981  |  Volume : 29  |  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

Correspondence Address:
U K Satsangi
Department of Ophthalmology, S.P. Medical College, Bikaner 334001, Rajasthan
India




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;29:97-99


How to cite this URL:
Mathur S K, Satsangi U K, Jain G C. Effect of antiprostaglandin drugs on human blood-aqueous barrier. Indian J Ophthalmol [serial online] 1981 [cited 2021 Jun 17 ];29:97-99
Available from: https://www.ijo.in/text.asp?1981/29/2/97/30972


Full Text

Specific biochemical mechanisms for the development of the irritative response caused by trauma to the eye have only recently been investigated. Ambache[1] 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[2] 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[3] 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[2]. Surprisingly the same characteristic changes in eye have been reported after topical application[4], sub­conjunctival, anterior chamber[5] and intra­cameral[6] 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[7] and Uveitis[8].

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[9] 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

1Ambache, N., 1955, J. Physic] (Lond), 129 : 65.
2Ambache, N., Kavanagh, L, and Whiting, J., 1965, J. Physiol (Lond), 176: 378.
3Lowry, O.H., Rosebrough, N.J., Farr. A.L. and Randall, R.J., 1951, J. Biol. Chem., 193 :265.
4Kass, M.A., Podos, S.M., Moses, R.A. and Becker, B., 1972, Invest. Ophthalmol, 11 : 1022.
5Waitzman, M.B.; and King, D. Carl, 1967, Amer. ,sub J. Physiol. 212 (2) : 329.
6Beitch, B.R. and Eakins, K.E., 1969, Brit. J, Pharmacol., 37: 158.
7Wyllie, A.M. and Wyllie, J.H., 1971, Brit. Med J., 3 : 615.
8Masuda, N. and Izawa, Y., 1973, Jap. Ophthal mol., 17: 166.
9Zimmerman, T.J., Gravenstein, N., Sugar, A and Kaufman, H.E., 1975, Amer. J. Ophthalmol. 79:817