Glaucoma and concomitant status of autonomic nervous system

There is much clinical evidence to suggest that certain types of Glaucoma are related to activity of autonomic nervous system (ANS). Although some local changes have been documented but systemic association has not been established, so far. Hence, the present study was initiated and an attempt was made to bring out the association of systemic autonomic functions with glaucoma (especially Primary Closed Angle Glaucoma (PCAG)) if any. This study was carried out in the Department of Physiology, Maulana Azad Medical College in association with Glaucoma Clinic of Guru Nanak Eye Centre, New Delhi from June 1993-August 94. ANS function tests were conducted using Polyrite-8-Medicare System. The subjects were confirmed cases of PCAG with 10P-22.1 +/- 4.4 mmHg and possibility of autonomic neuropathy due to any other cause was ruled out. They were matched with normal subjects for their age, anthropometry and were compared for their sympathetic activity of ANS by Galvanic Skin Resistance (GSR); Cold Pressor Response (CPR); corrected QT interval (QTc) and T-wave amplitude (TWA) and for parasympathetic activity of ANS by Resting Heart Rate (RHR); Standing to Lying Ratio (SLR) and Valsalva Ratio and analysed statistically using standard 't' test. The results obtained in this study indicated increase in sympathetic activity in 61% of PCAG subjects and decreased parasympathic activity in 80% of the PCAG subjects when compared with control group of subjects, suggesting association of autonomic neuropathy with PCAG.