Clinical Ophthalmology (Dec 2022)

A Novel Biomarker in Primary Glaucoma: Aqueous Humor and Serum Levels of Ischemia Modified Albumin (IMA)

  • Rusmayani E,
  • Artini W,
  • Sasongko MB,
  • Suhardjo,
  • Viona V

Journal volume & issue
Vol. Volume 16
pp. 4075 – 4087

Abstract

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Emma Rusmayani,1 Widya Artini,1 Muhammad Bayu Sasongko,2 Suhardjo,2 Viona Viona1 1Glaucoma Department, Jakarta Eye Center Hospitals and Clinics, Jakarta, Indonesia; 2Ophthalmology Department, Faculty of Medicine University Gadjah Mada, Yogyakarta, IndonesiaCorrespondence: Emma Rusmayani, Glaucoma Department, Jakarta Eye Center Hospitals and Clinics, Terusan Arjuna Utara / 1 Kedoya, West Jakarta, Jakarta, Indonesia, 11520, Email [email protected]: To analyze ischemia-modified albumin (IMA) levels in aqueous humor and serum, and their correlation to RNFL thinning in primary glaucoma patients.Design: Cross-sectional study.Methods: Patients were divided into the control and glaucoma groups. The control group was patients with senile cataracts. The glaucoma group consisted of patients diagnosed for the first time as primary open-angle glaucoma (POAG) or primary angle closure glaucoma (PACG). Exclusion criteria were secondary glaucoma and patients with systemic disease. A complete cataract examination was done for all patients, and glaucoma examinations for the glaucoma group. In both groups, the IMA aqueous humor was obtained during cataract and glaucoma procedure. Serum levels of IMA, malondialdehyde (MDA), and tumor necrosis factor alpha (TNF-α) were examined during preoperative examinations.Results: Control group comprised 33 participants, and glaucoma group 41 patients (21 PACG and 20 POAG). Mean IMA aqueous humor (AQH) levels found in cataract group 6.039± 3.16 ng/mL, glaucoma group 14.89± 6.08 ng/mL, PACG group 12.69± 6.25 ng/mL and POAG group 17.33± 4.988 mg/mL. Mean IMA serum levels in cataract group 14.75± 6.53 ng/mL, glaucoma group 13.89± 6.53 ng/mL, PACG group 12.79± 6.46 ng/mL± and POAG group 14.93± 10.74 ng/mL. Glaucoma group had significant higher level of IMA in aqueous humor compared to control group, but opposite findings in serum IMA levels between groups. POAG patients had a higher aqueous IMA level compared to PACG group and correlated significantly with IOP. IMA AQH also negatively correlated to the RNFL thickness in both POAG and PACG group. Cut off 9.5 ng/mL was considered as a normal limit value to differentiate between control and glaucoma group.Conclusion: Primary glaucoma patients showed a significantly increased level of IMA AQH as a local ischemic biomarker compared to the control group. Systemic oxidative activity is not a representation of local ocular oxidative stress in both cataract and glaucoma group.Keywords: ischemia-modified albumin, biomarker, primary glaucoma, early detection

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