Retinal ganglion cell death in primary aldosteronism - mechanism and comparison with structural abnormalities in glaucoma

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K09715
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56060:Ophthalmology-related
• Research Institution: Kanazawa University
• Principal Investigator: SUGIYAMA KAZUHISA 金沢大学, 医学系, 教授 (80179168)
• Co-Investigator(Kenkyū-buntansha): 東出 朋巳 金沢大学, 附属病院, 講師 (20291370) ; 米田 隆 金沢大学, 融合科学系, 教授 (60313649)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 正常眼圧緑内障 / アルドステロン / 視神経乳頭血流 / 網膜神経節細胞 / 網膜神経線維層欠損

Outline of Final Research Achievements

Our study showed that systemic administration of aldosterone in rats caused an optic nerve head blood flow decrease, retinal vessel constriction, retinal nerve fiber layer thickness thinning and retinal ganglion cell loss without changes in IOP.We also confirmed the characterization of fundus abnormalities in primary aldosteronism patient from clinical perspective, patient with primary aldosteronism had a significantly greater prevalence of retinal nerve fiber layer defects (RNFLDs) compared to the control group. Moreover, RNFLDs with their central ends located around retinal vessels were characteristic of primary aldosteronism. Further, vertical differences in circumpapillary retinal nerve fiber layer thickness and peripapillary vessel density were detected in patients with primary aldosteronism, which differed from the structural abnormalities observed in glaucoma patients.

Free Research Field

眼科学

Academic Significance and Societal Importance of the Research Achievements

本研究ではアルドステロン全身投与ラットにて眼圧非依存性に網膜血流速度低下、網膜動静脈血管径狭小化、網膜神経線維層厚菲薄化と網膜神経節細胞数を減少させることを明らかにした。またその網膜血流障害は網膜神経節細胞喪失の第一要因ではない可能性を示唆した。
臨床研究では原発性アルドステロン症における網膜神経線維欠損の構造的特徴及び緑内障眼との構造異常の違いを初めて報告した。これら基礎と臨床の両面からの知見は原発性アルドステロン症による網膜神経節細胞死の病態解明に繋がり最終的には正常眼圧緑内障の新規治療へと繋がっていく可能性がある。