Normal tension glaucoma and primary open angle glaucoma associated with increased platelet aggregation

On purpose of the present study was to evaluate platelet aggregation and fibrinolytic systems in patients with normal tension glaucoma (NTG) or primary open angle glaucoma (POAG). For platelet aggregation, we photoelectrophotometrically investigated adenosine diphosphate (ADP) or collagen-induced platelet aggregation in consecutively selected patients with glaucoma (22 patients with NTG and 13 patients with POAG) and 42 glaucoma free control subjects with normal ocular findings. The aggregation patterns of the patients' platelets reacted abnormally to ADP 1 microM or collagen 0.5 microg/ml as evidenced by secondary aggregation were compared with those of control subjects. For blood coagulative and fibrinolytic systems, we measured prothrombin time, activated partial thromboplastin time, fibrinogen, thrombin-antithrombin III complex (TAT), alpha2 plasmin inhibitor-plasmin complex. Seventeen of 22 patients (77%) with NTG and 5 of 13 patients (38%) with POAG showed abnormal secondary aggregation. A significant difference was observed between the two groups. No control subjects showed abnormal secondary aggregation. In the fibrinolytic test, all the parameters examined showed within normal ranges, although the log10(TAT) value was higher in NTG than in POAG. Results of the present study suggested that increased platelet aggregation as defined by ADP or collagen induced abnormal secondary aggregation in vitro is frequently associated with glaucoma patients and this tendency is more apparent in NTG than that in POAG.