Evaluation of Essential and Toxic Trace Elements in Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma
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Evaluation of Essential and Toxic Trace Elements in Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma Osman Melih Ceylan & Birsen Can Demirdöğen & Tarkan Mumcuoğlu & Osman Aykut
Received: 1 January 2013 / Accepted: 7 March 2013 / Published online: 20 March 2013 # Springer Science+Business Media New York 2013
Abstract Pseudoexfoliation syndrome (PEX), an agerelated 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. Keywords Pseudoexfoliation syndrome . Pseudoexfoliation glaucoma . Trace elements
O. M. Ceylan : T. Mumcuoğlu Ophthalmology Department, Gülhane Military Medical Academy, Ankara, Turkey B. Can Demirdöğen (*) : O. Aykut Turkish Ministry of Health, National Public Health Agency, Sıhhiye, Ankara, Turkey e-mail: [email protected]
Abbreviations Al Aluminum As Arsenic Cd Cadmium Cr Chromium Co Cobalt Cu Copper Hg Mercury Mn Manganese Mo Molybdenum Ni Nickel PEX Pseudoexfoliation syndrome PEG Pseudoexfoliation glaucoma Se Selenium Sr Strontium V Vanadium Zn Zinc
Introduction Pseudoexfoliation syndrome (PEX) is an age-related systemic disorder which is characterized by accumulation of granular amyloid-like fibrillar extracellular material in anterior structures of the eye. The buildup of abnormal fibrillar material can block normal drainage of the aqueous humor and can cause, in turn, a buildup of pressure leading to glaucoma and loss of vision. PEX can lead to both open-angle glaucoma and angleclosure glaucoma [1]. However, there are persons with PEX without glaucoma [2]. PEX prevalence was found to be 7.2 % among individuals older than 49 years in the Eastern Mediterranean region of Turkey [3]. Despite extensive research, the exact etiology of this disorder remains unknown. Trace elements are often suspected of being the missing link in some of the unexplained human diseases since they have important roles as catalytic and
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