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Mastronikolis S, Kagkelaris K, Pagkalou M, Tsiambas E, Plotas P, Georgakopoulos CD. Antioxidant Defense and Pseudoexfoliation Syndrome: An Updated Review. MEDICAL SCIENCES (BASEL, SWITZERLAND) 2022; 10:medsci10040068. [PMID: 36548003 PMCID: PMC9785126 DOI: 10.3390/medsci10040068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/04/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022]
Abstract
Oxidative stress (OS) affects the anterior ocular tissues, rendering them susceptible to several eye diseases. On the other hand, protection of the eye from harmful factors is achieved by unique defense mechanisms, including enzymatic and non-enzymatic antioxidants. The imbalance between oxidants and antioxidants could be the cause of pseudoexfoliation syndrome (PEXS), a condition of defective extracellular matrix (ECM) remodeling. A systematic English-language literature review was conducted from May 2022 to June 2022. The main antioxidant enzymes protecting the eye from reactive oxygen species (ROS) are superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), which catalyze the reduction of specific types of ROS. Similarly, non-enzymatic antioxidants such as vitamins A, E and C, carotenoids and glutathione (GSH) are involved in removing ROS from the cells. PEXS is a genetic disease, however, environmental and dietary factors also influence its development. Additionally, many OS products disrupting the ECM remodeling process and modifying the antioxidative defense status could lead to PEXS. This review discusses the antioxidative defense of the eye in association with PEXS, and the intricate link between OS and PEXS. Understanding the pathways of PEXS evolution, and developing new methods to reduce OS, are crucial to control and treat this disease. However, further studies are required to elucidate the molecular pathogenesis of PEXS.
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Affiliation(s)
- Stylianos Mastronikolis
- Department of Ophthalmology, Medical School, University of Patras, 26504 Patras, Greece
- Department of Neurosurgery, James Cook University Hospital, Middlesbrough TS4 3BW, UK
- Correspondence: (S.M.); (P.P.)
| | | | - Marina Pagkalou
- Department of Chemistry, University of Crete, 71500 Heraklion, Greece
| | | | - Panagiotis Plotas
- Laboratory of Primary Health Care, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
- Correspondence: (S.M.); (P.P.)
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Mastronikolis S, Pagkalou M, Plotas P, Kagkelaris K, Georgakopoulos C. Emerging roles of oxidative stress in the pathogenesis of pseudoexfoliation syndrome (Review). Exp Ther Med 2022; 24:602. [PMID: 35949329 PMCID: PMC9353531 DOI: 10.3892/etm.2022.11539] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/06/2022] [Indexed: 11/25/2022] Open
Abstract
Pseudoexfoliation syndrome (PEXS) is a systemic disease caused by defects in the extracellular matrix (ECM) remodelling process leading to the chronic deposition of extracellular, fibrillary, white flaky pseudoexfoliation material (PEXM) throughout the body. Specifically, PEXM deposits on the lens capsule cause open-angle glaucoma, cataracts and blindness in patients with PEXS. Several gene single nucleotide polymorphisms are linked to the development of PEXS in humans, including lysyl oxidase-like 1 gene, clusterin and fibulin-5. The exact reason for the PEXM generation and its resulting pathogenesis is not well understood. However, defective ECM remodelling and oxidative stress (OS) have been hypothesized as significant events leading to the PEXM. Specifically, the link between OS and PEXS has been well studied, although the investigation is still ongoing. The present review explored recent advances in various aspects of PEXS and the involvement of OS in the eye for PEXS development.
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Affiliation(s)
| | - Marina Pagkalou
- Department of Chemistry, University of Crete, 70013 Heraklion, Greece
| | - Panagiotis Plotas
- Laboratory of Primary Health Care, School of Health Rehabilitation Sciences, University of Patras, 26334 Patras, Greece
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Talebnejad MR, Azimi A, Khalili MR, Meshksar A. The Role of Trace Elements in Pseudoexfoliation Syndrome: A Cross-sectional Study. J Ophthalmic Vis Res 2021; 16:165-170. [PMID: 34055253 PMCID: PMC8126740 DOI: 10.18502/jovr.v16i2.9079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 01/08/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose Pseudoexfoliation syndrome (PXF) is an age-related condition, characterized by deposition of whitish flake-shaped materials in the anterior segment of the eye. Although it occurs all over the world, a considerable racial variation exists. According to the high frequency of PXF in Iran and the importance of prevention and early treatment, we evaluated the plasma level of iron, zinc, copper, and magnesium in patients with PXF. Methods In this study, 83 individuals were enrolled; 40 patients with cataract and PXF as the case group and 43 age- and sex-matched individuals with cataract but without PXF as the control group. The serum levels of the mentioned microelements were compared in two groups. Results In the case group, 25 (62.5%) male and 15 (37.5%) female subjects participated. In the control group, the corresponding figures were 22 (51.2%) and 21 (48.8%), respectively. The mean age of the case group was 66.07 ± 9.46 and that for the control group was 66.88 ± 8.04 years. Regarding the case group, the serum levels of iron, zinc, copper, and magnesium were 60.58 ± 21.04, 84.7 ± 14.37, 120.23 ± 14.43, and 2.11 ± 0.23, respectively. These serum levels in the control group were 89.07 ± 26.06, 97.51 ± 17.42, 123.33 ± 19.01, and 2.14 ± 0.16. The serum levels of iron and zinc were significantly lower in the case group than the control group (P< 0.0001); however, such a difference was not observed in terms of copper and magnesium serum levels. Conclusion Our study demonstrated that the serum iron and zinc levels were lower in PXF patients. Nutritional deficiency may be a cause of zonular weakness in these patients. Heme is a cofactor for the enzyme which contributes to the biosynthesis of fibrillin, the major protein in zonular fibers. Therefore, iron can play a substantial role in the biosynthesis of the fibrils and also in the zonular stability.
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Affiliation(s)
- Mohammad Reza Talebnejad
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Azimi
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Khalili
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aidin Meshksar
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
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Kosior-Jarecka E, Czop M, Gasińska K, Wróbel-Dudzińska D, Zalewski DP, Bogucka-Kocka A, Kocki J, Żarnowski T. MicroRNAs in the aqueous humor of patients with different types of glaucoma. Graefes Arch Clin Exp Ophthalmol 2021; 259:2337-2349. [PMID: 33929592 PMCID: PMC8352835 DOI: 10.1007/s00417-021-05214-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose The aim of the study was to compare the frequency and the level of expression of selected miRNAs in the aqueous humor of patients with various types of glaucoma. Methods The studied group consisted of 42 patients with glaucoma: 19 with primary open-angle glaucoma (POAG), 14 with pseudoexfoliation glaucoma (PEXG), 9 with primary angle closure glaucoma (PACG), and the control group of 36 patients with senile cataract without glaucoma. The real-time polymerase chain reaction method was used to analyze the expression of miRNAs. Results There were no significant differences in the frequency and the level of miRNA expression between various types of glaucoma. There was a tendency for hsa-miR-6722-3p and hsa-miR-184 to be expressed more frequently in PEXG and hsa-miR-1260b in POAG. The expression levels of hsa-miR-1260b and hsa-miR-6515-3p were correlated with age in POAG. Target annotation and functional analyses showed that genes targeted by the most frequently expressed miRNAs (hsa-miR-1202, -1260b, -184, -187-5p, -6515-3p, -6722-3p, and hsa-mir-4634) are involved mainly in response to hypoxia, cardiovascular system development, and apoptosis. Conclusion Hsa-miR-1260b was the most abundantly expressed among studied miRNAs and may be a potential biomarker of clinical status in PEXG and PACG. Supplementary Information The online version contains supplementary material available at 10.1007/s00417-021-05214-z.
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Affiliation(s)
- Ewa Kosior-Jarecka
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, ul. Chmielna 1, 20-079, Lublin, Poland
| | - Marcin Czop
- Department of Clinical Genetics, Medical University of Lublin, ul. Radziwiłłowska 11, 20-080, Lublin, Poland
| | - Karolina Gasińska
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, ul. Chmielna 1, 20-079, Lublin, Poland.
| | - Dominika Wróbel-Dudzińska
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, ul. Chmielna 1, 20-079, Lublin, Poland
| | - Daniel P Zalewski
- Department of Biology and Genetics, Medical University of Lublin, ul. Chodźki 4a, 20-093, Lublin, Poland
| | - Anna Bogucka-Kocka
- Department of Biology and Genetics, Medical University of Lublin, ul. Chodźki 4a, 20-093, Lublin, Poland
| | - Janusz Kocki
- Department of Clinical Genetics, Medical University of Lublin, ul. Radziwiłłowska 11, 20-080, Lublin, Poland
| | - Tomasz Żarnowski
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, ul. Chmielna 1, 20-079, Lublin, Poland
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Influence of Trace Elements on Neurodegenerative Diseases of The Eye-The Glaucoma Model. Int J Mol Sci 2021; 22:ijms22094323. [PMID: 33919241 PMCID: PMC8122456 DOI: 10.3390/ijms22094323] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/16/2021] [Accepted: 04/18/2021] [Indexed: 02/07/2023] Open
Abstract
Glaucoma is a heterogeneous group of chronic neurodegenerative disorders characterized by a relatively selective, progressive damage to the retinal ganglion cells (RGCs) and their axons, which leads to axon loss and visual field alterations. To date, many studies have shown the role of various elements, mainly metals, in maintaining the balance of prooxidative and antioxidative processes, regulation of fluid and ion flow through cell membranes of the ocular tissues. Based on the earlier and current research results, their relationship with the development and progression of glaucoma seems obvious and is increasingly appreciated. In this review, we aimed to summarize the current evidence on the role of trace elements in the pathogenesis and prevention of glaucomatous diseases. Special attention is also paid to the genetic background associated with glaucoma-related abnormalities of physiological processes that regulate or involve the ions of elements considered as trace elements necessary for the functioning of the cells.
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Abstract
Purpose: The aim of this study is to show the pseudoexfoliation syndrome (PES) material accumulated in the lens anterior capsule and the trace elements directly with using scanning electron microscopy (SEM) and to investigate the effect of PES materials on aqueous humor by chemical analyses.Methods: The study groups consisted of 30 patients with PES and 30 patients without PES. 0.1-0.3 mL of aqueous humor was aspirated from anterior chamber and anterior capsule sample was obtained by applying continuous curvilinear capsulorhexis. The level of selected elements (Zn, Cu, Se, Fe, Si, Al, Ca, K) were determined from aqueous humor samples via Inductively coupled plasma - optical emission spectrometry (ICP-OES) machine. The morphology and elemental distribution of anterior lens capsules were carried out via a Zeiss Sigma 300 scanning electron microscope with energy dispersive X-ray spectroscopy (semiquantitative EDX).Results: For aqueous humor, the ICP-OES results show that Cu and Zn levels is higher (p < .001, both of them) in PES group than that the obtained from control group. It was noticed that the ratio of Cu/Zn was higher (p = .008) in aqueous humor, while Cu/Se ratio was higher in both aqueous humor (p < .001) and anterior capsule (p < .001) for PES group. The SEM images show that different metal precipitates were obtained from anterior lens capsules with PES. However, there is no obvious element precipitates on the anterior lens capsules without PES.Conclusion: The results observed that the level of selected elements can be obtained at different level in both PES group and control group. Especially, if the oxidative behavior of these elements which is thought to play a role in PES formation can be clarified, new approaches will be done to evaluate the structure of PES.
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Affiliation(s)
- Kamil Yavuzer
- Van Training and Research Hospital, Ophthalmology Clinic, University of Health Sciences, Van, Turkey
| | - Yuksel Akinay
- Engineering Faculty, Van Yuzuncu Yil University, Van, Turkey
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Hohberger B, Chaudhri MA, Michalke B, Lucio M, Nowomiejska K, Schlötzer-Schrehardt U, Grieb P, Rejdak R, Jünemann AGM. Levels of aqueous humor trace elements in patients with open-angle glaucoma. J Trace Elem Med Biol 2018; 45:150-155. [PMID: 29173472 DOI: 10.1016/j.jtemb.2017.10.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/22/2017] [Accepted: 10/10/2017] [Indexed: 01/02/2023]
Abstract
PURPOSE Trace elements might play a role in the complex multifactorial pathogenesis of open-angle glaucoma. The aim of this study was to analyze concentrations of trace elements in aqueous humor samples of patients with primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG). PATIENTS AND METHODS Thirty-three aqueous humor samples were obtained from patients undergoing cataract surgery: 12 patients with POAG (age 65.3±10.50, female 8, male 4), 10 patients with PEXG (age 65.9±11.27, female 6, male 4) and 11 patients without glaucoma (age 69.5±13.70, female 7, male 4) serving as controls. Aqueous humor levels of cadmium, iron, manganese, cobalt, copper and zinc were measured by Flow-Injection-Inductively-Coupled-Plasma-Mass-Spectrometry (FI-ICP-MS). RESULTS From the statistical evaluation, we observed that patients with POAG had significantly higher aqueous humor levels of zinc (p=0.006) compared to controls. Increased aqueous humor levels of zinc were also observed in patients with PEXG in relation to control (p=0.0006). For iron we observed a significantly reduction in PEXG compared to control (p=0.002) and a significant difference between POAG and PEXG (p=0.0091). No significant differences were observed in aqueous humor levels of manganese, cobalt, copper, cadmium between glaucoma and control patients. No differences were seen for iron (POAG vs. controls). Analysis of trace element ratios was added. CONCLUSION Significant differences in aqueous humor levels of zinc and iron between glaucoma and control patients support the hypothesis that these trace elements are involved in the pathogenesis of open-angle glaucoma.
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Affiliation(s)
- Bettina Hohberger
- Department of Ophthalmology, University of Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany,.
| | - M Anwar Chaudhri
- Institute of Surface Science and Corrosion (LKO), Department of Materials Science and Engineering, Technische Fakultät, Friedrich-Alexander Universität Erlangen-Nürnberg, Martensstr. 7, 91058 Erlangen, Germany,.
| | - Bernhard Michalke
- Helmholtz Zentrum München - German Research Center for Environmental Health, Research Unit Analytical BioGeoChemistry, Ingolstaedter Landstr. 1, 85764 Neuherberg, Germany,.
| | - Marianna Lucio
- Helmholtz Zentrum München - German Research Center for Environmental Health, Research Unit Analytical BioGeoChemistry, Ingolstaedter Landstr. 1, 85764 Neuherberg, Germany,.
| | - Katarzyna Nowomiejska
- Department of General Ophthalmology, Medical University of Lublin, Aleje Racławickie 1, 20-950 Lublin, Poland,.
| | | | - Pawel Grieb
- Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, 5 Pawinskiego Street, 02-106 Warsaw, Poland,.
| | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, Aleje Racławickie 1, 20-950 Lublin, Poland,.
| | - Anselm G M Jünemann
- Department of Ophthalmology, University of Rostock, Doberaner Straße 140, 18057 Rostock, Germany,.
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Karaca I, Yilmaz SG, Palamar M, Onay H, Akgun B, Aytacoglu B, Aykut A, Ozkinay FF. Evaluation of CNTNAP2 gene rs2107856 polymorphism in Turkish population with pseudoexfoliation syndrome. Int Ophthalmol 2017; 39:167-173. [DOI: 10.1007/s10792-017-0800-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 12/11/2017] [Indexed: 01/15/2023]
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Kokavec J, Min SH, Tan MH, Gilhotra JS, Newland HS, Durkin SR, Grigg J, Casson RJ. Biochemical analysis of the living human vitreous. Clin Exp Ophthalmol 2016; 44:597-609. [DOI: 10.1111/ceo.12732] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 02/04/2016] [Accepted: 02/06/2016] [Indexed: 12/29/2022]
Affiliation(s)
- Jan Kokavec
- University of Adelaide; Adelaide South Australia Australia
| | - San H Min
- University of Adelaide; Adelaide South Australia Australia
| | - Mei H Tan
- University of Adelaide; Adelaide South Australia Australia
| | | | | | - Shane R Durkin
- University of Adelaide; Adelaide South Australia Australia
| | - John Grigg
- University of Sydney; Sydney New South Wales Australia
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Serum Uric Acid, Alanine Aminotransferase, Hemoglobin and Red Blood Cell Count Levels in Pseudoexfoliation Syndrome. J Ophthalmol 2015; 2015:914098. [PMID: 26075087 PMCID: PMC4444578 DOI: 10.1155/2015/914098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 04/15/2015] [Accepted: 04/15/2015] [Indexed: 11/23/2022] Open
Abstract
Purpose. The pathogenesis of pseudoexfoliation (PEX), the most common cause of secondary glaucoma, has not been clearly identified, but there is increasing evidence that points out the role of oxidative stress. The aim of this study is to evaluate some of the most commonly used blood parameters, hemoglobin (Hb), red blood cell count (RBC), alanine aminotransferase (ALT), and uric acid (UA) levels, in subjects with PEX. Materials and Methods. This study is performed in a state hospital between November 2011 and December 2012. Retrospective chart review of subjects who underwent cataract surgery was performed. Thirty-one healthy subjects with PEX and 34 healthy subjects without PEX were evaluated. Hb, RBC, ALT, and UA levels were recorded. Student's t-test was used to compare the two groups. Results. The mean age was 73.6 ± 14.1 years in PEX group and 70.1 ± 12.7 in control group (p = 0.293). Hb, RBC, ALT, and UA levels did not show a statistically significant difference among PEX and control groups (p > 0.05 for all). Conclusion. Serum levels of Hb, RBC, ALT, and UA levels were similar in subjects with and without PEX. Further studies are needed to clarify the precise role of Hb, RBC, ALT, and UA in the pathogenesis of PEX.
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Abstract
At present, no animal models fully embody exfoliation syndrome or exfoliation glaucoma. Both genetic and environmental factors appear critical for disease manifestation, and both must be considered when generating animal models. Because mice provide a powerful mammalian platform for modeling complex disease, this paper focuses on mouse models of exfoliation syndrome and exfoliation glaucoma.
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Chiras D, Kitsos G, Petersen MB, Skalidakis I, Kroupis C. Oxidative stress in dry age-related macular degeneration and exfoliation syndrome. Crit Rev Clin Lab Sci 2014; 52:12-27. [PMID: 25319011 DOI: 10.3109/10408363.2014.968703] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Oxidative stress refers to cellular or molecular damage caused by reactive oxygen species, which especially occurs in age-related conditions as a result of an imbalance between the production of reactive oxygen species and the antioxidant defense response. Dry age-related macular degeneration (AMD) and exfoliation syndrome (XFS) are two common and complex age-related conditions that can cause irreversible vision loss. Two subtypes of AMD, which is the leading cause of blindness in the Western world, exist: the most prevalent dry type and the most severe wet type. Early dry AMD is characterized by formation of drusen, which are sub-retinal deposits, in the macular area and may progress to geographic atrophy with more dramatic manifestation. XFS is a systemic disorder of the extracellular matrix characterized by the accumulation of elastic fibrils that leads, in most cases, to glaucoma development with progressive and irreversible vision loss. Due to the aging population, the prevalence of these already-widespread conditions is increasing and is resulting in significant economic and psychological costs for individuals and for society. The exact composition of the abnormal drusen and XFS material as well as the mechanisms responsible for their production and accumulation still remain elusive, and consequently treatment for both diseases is lacking. However, recent epidemiologic, genetic and molecular studies support a major role for oxidative stress in both dry AMD and XFS development. Understanding the early molecular events in their pathogenesis and the exact role of oxidative stress may provide novel opportunities for therapeutic intervention for the prevention of progression to advanced disease.
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Affiliation(s)
- Dimitrios Chiras
- Department of Ophthalmology, University Hospital of Ioannina , Ioannina , Greece
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Ceylan OM, Can Demirdöğen B, Mumcuoğlu T, Aykut O. Evaluation of essential and toxic trace elements in pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Biol Trace Elem Res 2013; 153:28-34. [PMID: 23512169 DOI: 10.1007/s12011-013-9644-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 03/07/2013] [Indexed: 10/27/2022]
Abstract
Pseudoexfoliation syndrome (PEX), an age-related disorder of the eye, is associated with significant ophthalmic morbidity and can lead to pseudoexfoliation glaucoma (PEG). The etiology of this disorder has not been clearly understood. Trace elements have been suggested to have roles in the pathogenesis of several disorders. This study aimed to determine whether trace element levels have a role in the development of PEX and/or PEG. Levels of zinc (Zn), copper (Cu), selenium (Se), manganese (Mn), chromium (Cr), cobalt (Co), molybdenum (Mo), nickel (Ni), vanadium (V), arsenic (As), aluminum (Al), mercury (Hg), cadmium (Cd), and strontium (Sr) were determined in serum samples of 32 cases of PEX, 30 cases of PEG, and 32 control subjects using inductively coupled plasma-mass spectrometry. Mn, Mo, and Hg concentrations were found to be significantly increased in patients with PEX. Logistic regression revealed Mn and Hg as the strongest determinants of PEX and Mo as the strongest determinant of PEG in the studied Turkish subjects. Levels of Mn, Cr, Co, Mo, Al, Hg, Sr, Ni, V, and As were determined for the first time in these ophthalmological disorders. Increased levels of serum Mn, Mo, and Hg suggest a possible role of these elements in the pathobiology of PEX.
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Affiliation(s)
- Osman Melih Ceylan
- Ophthalmology Department, Gülhane Military Medical Academy, Ankara, Turkey
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