ANTI-RO SS-A POSITIVITY AND HEAT-SHOCK-PROTEIN ANTIBODIES IN PATIENTSWITH NORMAL-PRESSURE GLAUCOMA/

PURPOSE: To describe the clinical and laboratory findings in 10 patien ts with normal-pressure glaucoma and anti-Ro/SS-A positivity by enzyme linked immunosorbent assay (ELISA) and to determine whether that posi tivity may be related to an autoimmune mechanism for the optic neuropa thy. METHODS: Zn this prospective study, we evaluated ocular and syste mic clinical findings of 10 patients with normal pressure glaucoma and anti-Ro/SS-A positivity by ELISA, including sicca complex features. O uchterlony immunodiffusion was performed to confirm the presence of an tibodies for Ro/SS-A, and the presence of other serum antibodies and t heir possible cross reactivities with Ro/SS-A were investigated. RESUL TS: None of the 10 patients with normal pressure glaucoma and anti-Ro/ SS-A positivity (by ELISA) had clinical or laboratory signs of Sjogren syndrome or other connective tissue diseases. Only one of 10 patients had evidence of anti-Ro/SS-A antibodies by Ouchterlony immunodiffusio n. All patients demonstrated serum immunore- activity to bacterial hea t shock protein 60 (hsp60) by Western blotting. Cross-reactivity betwe en bacterial hsp60 and Ro/SS-A was demonstrated by Western blotting. I mmunoreactivity to bacterial hsp60 by ELISA was significantly elevated in the sera of patients with normal-pressure glaucoma. Furthermore, p atients with either normal-pressure or primary open-angle glaucoma had increased serum immunoreactivity to human hsp60. CONCLUSIONS: Anti-Ro /SS-A positivity by ELISA in 10 patients with normal-pressure glaucoma was associated with a high level of serum immunoreactivity to bacteri al hsp60, which may indicate that their glaucomatous optic neuropathy involves an as yet unidentified autoimmune mechanism. The identificati on of autoantibodies that react with human hsp60 in patients with norm al pressure and primary open angle glaucoma may signify a common findi ng associated with the glaucomatous optic neuropathy process in some p atients and appears to be unrelated to intraocular pressure levels.