THE MYSTERY OF GLAUCOMA Edited by Tomas Kubena and Martina Kofronova The Mystery of Glaucoma Edited by Tomas Kubena and Martina Kofronova Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access articles distributed under the Creative Commons Non Commercial Share Alike Attribution 3.0 license, which permits to copy, distribute, transmit, and adapt the work in any medium, so long as the original work is properly cited. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published articles. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Mirna Cvijic Technical Editor Teodora Smiljanic Cover Designer Jan Hyrat Image Copyright l i g h t p o e t, 2010. Used under license from Shutterstock.com First published August, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org The Mystery of Glaucoma, Edited by Tomas Kubena and Martina Kofronova p. cm. ISBN 978-953-307-567-9 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Molecular Biology 1 Chapter 1 Evidence of Oxidative Stress Damage in Glaucoma 3 Sandra M Ferreira, Claudia G Reides, Fabián S Lerner and Susana F Llesuy Chapter 2 Differential Effects of Elevated Hydrostatic Pressure on Gene Expression and Protein Phosphorylation in Optic Nerve Head Astrocytes 19 Thomas J. Lukas, Pan Du, Haixi Miao and Simon Lin Chapter 3 Homocysteine in the Pathogenesis of Chronic Glaucoma 41 Mustafa R Kadhim and Colin I Clement Chapter 4 Expression of Metabolic Coupling and Adhesion Proteins in the Porcine Optic-Nerve Head: Relevance to a Flow Model of Glaucoma 61 Francisco-Javier Carreras, David Porcel, Francisco Rodriguez-Hurtado, Antonio Zarzuelo, Ignacio Carreras and Milagros Galisteo Chapter 5 Anatomical and Molecular Responses Triggered in the Retina by Axonal Injury 91 Marta Agudo-Barriuso, Francisco M. Nadal-Nicolás, Guillermo Parrilla-Reverter, María Paz Villegas-Pérez and Manuel Vidal-Sanz Chapter 6 Neuroprotective Agents in Glaucoma 115 Eleni Bagli and George Kitsos Part 2 Optic Nerve Head and Nerve Fiber Layer 145 VI Contents Chapter 7 The Optic Nerve in Glaucoma 147 Ivan Marjanovic Chapter 8 The use of Confocal Scanning Laser Tomography in the Evaluation of Progression in Glaucoma 171 Liamet Fernández Argones, Ibraín Piloto Díaz, Marerneda Domínguez Randulfe, Germán A. Álvarez Cisneros and Marcelino Río Torres Chapter 9 Nerve Fiber Layer Defects Imaging in Glaucoma 187 Kubena T., Kofronova M. And Cernosek P. Chapter 10 Optic Neuropathy Mimicking Normal Tension Glaucoma Associated with Internal Carotid Artery Hypoplasia 199 Kyoko Shidara and Masato Wakakura Chapter 11 Optic Nerve Head Blood Flow in Glaucoma 209 Tetsuya Sugiyama, Maho Shibata, Shota Kojima and Tsunehiko Ikeda Part 3 New Possibilities and Genetics 219 Chapter 12 Measurement of Anterior Chamber Angle with Optical Coherence Tomography 221 De Orta-Arellano F, Muñoz-Rodriguez P and Salinas-Gallegos JL Chapter 13 Association of TNF-and TNF- Gene Polymorphisms with Primary Open Angle and Primary Angle Closure Glaucoma 229 Najwa Mohammed Al- Dabbagh, Nourah Al-Dohayan, Abdulrahman Al-Asmari, Misbahul Arfin and Mohammad Tariq Chapter 14 Immune Modulation in Glaucoma – Can Manipulation of Microglial Activation Help? 257 Kin Chiu, Kwok-Fai So and Raymond Chuen-Chung Chang Chapter 15 Stem Cell Based Therapies for Glaucoma 269 Hari Jayaram, Silke Becker and G. Astrid Limb Chapter 16 Functional and Structural Evaluation of Retrobulbar Glaucomateus Damage 293 Kaya N Engin Contents VII Chapter 17 Central Changes in Glaucoma: Neuroscientific Study Using Animal Models 307 Kazuyuki Imamura, Masamitsu Shimazawa, Hirotaka Onoe, Yasuyoshi Watanabe, Kiyoshi Ishii, Chihiro Mayama, Takafumi Akasaki, Satoshi Shimegi, Hiromichi Sato, Kazuhiko Nakadate, Hideaki Hara and Makoto Araie Chapter 18 Using Artificial Neural Networks to Identify Glaucoma Stages 331 Gustavo Santos-García and Emiliano Hernández Galilea Preface Since long ago scientists have been trying hard to show up the core of glaucoma. To its understanding we needed to penetrate gradually to its molecular level. The newest pieces of knowledge about the molecular biology of glaucoma are presented in the first section. The second section deals with the clinical problems of glaucoma. Ophthalmologists and other medical staff may find here more important understandings for doing their work. What would our investigation be for, if not owing to the people’s benefit? The third section is full of new perspectives on glaucoma. After all, everybody believes and relies – more or less – on bits of hopes of a better future. Just let us engage in the mystery of glaucoma, to learn how to cure it even to prevent suffering from it. Each information in this book is an item of great importance as a precious stone behind which genuine, through and honest piece of work should be observed. It is a point of honour to edit such a book. Tomas Kubena, M.D. Head of the Glaucoma service, Zlin, Czech Republic Martina Kofronova, M.D. Glaucoma service, Zlin, Czech Republic [...]... On the other hand, the mean values of the total reactive antioxidant potential were found to be 55 ± 8 µM Trolox in the aqueous humor of POAG group and 28 ± 2 µM Trolox in aqueous humor of the XFG group In other words, the levels of TRAP were significantly decreased (49 %) in the XFG aqueous humor when compared to the POAG group (p < 0.001) TRAP values of both types of glaucoma were lower than the. .. patients, no other explanation for the optic nerve damage and the visual field loss should be found apart from the glaucoma XFS was defined by the presence of exfoliation material on the anterior surface of the lens Exfoliation material was also investigated in the pupillary border, corneal endothelium, anterior hyaloid, and angle However, for the diagnosis of XFS only the presence of material in the anterior... generalized agerelated disorder of the extracellular matrix with abnormalities in the basal membranes Exfoliation syndrome: The clinical diagnosis is made by the presence of exfoliative material on the surface of the anterior capsule of the lens Exfoliative material may also be present in the corneal endothelium and the trabecular meshwork Other clinical features include atrophy of the pupillary border and... mimic features of primary open angle glaucoma; therefore, it may be useful to understand the time-course of this ocular disease (Ferreira et al., 2010) The relationship between the development of glaucoma and oxidative stress was evaluated The occurrence of oxidative stress was evaluated by the following markers: in vivo chemiluminescence of the eye surface, the total antioxidant capacity in the aqueous... aqueous humor of XFS patients It is well known that growth factors and proteases can be activated by free radicals, so the occurrence of oxidative stress and therefore the antioxidant status of the aqueous humor may play a role in the oxidative metabolism of the cells implicated in the production of exfoliative material The antioxidant status was evaluated in order to assess the occurrence of oxidative... activities was found in the aqueous humor of glaucoma patients, whereas catalase activity was not affected These results imply a 57 % increase in SOD activity Glutathione peroxidase activity in the aqueous 10 The Mystery of Glaucoma humor of glaucoma patients showed a threefold increase when compared with value obtained in the control group The changes observed in the antioxidant enzymes in glaucoma patients... mechanism to ameliorate the oxidative stress in the aqueous humor of XFG and POAG patients (Ferreira et al., 2009) No significant changes were found in catalase levels, and this may be due to the nitric oxide (NO) inhibition of the catalase because of the union of NO to the heme group of the enzyme NO competes with hydrogen peroxide for the union to the complex I of the catalase (Brown, 1995); if catalase... decrease in the total level of antioxidants These molecules prevent or reduce the extent of the oxidative destruction of biomolecules The nitrite levels in the optic nerve head were represented at different times of surgery in Figure 7 A significant increase of nitrite concentration in the optic nerve head was found since 7 days of surgery and this increase was kept up until 60 days of treatment There was... al., 2003) In the glaucomatous ONH, compression, stretching, and remodeling of the cribriform plates of the lamina cribrosa occur In many POAG patients, these elevated IOP related changes result in remodeling of the extracellular matrix (ECM), altering the quantity and composition of several ECM macromolecules that significantly affect the biomechanical properties of the tissue supporting the nerve fibers... et al., 2008) compared to other populations A positive family history of POAG is a major risk factor for the disease in AA (Leske et al., 20 The Mystery of Glaucoma 2008) The Advanced Glaucoma Intervention Study (AGIS), which compared the glaucoma outcomes in AA and CA patients, concluded that after failure of medical therapy, surgical trabeculectomy delayed progression of glaucoma more effectively . oxide (NO) inhibition of the catalase because of the union of NO to the heme group of the enzyme. NO competes with hydrogen peroxide for the union to the complex I of the catalase (Brown, 1995);. radicals, so the occurrence of oxidative stress and therefore the antioxidant status of the aqueous humor may play a role in the oxidative metabolism of the cells implicated in the production of exfoliative. THE MYSTERY OF GLAUCOMA Edited by Tomas Kubena and Martina Kofronova The Mystery of Glaucoma Edited by Tomas Kubena and Martina Kofronova Published