BACKGROUND: The “double-faced” effect of nitric oxide (NO) is thought to play an important role in triggering and progression of glaucoma.

MATERIAL AND METHODS: Iris samples were obtained during iridectomy in 35 patients (mean age of 65.4±5.3 years) with diagnosed primary open-angle glaucoma (POAG). The controls were collected postmortem from 10 donors with a mean age of 62.2±1.9 years. Visual field defects were evaluated by perimetry. The Hodapp-Parrish-Anderson classification was used to divide patients into 3 visual field defect groups. The intraocular pressure was measured 3 times before surgery using applanation tonometry. The phenotype activity of nitric oxide synthase (NOS) isoenzymes (endothelial – eNOS and inducible – iNOS) and expression of nitrotyrosine in iris vasculature was assessed.

RESULTS: Significant differences were found between glaucoma patients and the controls in eNOS and iNOS activity (Mann-Whitney test, U=35.5, Z=–2.037, p=0.04 and U=21, Z=2.69, p=0.007, respectively). In addition, the results showed an upregulation of nitrotyrosine in the capillary endothelial cells in the study group, which was associated with the duration of diagnosed glaucoma (R-Spearman of 0.33, p=0.0047) and visual field mean defect MD (R-Spearman of 0.29, p=0.019). Moreover, the activity of nitrotyrosine was significantly correlated with iNOS immunoreactivity (R-Spearman of 0.5, p=0.0001). However, the iNOS activity significantly varied among Hodapp-Parrish-Anderson groups (p=0.03).

CONCLUSIONS: Our observations confirmed the association between glaucomatous disturbances and upregulation of iNOS, together with increased nitrotyrosine storage.

Keywords: Disease Progression, Gene Expression Regulation, Enzymologic, Glaucoma, Open-Angle - metabolism, Iris - enzymology, Manometry, Nitric Oxide Synthase Type II - metabolism, Nitric Oxide Synthase Type III - metabolism, Phenotype, Pilot Projects, Predictive Value of Tests, Tyrosine - chemistry