Elevated nitric oxide level in aqueous humor of patients with acute angle-closure glaucoma.

Nitric oxide, a noxious and free-radical gas, plays a key role in vasodilatation, inflammation, immunity, and neurotoxicity. Studies have shown that a recently detected NO synthase inducible isoform, found in astrocytes in the optic nerve heads of glaucoma patients, could stimulate excessive production of NO. The purpose of our study was to elucidate the role of NO production in the pathogenesis of glaucoma. We measured the concentrations of NO in aqueous humor from 11 patients with acute angle-closure glaucoma (AACG) and 14 patients with cataract. All samples were collected from patients who were free of any other systemic disease. Utilizing a chemiluminescence assay, we found that in AACG patients the NO levels in aqueous humor samples (83.2 +/- 6.7 microM) were significantly higher than in cataract patients (27.1 +/- 3.6 microM; p < 0.001). We therefore concluded that excessive NO in AACG patients reflects the degree of ocular impairment demonstrated by concomitant retinal cell and optic nerve cell damage.