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Jannis Kountouras, MD, PhD; Nikolaos Mylopoulos, MD, PhD; Dimitrios Chatzopoulos, MD; Christos Zavos, MD; Panagiota Boura, MD, PhD; Anastasios G. P. Konstas, MD, PhD; John Venizelos, MD, PhD

Arch Intern Med. 2002;162:1237-1244.

Background  We have documented a high prevalence of Helicobacter pylori infection in patients with glaucoma.

Objective  To evaluate the effect of H pylori eradication on the 2 most commonly used glaucoma parameters: intraocular pressure and visual field.

Methods  A total of 41 patients with glaucoma and 30 age-matched anemic controls underwent upper gastrointestinal endoscopies and gastric mucosal biopsies to detect the presence of H pylori infection by histologic analysis and rapid urease test (CLOtest; Delta West, Draper, Utah). Saliva samples were also tested by CLOtest. Serum anti–H pylori–specific IgG was analyzed by enzyme-linked immunosorbent assay. Helicobacter pylori–positive patients received a triple eradication regimen (omeprazole, clarithromycin, and amoxicillin treatment), and all patients were observed for 2 years while remaining under the same antiglaucoma therapy.

Results  Helicobacter pylori was detected in 88% of glaucoma cases and in 47% of controls (P<.001). Helicobacter pylori eradication was successful in 83% of treated patients. At the 2-year clinical end point, glaucoma parameters (mean intraocular pressure and mean visual field parameters) were improved in the subgroup of patients where H pylori eradication was successful (P<.001 for intraocular pressure; P.01 for visual field parameters), but not in the other patients.

Conclusion  Helicobacter pylori eradication may positively influence glaucoma parameters, suggesting a possible causal link between H pylori and glaucoma.

From the Departments of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki (Drs Kountouras, Chatzopoulos, Zavos, and Boura), Ophthalmology (Dr Mylopoulos), and Pathology (Dr Venizelos), Ippokration Hospital, and the University Department of Ophthalmology, AHEPA Hospital (Dr Konstas), Thessaloniki, Greece.

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