Abstract
Twenty patients with untreated primary open angle glaucoma (POAG) were tested for the presence of cholinergic supersensitivity of the iris using a 0.1% solution of pilocarpine. Nineteen patients had a significant miotic response compared to six of a group of twenty control subjects. We believe that an ocular parasympathetic neuropathy may be an important factor in promoting or perpetuating elevated intra ocular pressure in POAG. The mechanism of this is suggested and several possible areas of further study discussed.
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References
von Graefe A Uber die iridectomie bei glaucom und uber den glaucomatosen prozess. Albrecht v Graefes Arch Ophthalmol 1857; 3: 456–650.
Donders FF, cited by Hoffmans JHA . Beitrage zur kenntis des glacoms. Albrecht v Graefes Arch Ophthalmol 1862; 8: 124–48.
Barkan O . Glaucoma: classification, causes and surgical control of microgonioscopic research. Am J Ophthalmol 1938; 21: 1099–17.
Nesterov AP . Role of the blockade of Schlemm's canal in pathogenesis of primary open angle glaucoma. Am J Ophthalmol 1970; 70: 691–6.
Kolker AE, Hetherington J . Gonioscopic and microscopic anatomy of the angle of the anterior chamber of the eye. In Becker-Shaffer's Diagnosis and therapy of the glaucomas. 5th ed. St. Louis: CV Mosby 1983: 39.
Grierson I . What is open angle glaucoma? Eye 1987; 1: 15–28.
Weber A . Das calabar und seine therapeutische vewendung. Albrechtv Graefes Arch Ophthalmol 1877; 23 1–91.
Abrams D . Duke-Elder's Practice of Refraction. 9th ed. Edinburgh: Churchill- Livingstone, 1978: 59–69.
Lowenstein O, Schoenberg W . Arch Ophthalmol 1942-1944, cited by Duke-Elder Sir S. System of Ophthalmology. Vol XI London: Henry Kimpton 1969: 448.
Sigsbee B, Torkelson R, Kadis G, Wright JW, Reeves AG . Parasympathetic denervation of the iris in diabetes mellitus. J Neurol Neurosurg Psych 1974; 37: 1031–5.
Shen SC and Cannon WB . Sensitization of the denervated pupillary sphincter to acetyl-choline. Chi J Physiol 1936; 10: 359–72.
Cannon WB and Rosenbluth A . The supersensitivity of denervated structures: A law of denervation. New York. Macmillan, 1949.
Scheie HG and Adler FH . Site of the disturbance of tonic pupils (Adies's syndrome). Arch ophthalmol 1940; 24: 1041–4.
Cohen DN and Zakov ZN . The diagnosis of Adie's pupil using 0.0625 pilocarpine solution. Am J Ophthalmol 1975; 79: 883–5.
Dancis J and Smith AA . Familial dysautonomia. N Engl J Med 1966; 274: 207–9.
Axelrod FA, Nachtigal R, Dancis J . Familial dysautonomia: diagnosis, pathogenesis and management. Adv Paediatr 1974; 21: 75–95.
Brunnschweiler H . Zur Differentialdiagnose der Pupillotonie unter besonderer Berucksichtigung des Mecholyltests. Confinia Neurologia 1954; 15: 50–64.
Clark CV and Mapstone R . Autonomic function tests in closed angle glaucoma. Res. Clin Forums 1985; 7: 45–50.
Mapstone R and Clark CV . The Prevalence of autonomic neuropathy in (closed angle) glaucoma. Trans Ophthalmol Soc UK 1985; 104: 265–9.
Becker B . Diabetes mellitus and primary open angle glaucoma. Am J Ophthalmol 1971; 71: 1–16.
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Jordan, K., Perry, S., McCormack, P. et al. Cholinergic supersensitivity of the iris in primary open angle glaucoma. A clinical study. Eye 2, 233–237 (1988). https://doi.org/10.1038/eye.1988.47
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DOI: https://doi.org/10.1038/eye.1988.47
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