Helicobacter pylori IgG antibodies in aqueous humor and serum of subjects with primary open angle and pseudo-exfoliation glaucoma in a South Indian population.

PURPOSE: A prospective, nonrandomized, comparative study was carried out to investigate levels of anti-Helicobacter pylori-specific IgG antibodies in the aqueous humor and serum of patients with primary open angle glaucoma (POAG), exfoliation syndrome [pseudo-exfoliation glaucoma (PXFG)], and with normotensive cataract patients, who served as controls. METHODS: Aqueous humor was aspirated at the beginning of glaucoma surgery from 50 eyes of 50 patients with POAG, with PXFG and at the beginning of phacoemulsification cataract surgery from controls. Serum samples were obtained. Anti-H. pylori IgG concentration in the aqueous humor and serum was measured by means of enzyme linked immunosorbent assay. RESULTS: Serum analysis of anti-H. pylori IgG antibodies revealed statistically significant difference between POAG and PXFG (52.26+/-52.51 vs. 25.22+/-35.27, P=0.01). Also, the difference between POAG and controls was statistically significant (54.05+/-55.04 vs. 33.83+/-41.73, P=0.04). However, on comparing PXFG with the control group, the difference was statistically insignificant (P=0.12). The mean concentration of anti-H. pylori IgG antibodies in aqueous humor of patients in POAG and controls were not statistically different (3.93+/-5.14 vs. 2.65+/-2.87, respectively, P=0.73). The mean concentration of anti-H. pylori IgG antibodies in aqueous humor of patients in PXFG and controls were not statistically different (8.87+/-30.25 vs. 2.65+/-2.87, respectively, P=0.83). There was also no statistical difference of IgG levels between POAG and PXFG (3.93+/-5.14 vs. 8.87+/-30.25, respectively, P=0.87). CONCLUSIONS: The levels of anti-H. pylori IgG titers in sera of individuals with POAG were significantly higher compared with PXFG and control groups. We support the hypothesis of the role of anti-H. pylori antibodies in causative mechanism for POAG. We could not find a significant link between the anti-H. pylori IgG antibodies and the PXFG.

No association between Helicobacter pylori infection or CagA-bearing strains and glaucoma.

BACKGROUND AND PURPOSE: Accumulating evidence indicates that a variety of infections contribute to the pathogenesis of glaucoma. The role of Helicobacter pylori infection in glaucoma is controversial. DESIGN: Prospective, population-based study. PARTICIPANTS: Patients with various types of glaucoma and a control group of patients with cataract. METHODS: We evaluated seropositivity to H. pylori and to its cytotoxin-associated gene A (CagA) product in patients with various types of glaucoma and compared the findings to those of a control group of patients with cataract. RESULTS: H. pylori infection and CagA seropositivity were detected in 31/51 (60.8%) and 26/51 (51%) glaucoma patients compared with 22/36 (61.1%) and 19/36 (52%) control patients, respectively (P=0.88, 0.67, not significant). Similar rates of H. pylori infection and CagA-positive strain were found in all glaucoma subgroups, and none of them was statistically different from those of controls. CONCLUSIONS: Neither H. pylori infection nor seropositivity for virulent CagA-bearing H. pylori strains have significant association with the occurrence of glaucoma of any type.

Increased levels of Helicobacter pylori IgG antibodies in aqueous humor of patients with primary open-angle and exfoliation glaucoma.

PURPOSE: A prospective, nonrandomized, comparative study was carried out to investigate the levels of anti- H. pylori-specific IgG antibodies in the aqueous humor and serum of patients with primary open-angle glaucoma (POAG) and patients with exfoliation glaucoma (XFG), and to compare them with those in age-matched cataract patients. METHODS: Aqueous humor was aspirated at the beginning of glaucoma surgery from 26 eyes of 26 patients with POAG, 27 eyes of 27 patients with XFG, and at the beginning of phakoemulsification cataract surgery from 31 eyes of 31 age-matched normotensive cataract patients. Serum samples were obtained the day before surgery from all patients. Anti- H. pylori IgG concentration in the aqueous humor and serum was measured by means of an enzyme-linked immunosorbent assay. RESULTS: The mean concentration (+/- SE) of anti- H. pylori-specific IgG was significantly greater in the aqueous humor samples from patients with POAG (14.27+/-3.86 U/ml) and XFG (14.25+/-3.39 U/ml) than in those from age-matched control cataract patients (4.67+/-1.07 U/ml); ( P=0.006 and P=0.003, respectively). No difference was observed in the levels of H. pylori-specific IgG antibodies between POAG and XFG aqueous humor samples ( P=0.5). Similarly, the serum concentration of anti- H. pylori antibodies was significantly greater in patients with POAG (69.96+/-9.69 U/ml; P=0.013) and XFG (81.37+/-10.62 U/ml; P=0.002) than in the cataract controls (44.16+/-6.48 U/ml). The mean vertical cupping correlated significantly with the titer of anti- H. pylori-specific IgG in the aqueous humor in the POAG patients. CONCLUSION: H. pylori-specific IgG antibody levels are significantly increased in the aqueous humor and serum of patients with POAG and XFG. Moreover, the titer of anti- H. pylori antibody in the aqueous humor might reflect the severity of glaucomatous damage in POAG patients. These findings support a role for H. pylori infection in the pathobiology of these two common glaucomas.

Helicobacter pylori infection and the risk for open-angle glaucoma.

PURPOSE: To determine the frequency of exposure to Helicobacter pylori infection in glaucoma patients. DESIGN: Prospective case-control study. PARTICIPANTS: Ninety-seven consecutive patients attending a glaucoma clinic. These included 38 patients with primary open-angle glaucoma (POAG), 19 with normal pressure glaucoma (NPG), 16 with pseudoexfoliation glaucoma (PXE), and 24 with ocular hypertension (OHT). Ninety-four age-matched participants without glaucoma served as a control population. METHODS: Serum was analyzed for the presence of H. pylori-specific immunoglobulin G antibodies by enzyme-linked immunosorbent assay. MAIN OUTCOME MEASURES: Serologic analysis for H. pylori. RESULTS: Seropositivity for H. pylori was higher in patients with glaucoma (26.0%) than in controls (20.2%), but this did not achieve statistical significance (P = 0.46). A total of 26.3% of POAG patients, 26.3% of NPG patients, 25.0% of PXE patients, and 25.0% of OHT patients were seropositive. CONCLUSIONS: This study suggests that exposure to H. pylori infection is not associated with open-angle glaucoma.

Endogenous Serratia marcescens endophthalmitis with dark hypopyon: case report and review.

A case of endogenous Serratia marcescens endophthalmitis in a patient with diabetes, end-stage renal disease, and an indwelling venous catheter is reported. The patient presented with a tan hypopyon and elevated intraocular pressure. Diagnosis was established by positive blood, vitreous, conjunctival, and catheter tip cultures. After a deteriorating course the eye was enucleated. Gross and histopathologic examination revealed the presence of a dark hypopyon with iris necrosis and pigment dispersion and possible spontaneous globe perforation. This is the eleventh reported case of endogenous Serratia endophthalmitis. Previous association of a pink hypopyon and of pigmented vitreous fluid and Serratia endophthalmitis has been reported. This is the first case of dark hypopyon in endogenous Serratia marcescens endophthalmitis reported in the medical literature. Previous entities associated with dark hypopyon have been limited to intraocular melanoma and Listeria monocytogenes endophthalmitis. Dark hypopyon in the appropriate clinical setting may be useful in aiding diagnostic and therapeutic decisions.