Evaluation of renin and angiotensin II levels in pseudoexfoliation syndrome.

Burcin Kepez Yildiz,Murat Hasanreisoglu,Zeynep Aktas,Mehmet Cingirt,Nilay Yuksel,Ozlem Gulbahar,Huseyin Baran Ozdemir,Fulya Yaylacioglu Tuncay

doi:10.5935/0004-2749.20180092

Abstract

Pseudoexfoliation syndrome has been linked to impaired function of the heart and blood vessels. We conducted a study to investigate the role of the renin-angiotensin system in the etiopathogenesis of pseudoexfoliation syndrome. The subjects were 14 patients with pseudoexfoliation syndrome and 14 healthy controls who underwent cataract extraction. Preoperative 5-ml samples of peripheral venous blood and perioperative aqueous humor were collected from the patients in both groups. Plasma and aqueous humor renin levels were analyzed by an immunoradiometric method, and angiotensin II levels were analyzed by radioimmunassay. SPSS version 16.0 was used for statistical analyses. A p-value <0.05 was considered to indicate a statistically significant difference. The mean ages of the patients in pseudoexfoliation and control groups were 71.7 ± 7.1 and 67.4 ± 9.3 years, respectively (p=0.140). The median aqueous humor renin level was 7.73 pg/ml (4.15-21) in the control group and 11.95 pg/ml (3.75-18.54) in pseudoexfoliation group (p=0.022). There were no differences between the two groups in the plasma renin, plasma angiotensin II, or aqueous humor angiotensin II levels. The correlations between plasma and aqueous humor renin levels and between plasma and aqueous humor angiotensin II levels were examined separately for each group; no significant correlations were observed in pseudoexfoliation group (r=-0.440, p=0.115; r=-0.414, p=0.142) or the control group (r=-0.232, p=0.425; r=0.482, p=0.081). Aqueous humor renin levels are higher in pseudoexfoliation syndrome. The results indicate a probable role of renin-angiotensin system in pseudoexfoliation syndrome. Further studies with larger numbers of cases are needed to clarify the precise association of renin-angiotensin system with the etiopathogenesis of pseudoexfoliation syndrome.

Highlights

Pseudoexfoliation (PEX) syndrome is a common age-related fibrillopathy of unknown cause
Plasma and aqueous humor renin levels were analyzed by an immunoradiometric method, and angiotensin II levels were analyzed by radioimmunassay
PEX syndrome is a systemic disease characterized by the presence of dust-like PEX material in the ocular tissues, with a reported worldwide prevalence of 1.8%13.5%(18)

Summary

Introduction

Pseudoexfoliation (PEX) syndrome is a common age-related fibrillopathy of unknown cause. It is characterized by the deposition of distinctive fibrillar material in the anterior segment[1]. PEX syndrome is an ocular disease and a generalized disorder that involves the abnormal production of extracellular matrix material[2]. Systemic and ocular blood flow changes, altered parasympathetic vascular control, increased vascular resistance, and decreased blood flow velocity, high levels of plasma homocysteine, and arterial hypertension have all been demonstrated in patients with PEX syndrome[3]. Deposition of pseudoexfoliative fibers in the cardiovascular system and the relation of PEX syndrome to coronary artery disease and cardiovascular mortality have been documented, data about the significance of the relationship are limited and conflicting[5,6]. The probable role of angiotensin II in the PEX syndrome is a matter of wonder

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