Sympatho-adrenal dysregulation and clinical manifestations of angiogenic activity in patients with secondary neovascular glaucoma
DOI:
https://doi.org/10.31288/Ukr.j.ophthalmol.202632230Keywords:
neovascular glaucoma, beta-adrenoreceptor activity, sympatho-adrenal dysregulation, iris rubeosis, angiogenesis, proliferative diabetic retinopathy, retinal vein occlusionAbstract
Purpose: To examine the relationship of beta-adrenoreceptor (β-AR) activity as a marker of sympatho-adrenal dysregulation with clinical manifestations of angiogenic activity in patients with secondary neovascular glaucoma.
Material and Methods: This prospective observational study included 188 patients with secondary neovascular glaucoma (NVG). Of these, 112 had NVG associated with proliferative diabetic retinopathy (PDR), and 76, NVG secondary to retinal vein occlusion (RVO). The control group comprised 34 individuals. All study subjects underwent routine ophthalmological examination, and the grade of rubeosis was determined according to the Weiss grading system. β-AR activity was determined by assessing specific lymphocyte sensitivity to adrenaline. Non-parametric statistical methods, Spearman correlation analysis and receiver operating curve (ROC) analysis were employed for analysis.
Results: β-AR level was 1.7–2.0 times higher in patients with NVG than in controls, and this difference was significant (p < 0.05). β-AR level was strongly positively correlated with the Weiss grade of rubeosis (rs = 0,69; p < 0.001). ROC analysis demonstrated a moderate discriminative ability for detecting clinically significant iris rubeosis (Weiss ≥ 2) (AUC = 0.70). At a threshold level of β-AR ≥ 14, there was a five-fold increase in the risk of developing clinically significant iris rubeosis (odds ratio = 5.02; 95% confidence interval, 2.64–9.56; p < 0.001).
Conclusion: Secondary NVG is associated with an increased β-AR activity, which may reflect the involvement of sympatho-adrenal dysregulation in the course of the disease. The finding of the correlation of β-AR with the grade of rubeosis indicates an association of systemic neuroautonomic mechanisms with clinical manifestations of angiogenic activity. β-AR level can be considered a promising marker for determining a phenotype of clinically active NVG.
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