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Related Experiment Videos

Altered peripheral sensitivity to glucocorticoids in primary open-angle glaucoma.

John Stokes1, Brian R Walker, Jill C Campbell

  • 1Endocrinology Unit, School of Molecular and Clinical Medicine, University of Edinburgh, Western General Hospital, Edinburgh, Scotland, U.K. jst2121@aol.com

Investigative Ophthalmology & Visual Science
|November 26, 2003
PubMed
Summary

Patients with primary open-angle glaucoma (POAG) show increased peripheral sensitivity to glucocorticoids. This heightened sensitivity may worsen ocular side effects in POAG by enhancing local glucocorticoid action in the eye.

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Area of Science:

  • Ophthalmology
  • Endocrinology
  • Pharmacology

Background:

  • Glucocorticoids can increase intraocular pressure (IOP).
  • 11beta-hydroxysteroid dehydrogenases (11beta-HSD) regulate glucocorticoid activity at a prereceptor level.
  • Understanding glucocorticoid metabolism and sensitivity is crucial for managing conditions like POAG.

Purpose of the Study:

  • To investigate central and peripheral glucocorticoid sensitivity in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT).
  • To examine the differential metabolism of glucocorticoids by 11beta-HSDs in these patient groups.
  • To correlate glucocorticoid activity with intraocular pressure (IOP) regulation.

Main Methods:

  • Assessed peripheral glucocorticoid sensitivity via dermal blanching.

Related Experiment Videos

  • Evaluated central sensitivity using dexamethasone suppression testing.
  • Quantified daily glucocorticoid production by measuring urinary metabolites.
  • Measured plasma and aqueous humor cortisol levels in POAG patients and controls.

    • Main Results:

    • Patients with POAG demonstrated significantly greater cutaneous vasoconstriction in response to glucocorticoids compared to OHT patients and controls.
    • No significant differences were observed in total glucocorticoid production rates or circulating cortisol levels between groups.
    • An elevated ratio of urinary cortisol to cortisone metabolites in POAG patients indicated altered 11beta-HSD activity, suggesting a shift in glucocorticoid metabolism.

    Conclusions:

    • Patients with POAG exhibit heightened peripheral vascular sensitivity to glucocorticoids.
    • This increased sensitivity may amplify local glucocorticoid effects within the eye.
    • Enhanced glucocorticoid action could exacerbate adverse effects in POAG management.