Relationship between retinal glial cell activation in glaucoma and vascular dysregulation.
OBJECTIVE
To investigate the possible relationship between presumed activated retinal astrocytes and Müller cells (ARAM) and primary vascular dysregulation (PVD) in patients with primary open-angle glaucoma (POAG).


METHODS
One hundred eighty-six eyes of 93 patients with POAG were included in the study. Presumed ARAM was defined as patchy, discrete glittering but transparent changes of the retina. The diagnosis of PVD was based on both the patient's history and an abnormal circulatory behavior. Frequency tables were used to describe categorical variables, and differences were compared by means of chi test. A generalized linear mixed model was applied to determine the influence of vascular dysregulation, mean visual defect, and age on ARAM.


RESULTS
ARAM was found to be bilateral in 26.8% of patients (50 eyes), and unilateral in 11.8% (11 eyes). Patient's mean age was 68.6 (SD+/-8.1) years in the group with ARAM and 65.6 (SD+/-13.6) years in the group without (P=0.56). In the generalized linear mixed model, ARAM was significantly associated with vascular dysregulation [odds ratios (OR): 4.4, confidence intervals (CI): 1.7-11.3, P=0.002] but not with greater age (OR: 1.1 per decade of years, 0.7-1.6, P=0.48) and eye side (OR: 1.1, CI: 0.8-1.6, P=0.52). An increase of mean visual defect of 5.5 dB doubled the risk for ARAM (OR: 2.0; CI: 1.5-2.7, P<0.001).


CONCLUSIONS
Presumed retinal glial cell activation in POAG is clearly related to vascular dysregulation and to some extent to the stage of glaucomatous damage.
Grieshaber
Matthias C
MC
Department of Ophthalmology, University Hospital Basel, Basel, Switzerland.
Orgul
Selim
S
Schoetzau
Andreas
A
Flammer
Josef
J
D000368:Aged; D001783:Blood Flow Velocity; D002829:Choroid / Q000098:blood supply; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology*; D005911:Gliosis / Q000503:physiopathology; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D009262:Nails / Q000098:blood supply; D009457:Neuroglia / Q000502:physiology*; D016491:Peripheral Vascular Diseases / Q000503:physiopathology*; D011446:Prospective Studies; D012039:Regional Blood Flow; D012160:Retina / Q000166:cytology*; D014794:Visual Fields