| Background and PurposeGlaucoma, as a blindness-causing disease, is an optic neuropathy and visual field defect characterized by optic nerve damage. Retinal ganglion cells (RGC) progressive loss is the common pathological changes. Up to now, almost all treatment options for glaucoma have hitherto been limited to intraocular pressure (IOP) reduction since elevated IOP is traditionally considered to be the most important risk factor. However, visual field loss and RGC death continue to occur in patients with well controlled IOP. thus, a consensus has recently emerged that additional treatment strategies are needed.With the rapid development of animal models for glaucoma, we have more proformal understanding of the pathological processes occurring in glaucoma. Pharmacological neuroprotection demonstrates more and more superiority based on these experiments, Nerve growth factor (NGF) act on the central and peripheral neurons as an important biological active molecules. In recent years,It has been confirmed that extraneous NGF combinated with its receptor can offer in two ways, through animal models in glaucoma. On the one hand, it can inhibite apotosis in RGCs though exogenous scavenge oxygen radicals, preventing glutamate induced cxcitatory toxicity and stabiliting of intracellular Ga2+ concentration. On the other hand, they can promote the development of RGCs and regeration of axons after injury by the activation of different signal transduction pathways. This research further expore NGF'mechanisming observing the indicators in primary angle-closure glaucoma such as plasma endothelin(ET), serum nitric oxide(NO), visual acuity, intraocular pressure, visual field, visual electrophysiology. Of course, it can provide a new ideas for clinical prevention and treatment for glaucoma.MethodsThe study was carried on with Patients with PACG from December 2008 to October 2009 in the First Affiliated Hospital of Zhengzhou University. All the patients were operated on for trabeculectomy. There were 18 males and 25 females in 56 cases, and their average age54.3±7.97,range 41-68. Both eyes in patients underwent surgery, we observed the eyes which corrected visual acuity were better then the other one. The 56(56 eyes) cases of the patients were divided randomly into two groups, which were NGF treatment group and control group. Treatment group patients were treated by NGF, the control group patients by methylcobalamin tablets. Conventionally, we compared the two treatments by such aspects as vision, intraocular pressure, visual field, visual electrophysiology, plasma ET and serum NO levels.Statistical analyses were performed with SPSS 17.0 software. All results are expressed as the Mean±SD. T test was used in group, one-way ANONA was used in two groups in the same time. The numeration data were analyzed with chi-square test between groups. It was considered significant if P value was<0.05 between groups.,Results1. There was no difference between NGF group and control group in visual acuity at pro and post treatment, one month after treatment (P>0.05); visual acuity one month after treatment in NGF group was higher than that in control group (P< 0.05).2. There was no difference between NGF group and control group in intraocular pressure at pro and post treatment, one month after treatment (P>0.05).3. NGF group of visual field mean photosensitive degree, visual evoked potential amplitude, serum NO levels were significantly higher than control group at post treatment and one month after treatment (P<0.05); visual field MD, visual evoked potential latency and plasma ET-1 were significantly lower than control group(P<0.05).Conclusions1. NGF can promote the recovery of the function recovery of optic nerve partly of patients with glaucoma who IOP were controlled.2. NGF may be the existence of a long-term mechanism, the parameters of visual fields, visual acuity, electrophysiologic continues to improve at review.3. NGF has no obviously effect to the patients'intraocular pressure.4. The protection mechanisms of NGF may relate with the influence of ET/ NO. |
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