Relationship between Helicobacter pylori infection and glaucoma

Objective: To determine the frequency of Helicobacter pylori (H. pylori) in fection in glaucoma patients and in anemic control participants. Design: Prospective, nonrandomized, comparative study. Participants: The authors investigated 32 patients with chronic open-angle glaucoma (COAG), 9 patients with pseudoexfoliation glaucoma (PEG), and 30 a ge-matched anemic control participants. Methods: Upper gastrointestinal endoscopy was performed to evaluate macrosc opic abnormalities, and gastric mucosal biopsy specimens were obtained for the presence of H. pylori infection tested by rapid urease slide test (CLO test) and by Cresyl fast violet staining, Giemsa staining, or both. The pre sence of gastritis was classified in accordance with the Sydney system by u sing hematoxylin and eosin stain. In addition, intestinal metaplasia was ev aluated with Alcian blue stain. Saliva samples were also tested by CLO. Ser um was analyzed for the presence of H. pylori-specific IgG antibodies by en zyme-linked immunosorbent assay. Main Outcome Measurer Histologic examination for the presence of H. pylori. Results: In 87.5% of the COAG patients, 88.9% of the PEG patients, and 46.7 % of the anemic control participants, H. pylori infection was histologicall y confirmed (odds ratio, 8.00; chi-square, 11.81; P = 0.0006 and 9.14; chi- square, 5.01; P = 0.02, respectively). H. pylori was detected by urease tes t: (1) in the gastric mucosa in 71.9% of the COAG patients, in 77.8% of the PEG patients, and in 46.7% of the anemic control participants (P = 0.03 an d P > 0.05, respectively); and (2) in the saliva in 37.5% of the COAG patie nts, in 55.6% of the PEG patients, and in 30% of the anemic control partici pants (P > 0.05). Sixty-eight percent of glaucoma patients and 30% of anemi c control participants were seropositive for H. pylori (P = 0.002). When co mpared with anemic control participants, glaucoma patients exhibited less o ften endoscopic normal appearance of gastric mucosa (P = 0.01), and more of ten antral gastritis (P = 0.0004) or peptic ulcer disease (P = 0.01). Histo logic grade 3 gastritis was observed only in the glaucoma patients (P = 0.0 3). Conclusions: H. pylori infection seems more frequent in glaucoma patients. If confirmed, this may indicate either a common factor that causes suscepti bilities to both glaucoma and H. pylori infection or that H. pylori may be a causal factor for developing glaucoma.