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To the Editor:
—In the paper by Mansour F. Armaly, entitled "Effect of Corticosteroids on Intraocular Pressure and Fluid Dynamics" (Arch Ophthal (Chicago) 70:482, 1963), it is suggested that "deposition" of mucopolysaccharides may provide an explanation for the ocular hypertension seen after prolonged use of topical corticosteroids. The author notes that cortisone has been shown to cause mast cell degeneration and that "the released mast cell granules are mucopolysaccharides or their components." There are a number of objections to this hypothesis. While adrenocortical hormones do cause mast cell degranulation, this is not their only nor even their most important effect on the connective tissue.Despite the extensive work of Asboe-Hansen (cited by Dr. Armaly) there is considerable controversy as to whether the granules of the mast cell contain mucopolysaccharides. Heparin, histamine, and serotonin have been demonstrated by James F. Riley (The Mast Cells, Edinburgh: E. and S. Livingston Ltd., 1959)
Richard S. Smith. MUCOPOLYSACCHARIDES, MAST CELLS AND STEROID GLAUCOMA. Arch Ophthalmol. 1964;71(3):447. doi:10.1001/archopht.1964.00970010463027