Conjunctival Bacteria Flora of Glaucoma Patients During Long-Term Administration of Prostaglandin Analog Drops.

Purpose: To investigate the effects of the long-term use of prostaglandin analogs for glaucoma treatment on the indigenous flora of the conjunctiva. Methods: Bacterial isolates were collected from the conjunctival sacs of 68 patients at Miyata Eye Hospital from February to September 2014, who had been receiving continuous monotherapy with prostaglandin analogs for glaucoma for at least 1 year. Minimum inhibitory concentrations of levofloxacin, gatifloxacin, moxifloxacin, cefmenoxime, tobramycin, chloramphenicol, and erythromycin against the isolates were measured to determine susceptibility. Results: The positive culture rate in all cases was 90.5% (57/63 eyes), and a total of 79 bacterial strains were isolated. The isolated bacteria included aerobic gram-positive cocci (8% Staphylococcus aureus and 41% Staphylococcus epidermidis), coagulase-negative staphylococci (5%), Streptococcus spp. (1%), Corynebacterium spp. (4%), gram-negative bacteria (4%), and the facultative anaerobe Propionibacterium acnes (33%). The positive culture rates for patients using 0.005% latanoprost (Xa group) and 0.004% travoprost (Tz group) were 88.9% and 92.6%, respectively, with no statistically significant difference in the composition of isolated bacteria between groups. Methicillin-resistant S. epidermidis (MRSE) was significantly more frequently isolated in the Xa group. The antimicrobial susceptibility rates of S. epidermidis were significantly lower in the Xa group for levofloxacin, gatifloxacin, moxifloxacin, and tobramycin. Conclusions: The indigenous flora may be affected by the long-term use of prostaglandin analogs. The higher incidence of MRSE in the Xa group should be considered during the long-term, continuous administration of eye drops, such as in glaucoma treatment.

Investigation of the association between glaucoma and Helicobacter pylori infection using the 14C-urea breath test.

PURPOSE: To investigate the association between glaucoma and Helicobacter pylori infection by evaluating for the presence of H. pylori infection in patients with glaucoma using the 14C-urea breath test (14C-UBT). METHODS: Using 14C-UBT, H. pylori infection positivity was compared between a group of patients with primary open-angle glaucoma and a control group with normal intraocular pressure and a normal optic disc or normal perimetry. RESULTS: The 14C-UBT was positive in 18 (51.42%) out of 35 patients in the glaucoma group and in 15 (42.85%) out of 35 patients in the control group. H. pylori infection positivity rates were similar between the glaucoma and control groups (p>0.05). CONCLUSION: According to the 14C-UBT, there is no association between primary open-angle glaucoma and H. pylori infection.

The Relationship Between Helicobacter pylori Infection and Open-Angle Glaucoma: A Meta-Analysis.

PURPOSE: Previous studies assessed the associations between Helicobacter pylori infection and open-angle glaucoma (OAG) and produced inconsistent results. Therefore, we performed a meta-analysis to evaluate the effects of H. pylori infection on OAG risk. METHODS: Relevant studies that reported the associations between H. pylori infection and OAG were identified through an extensive search of the Exerpta Medica Database (EMBASE), Web of Science, and PubMed databases in English and Chinese National Knowledge Infrastructure, VIP, and Wan Fang databases in Chinese, and by reviewing the reference lists of the key articles. The summary odds ratio (OR) and 95% confidence interval (CI) were calculated using the random-effects model. RESULTS: This meta-analysis involved 695 glaucoma patients and 1580 control individuals. The overall combined ORs showed a significant correlation between H. pylori infection and OAG (OR = 2.08, 95% CI = 1.42-3.04). The subgroup analysis showed the association of H. pylori infection with primary open-angle glaucoma (POAG; OR = 3.06, 95% CI = 1.27-2.46) and normal tension glaucoma (NTG; OR = 1.77, 95% CI = 1.76-5.34), but not with pseudoexfoliation glaucoma (PXFG; OR = 1.46, 95% CI = 0.40-5.30). CONCLUSIONS: The result of this meta-analysis suggested a statistically significant association between H. pylori infection and OAG. Further analysis showed that this positive relation is observed only in POAG and NTG patients, but not in the PXFG patients.

Investigation of the association between glaucoma and Helicobacter pylori infection using the 14C-urea breath test / Investigação de associação entre glaucoma e infecção pelo Helicobacter pylori pelo teste respiratório da ureia 14C

ABSTRACTPurpose:To investigate the association between glaucoma and Helicobacter pylori infection by evaluating for the presence of H. pylori infection in patients with glaucoma using the 14C-urea breath test (14C-UBT).Methods:Using 14C-UBT, H. pylori infection positivity was compared between a group of patients with primary open-angle glaucoma and a control group with normal intraocular pressure and a normal optic disc or normal perimetry.Results:The 14C-UBT was positive in 18 (51.42%) out of 35 patients in the glaucoma group and in 15 (42.85%) out of 35 patients in the control group. H. pylori infection positivity rates were similar between the glaucoma and control groups (p>0.05).Conclusion:According to the 14C-UBT, there is no association between primary open-angle glaucoma and H. pylori infection.

RESUMOObjetivo:Investigar a associação entre glaucoma e infecção por H. pyloripor meio do teste para a presença de infecção por H. pylori em pacientes com glaucoma usando o teste de respiração da ureia 14C (14C-UBT).Métodos:Foi feita uma comparação em relação a positividade H. pyloriutilizando 14C-UBT entre um grupo de pacientes com glaucoma primário de ângulo aberto e um grupo controle com pressão intraocular normal e sem verificação de disco óptico glaucomatosa.Resultados:O 14C-UBT foi positivo em 18 (51,42%) dos 35 pacientes no grupo de glaucoma e em 15 (42,85%) dos 35 pacientes no grupo de controle. As taxas de positividade foram semelhantes entre os grupos de glaucoma e de controle e não houve diferença significativa entre os grupos (p>0,05).Conclusão:De acordo com o 14C-UBT, não há associação entre o glaucoma primário de ângulo aberto e H. pylori.

Histological presence of Helicobacter pylori bacteria in the trabeculum and iris of patients with primary open-angle glaucoma.

PURPOSE: To investigate the role of Helicobacter pylori in primary open-angle glaucoma (POAG) pathophysiology by detecting its presence in eye biopsies of POAG patients during trabeculectomy. PATIENTS AND METHODS: Fifty-one consecutive patients who underwent trabeculectomy for POAG not responsive to antiglaucoma therapy, and 35 consecutive anemic controls were examined for H. pylori presence mainly by gastric mucosa histology. In POAG patients, eye biopsies were also obtained and stained for H. pylori presence in situ. RESULTS: Forty-three of 51 (84.3%) POAG patients and 17 of 35 (48.6%) controls were tested H. pylori positive (p = 0.0004). In 5 H. pylori-positive POAG patients, H. pylori bacteria were identified in the trabeculum and iris specimens. CONCLUSION: For the first time, H. pylori bacteria have been detected histologically in eye biopsies of POAG patients.

Elevated serum immunoglobulin G titers against Chlamydia pneumoniae in primary open-angle glaucoma patients without systemic disease.

PURPOSE: To determine if Chlamydia pneumoniae infection is associated with primary open-angle glaucoma (POAG). PATIENTS AND METHODS: Consecutive patients with newly diagnosed primary POAG attending the Glaucoma clinic of Keio University Hospital between June 2007 and January 2008 were considered for inclusion in this prospective case-control study. Forty consecutive POAG patients and 41 normal healthy individuals as a control population met the inclusion criteria. The exclusion criteria for both groups were; taking steroids or immunosuppressive agents, smoking, and history of any acute or chronic systemic disease including stroke, heart attack, diabetes mellitus, hypertension, asthma, and autoimmune diseases. The serum was analyzed for C. pneumoniae and C. trachomatis immunoglobulin G antibody titers by enzyme-linked immunosorbent assay. Seroactivity to each antigen between case and control groups was evaluated by Mann-Whitney U test. RESULTS: The age, male/female ratio, and intraocular pressure of the cases and control groups were not significantly different. Immunoglobulin G titers for C. pneuemoniae was significantly higher in patients with POAG than in controls (P=0.009). The titers to C. trachomatis were not significantly different between the 2 groups (P=0.99). CONCLUSION: The results suggest that higher C. pneumoniae titers are associated with POAG. If confirmed, this may indicate either a common factor that causes susceptibilities to both glaucoma and C. pneumoniae infection or that C. pneumoniae may be a causal factor for developing POAG.

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.

Eradication of Helicobacter pylori may be beneficial in the management of chronic open-angle glaucoma.

BACKGROUND: We have documented a high prevalence of Helicobacter pylori infection in patients with glaucoma. OBJECTIVE: To evaluate the effect of H pylori eradication on the 2 most commonly used glaucoma parameters: intraocular pressure and visual field. METHODS: A total of 41 patients with glaucoma and 30 age-matched anemic controls underwent upper gastrointestinal endoscopies and gastric mucosal biopsies to detect the presence of H. pylori infection by histologic analysis and rapid urease test (CLOtest; Delta West, Draper, Utah). Saliva samples were also tested by CLOtest. Serum anti-H pylori-specific IgG was analyzed by enzyme-linked immunosorbent assay. Helicobacter pylori-positive patients received a triple eradication regimen (omeprazole, clarithromycin, and amoxicillin treatment), and all patients were observed for 2 years while remaining under the same antiglaucoma therapy. RESULTS: Helicobacter pylori was detected in 88% of glaucoma cases and in 47% of controls (P<.001). Helicobacter pylori eradication was successful in 83% of treated patients. At the 2-year clinical end point, glaucoma parameters (mean intraocular pressure and mean visual field parameters) were improved in the subgroup of patients where H. pylori eradication was successful (P<.001 for intraocular pressure; P< or =.01 for visual field parameters), but not in the other patients. CONCLUSION: Helicobacter pylori eradication may positively influence glaucoma parameters, suggesting a possible causal link between H pylori and glaucoma.