Microvascular endothelial function and severity of primary open angle glaucoma

Area of Science:

• Ophthalmology
• Vascular Biology
• Glaucoma Research

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• The role of microvascular health in POAG pathogenesis remains an area of active investigation.
• Endothelial dysfunction is implicated in various vascular diseases and may affect ocular microcirculation.

Purpose of the Study:

• To investigate the association between microvascular endothelial dysfunction and the severity of primary open-angle glaucoma (POAG).
• To explore the potential role of endothelial function in POAG progression among ethnically Malay patients.

Main Methods:

• A prospective cohort study involving 114 ethnically Malay POAG patients (aged 40-80).
• Glaucoma severity was assessed using the Advanced Glaucoma Intervention Study (AGIS) score based on Humphrey visual field analysis.
• Microvascular endothelial function was evaluated using Laser Doppler fluximetry and iontophoresis with acetylcholine (endothelium-dependent) and sodium nitroprusside (endothelium-independent) to measure vasodilatation.

Main Results:

• Patients were stratified into mild (55), moderate (29), and severe (30) POAG groups based on AGIS scores.
• Statistically significant differences in microvascular endothelial function (acetylcholine response) were observed between mild vs. moderate and mild vs. severe POAG groups (P=0.023 and P<0.001, respectively).
• A significant negative correlation was found between microvascular endothelial function and POAG severity (r=-0.457, P<0.001).

Conclusions:

• Microvascular endothelial dysfunction is associated with increased severity of primary open-angle glaucoma in Malay patients.
• Impaired endothelial-dependent vasodilatation may contribute to the progression of POAG.
• These findings highlight the potential importance of vascular health in POAG management and research.