Respon Antibodi terhadap Protein Retina pada Miopia dibandingkan dengan Emetropia dan Glaukoma Sudut Terbuka Primer

FIFIN LUTHFIA RAHMI, Prof. dr. Suhardjo, SU, SpM(K).

2015 | Disertasi | S3 Ilmu Kedokteran

Pendahuluan: Miopia aksial merupakan salah satu faktor risiko glaukoma sudut terbuka primer (GSTaP). Imunoreaktivitas diduga berperan dalam patogenesis GSTaP. Tujuan: Tujuan penelitian ini adalah menganalisis dan membandingkan respon antibodi terhadap protein retina pada miopia dibandingkan dengan emetropia dan GSTaP, dan mencari protein retina yang berpotensi menjadi penanda biologis degenerasi glaukomatosa. Metoda: Subjek penelitian dikelompokkan menjadi kelompok emetropia, miopia, miopia dengan GSTaP, dan GSTaP. Data meliputi data demografi, panjang sumbu bolamata dan hasil pemeriksaan OCT (ketebalan serabut saraf retina dan nisbah cup/disc). Immunoblottting serum terhadap protein-protein retina juga dilakukan dalam penelitian ini. Jumlah subjek dengan respon antibodi positif dihitung dan dibandingkan diantara kelompok-kelompok penelitian dan dianalisis dengan uji Kruskall-Wallis dan uji Mann-Whitney. Korelasi antara respon antibodi dan data klinis dianalisis dengan uji korelasi Spearman. Hasil: Subjek penelitian terdiri dari 43 subjek emetropia, 43 subjek miopia, 37 subjek miopia dengan GSTaP dan 37 subjek GSTaP. Jumlah subjek dengan respon antibodi positif terhadap protein retina dengan berat molekul (BM) < 35 kDa pada miopia lebih tinggi dibandingkan emetropia, sedang jumlah subjek dengan respon antibodi positif terhadap protein retina dengan BM 40 kDa pada miopia lebih rendah daripada subjek dengan GSTaP. Jumlah subjek dengan respon antibodi positif terhadap protein retina dengan BM 40 kDa, 60-90 kDa and 125 kDa pada subjek dengan GSTaP lebih tinggi dibandingkan subjek tanpa GSTaP. Terdapat korelasi bermakna antara ketebalan SRR dan status glaukoma (dan 2 variabel lain) dengan respon antibodi terhadap protein retina (p<0,001) Kesimpulan: Respon antibodi terhadap protein dengan BM 40 kDa, 60-90 kDa dan 125 kDA berpotensi sebagai penanda biologi untuk penapisan dini defek glaukomatosa

Introduction : Axial myopia is one of the risk factors of primary open angle glaucoma (POAG). Immune reactivity has been known to contribute to POAG pathogenesis. Aims: The purpose of this study was to analyze and compare the antibody response against retinal proteins in myopia compared withemetropia and POAG, and search for retinal proteins which has potentials as biomarker for glaucomatous degeneration.. Methods: Subjects were classified as emetropia, myopia, myopia with POAG, and POAG. The data collected were demographic data, axial length and OCT examination result (RNFL thickness and cup/disc ratio). Serum immunoblotting against retinal proteins were performed. Number of subjects with positive antibody responses were counted and compared between groups and analyzed used Kruskall-Wallis and Mann-Whitney tests, Correlation between antibody responses and clinical data were analyzed with Spearman correlation test. Results: Subjects consisted of 43 emetropia, 43 myopia, 37 myopia with POAG, and 37 POAG patients. Number of subjects with positive antibodies response against protein with molecular weight (MW) < 35 kDa were sigficantly higher in myopia subject compare to emetropia, however number of subject with positive antibodies respons against protein with MW 40 kDa were significantly lower in myopia subject compare to subjects with POAG. Number of subject with positive antibodies response against protein with MW 40 kDa, 60-90 kDa and 125 kDa were significantly higher in POAG subjects compare to non POAG subjects (p<0,001). There were significant correlations between RNFL thickness and glaucoma state with antibody response against retinal proteins and two other variables, i.e. (p<0,001). Conclusion: Antibody responses against retinal protein with MW of 40kDa, 60-90kDa, and 125 kDa were promising as biological marker for early screening of glaucomatous defect.

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