Peripheral vascular endothelial dysfunction in glaucomatocyclitic crisis: a preliminary study.
OBJECTIVE
Glaucomatocyclitic crisis (GCC) is a syndrome of recurrent unilateral increased intraocular pressure associated with mild cyclitis and few clinical symptoms. This study was undertaken to assess brachial artery endothelium-dependent flow-mediated vasodilation (FMD) as an indicator of vascular endothelial function, to describe the association between GCC and endothelial dysfunction excluding age effects.


METHODS
This prospective study was conducted from January 2007 to April 2009 and included 12 patients with GCC and 15 age-matched normal control subjects. Detailed clinical parameters were reviewed, including highly sensitive C-reactive protein (hs-CRP), homocysteine, anti-SSA, anti-cardiolipin antibodies, and HLA type. Brachial artery FMD and endothelium-independent, nitroglycerin-mediated vasodilation (NMD) were studied by using high-resolution, two-dimensional (2-D) ultrasonic imaging.


RESULTS
Twelve patients with GCC were evaluated. The mean age of the patients was 36.3 years including 5 (41.6%) women and 7 (58.4%) men. There were no significant differences between patients with GCC and control subjects with regard to basal data, including body mass index, smoking, blood pressure, complete blood count, and routine blood biochemistries. Homocysteine and hs-CRP were within normal limits. Two (16.7%) patients were positive for HLA-B27, anti-SSA, and anti-cardiolipin antibodies. The nitroglycerin-mediated vasodilation in the patients with GCC was not significantly different from that of the control group. The FMD was much lower in the GCC group than in the control groups (mean 4.81% vs. 7.89%, P < 0.01).


CONCLUSIONS
The significantly lower FMD in patients with GCC implies peripheral vascular endothelial dysfunction. However, in the 16.7% positive for the HLA-B27, anti-SSA, and anti-cardiolipin antibodies, these parameters are associated with GCC and abnormal FMD.
Shen
Su-Chin
SC
Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
Ho
Wan-Jing
WJ
Wu
Shiu-Chen
SC
Yu
Kuang-Hui
KH
Lin
Hsin-Chiung
HC
Lin
Yu-Sheng
YS
Tsay
Pei-Kwei
PK
Chu
Pao-Hsien
PH
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001783:Blood Flow Velocity; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001916:Brachial Artery; D002784:Cholesterol / Q000097:blood; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005901:Glaucoma / Q000097:blood / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure; D015863:Iridocyclitis / Q000097:blood / Q000503:physiopathology*; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000503:physiopathology*; D011446:Prospective Studies; D012039:Regional Blood Flow; D014665:Vasodilator Agents / Q000008:administration & dosage; D055815:Young Adult
D001323:Autoantibodies; D001786:Blood Glucose; D014665:Vasodilator Agents; D002784:Cholesterol; D005996:Nitroglycerin