Pathogenesis of epidemic dropsy glaucoma
M. S. Sachdev, N. N. Sood, L. K. Verma, S. K. Gupta and N. F. Jaffery
Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi.
Thirty-one cases of epidemic dropsy with raised intraocular pressure were
studied. Glaucoma was bilateral in all, with open angles and no signs of
anterior segment inflammation. The outflow facility was unimpaired (C
value, 0.24 +/- 0.09 microL/min/mm Hg). Aqueous bioassays revealed
significantly elevated prostaglandin E2 level (23.33 +/- 4.32 ng/mL) and
histamine activity (13.0 +/- 2.76 ng/mL) in all samples from patients with
epidemic dropsy glaucoma as compared with negligible levels in control
samples from patients with open angle glaucoma. Aqueous biochemical
analysis revealed increased total protein level (1.03 +/- 0.10 g/L) with a
normal globulin pattern as compared with controls (0.26 +/- 0.08 g/L). On
histopathologic and histochemical testing, a normal trabecular meshwork was
found in 11 of the 12 trabeculectomy specimens. It is concluded that dropsy
glaucoma is hypersecretory in nature; prostaglandin and histamine release
may have significant roles in its pathogenesis.
