Normal Tension Glaucoma Clinical Trial
Official title:
Reduced Serum Bilirubin Levels in Patients With Normal-tension Glaucoma
Purpose: To analyze the relationship between normal-tension glaucoma (NTG) and serum
bilirubin levels.
Materials and Methods: This research included 38 patients with NTG and 38 healthy controls
with similar age and sex distribution, for a total of 76 subjects. Serum samples were taken
from all of the subjects, direct serum bilirubin, indirect serum bilirubin and the total
serum bilirubin were measured.
This is a retrospective study of cases with recently or previously diagnosed NTG who were
admitted to our clinic between 2010 and 2017. This study included 38 patients with NTG and 38
healthy controls with similar age and sex distribution, for a total of 76 subjects. Written
informed consent was obtained from all of the participants. The study was approved by the
institutional review board of the hospital and adhered to the tenets of the Declaration of
Helsinki.
A complete ophthalmic examination including best-corrected visual acuity, slit-lamp
biomicroscopy, Goldmann applanation tonometry (AT 900, Haag-Streit Diagnostics, Koeniz, CH),
corneal thickness evaluation (Pachymeter SP-3000, Tomey Corporation, Nagoya, JP), gonioscopy
and ophthalmoscopy was performed in all NTG cases. Additionally, optical coherence tomography
(OCT RS-3000 Lite, NIDEK Corporation, Tokyo, JP) measurement of the peripapillary retinal
nerve fibre layer thickness, and Humprey visual field testing (Carl-Zeiss Meditec, Dublin,
CA) were also performed.
NTG was diagnosed based on a clinical examination showing a normal IOP (corrected for corneal
thickness), thinning of the peripapillary retinal nerve fibre layer, optic nerve damage, and
characteristic glaucomatous visual field defects. The exclusion criteria included other forms
of glaucoma such as primary open-angle glaucoma, primary closed-angle glaucoma, pigmentary
glaucoma and exfoliative glaucoma. Patients who had active systemic diseases such as those
affecting the liver, biliary system, pancreas and kidney and infectious diseases or malignant
tumours that could influence the serum bilirubin concentrations were also excluded.
Fasting blood samples were taken from each participant to measure direct bilirubin, indirect
bilirubin, and the total serum bilirubin concentrations. The direct bilirubin and total
bilirubin concentrations were measured with an Architect C16000 Clinical Chemistry Analyzer
(Abbott Laboratories, Abbott Park, IL, USA), using its original kits, and the indirect
bilirubin concentrations were calculated by the following formula: indirect bilirubin = total
bilirubin - direct bilirubin.
All the data were compiled into a computer file, and Statistical Package for Social Sciences
for Windows 22.0 was used to perform the statistical analysis. Student's t test or the
Mann-Whitney U test were used to compare the mean values between the two groups, after the
evaluation of the data for a normal distribution using the Kolmogorov-Smirnov test. A p value
less than 0.05 was considered statistically significant.
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