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Cheong AJY, Wang SKX, Woon CY, Yap KH, Ng KJY, Xu FWX, Alkan U, Ng ACW, See A, Loh SRH, Aung T, Toh ST. Obstructive sleep apnoea and glaucoma: a systematic review and meta-analysis. Eye (Lond) 2023; 37:3065-3083. [PMID: 36977937 PMCID: PMC10564942 DOI: 10.1038/s41433-023-02471-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/13/2022] [Accepted: 02/27/2023] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION Obstructive sleep apnoea (OSA) has been thought to be associated with glaucoma, however there are many conflicting studies on this topic. With many new studies having been published since the previous meta-analysis, we believe it is important to clarify this association. Hence, in this study we meta-analyse the recent literature regarding the association between OSA and glaucoma. METHODS Pubmed, Embase, Scopus and Cochrane Library were searched from inception till the 28th February 2022 for observational as well as cross-sectional studies examining the association between OSA and glaucoma. Two reviewers selected studies, extracted data, graded the quality of included non-randomized studies using the Newcastle-Ottawa scale. The overall quality of evidence was assessed using GRADE. Random-effects models were used to meta-analyse the maximally covariate- adjusted associations. RESULTS 48 studies were included in our systematic review, with 46 suitable for meta-analysis. Total study population was 4,566,984 patients. OSA was associated with a higher risk of glaucoma (OR 3.66, 95% CI 1.70 to 7.90, I2 = 98%, p < 0.01). After adjustment for various important confounders including age, gender and patient comorbidities such as hyperlipidaemia, hypertension, cardiovascular diseases and diabetes, patients with OSA had up to 40% higher odds of glaucoma. Substantial heterogeneity was eliminated through subgroup and sensitivity analyses after consideration of glaucoma subtype, OSA severity and adjustment for confounders. CONCLUSIONS In this meta-analysis, OSA was associated with higher risk of glaucoma, as well as more severe ocular findings characteristic of the glaucomatous disease process. We suggest more clinical studies looking into the effects of OSA treatment on the progression of glaucoma to help clinical decision making for patients.
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Affiliation(s)
- Alex Jia Yang Cheong
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
| | - Sean Kang Xuan Wang
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
| | - Chang Yi Woon
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
| | - Ki Han Yap
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
| | - Kevin Joo Yang Ng
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
| | - Flora Wen Xin Xu
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
| | - Uri Alkan
- Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adele Chin Wei Ng
- Department of Otorhinolaryngology-Head & Neck Surgery, Singapore General Hospital, Singapore, Singapore
| | - Anna See
- Department of Otorhinolaryngology-Head & Neck Surgery, Singapore General Hospital, Singapore, Singapore
| | - Shaun Ray Han Loh
- Department of Otorhinolaryngology-Head & Neck Surgery, Singapore General Hospital, Singapore, Singapore
| | - Tin Aung
- Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Song Tar Toh
- Department of Otorhinolaryngology-Head & Neck Surgery, Singapore General Hospital, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
- Surgery Academic Clinical Program, SingHealth, Singapore, Singapore.
- Singhealth Duke-NUS Sleep Centre, Singhealth, Singapore, Singapore.
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Meesala A, Tripathy R, Chaudhury HC, Sahoo JP. A Drug Utilization Study of Anti-glaucoma Drugs in a Tertiary Care Hospital. Cureus 2023; 15:e46765. [PMID: 37954708 PMCID: PMC10632242 DOI: 10.7759/cureus.46765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Today, branded medications and polytherapy are frequently prescribed for glaucoma, even without giving the patient the proper instructions. Hence, the safety, effectiveness, cost, and patient compliance of glaucoma medication must be weighed, and the anti-glaucoma medicine usage must be studied. Analysis of glaucoma patients' prescription usage was the objective of this study. MATERIAL AND METHODS Between January 2021 and February 2022, this prospective and observational study was carried out at Andhra Medical College in Vishakhapatnam. One hundred prescriptions of those with primary open-angle and angle closure glaucoma were assessed. Age and gender-based subgroup analyses were conducted. R software (version 4.2.1) (The R Foundation for Statistical Computing, Vienna, Austria) was leveraged for data analysis. RESULTS Out of 146 examined prescriptions, 100 (69%) were deemed suitable for analysis. Participants' mean age was 54.2 ± 10.8 years. Sixty-two were over 50 years old, and 36 were men. The mean intraocular pressure was 25.4 ± 1.7 mm of Hg. Per prescription, there were about 1.75 anti-glaucoma drugs. Fixed-dose combinations (FDC) were found in 43 prescriptions. Generic medications and patient instructions prevailed in most prescriptions (78%) and (84%). Timolol was used in each FDC with brimonidine, dorzolamide, or bimatoprost. CONCLUSION The most often prescribed anti-glaucoma drug, timolol, was also identified as an essential component of the FDC. Doctors must prescribe generic medications with detailed directions for the patients.
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Affiliation(s)
- Anusha Meesala
- Pharmacology, Andhra Medical College, Visakhapatnam, IND
- Pharmacology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
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Chiarini LB, Petrs-Silva H, Linden R. Novel approaches to glaucomatous neurodegeneration, based on the integrated stress response. MOLECULAR THERAPY. NUCLEIC ACIDS 2023; 33:845-847. [PMID: 37662966 PMCID: PMC10474567 DOI: 10.1016/j.omtn.2023.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Affiliation(s)
- Luciana B. Chiarini
- Laboratório de Neurogênese, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Hilda Petrs-Silva
- Laboratório de Terapia Gênica e Vetores Virais, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Rafael Linden
- Laboratório de Neurogênese, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, RJ, Brazil
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Ujiie N, Norden PR, Fang R, Beckmann L, Cai Z, Kweon J, Liu T, Tan C, Kuhn MS, Stamer WD, Aoto K, Quaggin SE, Zhang HF, Kume T. Differential roles of FOXC2 in the trabecular meshwork and Schlemm's canal in glaucomatous pathology. Life Sci Alliance 2023; 6:e202201721. [PMID: 37414529 PMCID: PMC10326420 DOI: 10.26508/lsa.202201721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023] Open
Abstract
Impaired development and maintenance of Schlemm's canal (SC) are associated with perturbed aqueous humor outflow and intraocular pressure. The angiopoietin (ANGPT)/TIE2 signaling pathway regulates SC development and maintenance, whereas the molecular mechanisms of crosstalk between SC and the neural crest (NC)-derived neighboring tissue, the trabecular meshwork (TM), are poorly understood. Here, we show NC-specific forkhead box (Fox)c2 deletion in mice results in impaired SC morphogenesis, loss of SC identity, and elevated intraocular pressure. Visible-light optical coherence tomography analysis further demonstrated functional impairment of the SC in response to changes in intraocular pressure in NC-Foxc2 -/- mice, suggesting altered TM biomechanics. Single-cell RNA-sequencing analysis identified that this phenotype is predominately characterized by transcriptional changes associated with extracellular matrix organization and stiffness in TM cell clusters, including increased matrix metalloproteinase expression, which can cleave the TIE2 ectodomain to produce soluble TIE2. Moreover, endothelial-specific Foxc2 deletion impaired SC morphogenesis because of reduced TIE2 expression, which was rescued by deleting the TIE2 phosphatase VE-PTP. Thus, Foxc2 is critical in maintaining SC identity and morphogenesis via TM-SC crosstalk.
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Affiliation(s)
- Naoto Ujiie
- Feinberg Cardiovascular and Renal Research Institute, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Pieter R Norden
- Feinberg Cardiovascular and Renal Research Institute, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Raymond Fang
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Lisa Beckmann
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Zhen Cai
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Junghun Kweon
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Ting Liu
- Feinberg Cardiovascular and Renal Research Institute, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Can Tan
- Feinberg Cardiovascular and Renal Research Institute, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Megan S Kuhn
- Duke Eye Center, Duke University, Durham, NC, USA
| | | | - Kazushi Aoto
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Susan E Quaggin
- Feinberg Cardiovascular and Renal Research Institute, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Hao F Zhang
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
- Department of Ophthalmology, Northwestern University, Chicago, IL, USA
| | - Tsutomu Kume
- Feinberg Cardiovascular and Renal Research Institute, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Ophthalmology, Northwestern University, Chicago, IL, USA
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Bacharach J, Ahmed IIK, Sharpe ED, Korenfeld MS, Zhang S, Baudouin C. Preservative-Free versus Benzalkonium Chloride-Preserved Latanoprost Ophthalmic Solution in Patients with Primary Open-Angle Glaucoma or Ocular Hypertension: A Phase 3 US Clinical Trial. Clin Ophthalmol 2023; 17:2575-2588. [PMID: 37674591 PMCID: PMC10478989 DOI: 10.2147/opth.s414015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/18/2023] [Indexed: 09/08/2023] Open
Abstract
Purpose To evaluate the safety and efficacy of a preservative-free latanoprost 0.005% formulation (T2345) in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT) compared to benzalkonium chloride-preserved latanoprost 0.005% (BPL) formulation in the United States (US). Patients and Methods A prospective, randomized, multicenter, observer-masked, parallel-group study enrolled 335 patients diagnosed with POAG or OHT from 31 US sites who had adequately controlled intraocular pressure (IOP; ≤18 mm Hg) with latanoprost monotherapy. After a ≥72-hour washout period, patients were randomized to T2345 (n=165) or BPL (n=170) groups. Study drugs were dosed once-daily from Day 0 to Day 84 in one or both eyes. The study eye was the eye with lower IOP at baseline. The primary efficacy measure was the between-group comparison of the mean IOP values in the study eye at each time point (8 AM, 10 AM, and 4 PM on Days 15, 42, and 84). Safety measurements included ocular and systemic treatment-emergent adverse events (TEAEs). Results Both T2345 and BPL adequately controlled IOP with 95% CIs within 1.5 mm Hg in the study eye at all assessed time points. The percentages of patients with diurnal IOP <18 mm Hg at Day 84 were 73.1% vs 78.7% for the T2345 and BPL groups, respectively. Adverse events were generally mild-to-moderate and primarily ocular. Fewer patients in the T2345 group experienced ocular TEAEs (13.9% vs 22.5%, respectively) and TEAEs with a suspected relationship to the study medication compared with the BPL group (5.5% vs 11.8%, respectively). The most common ocular TEAEs were instillation site pain and conjunctival hyperemia. Conclusion In patients with POAG or OHT, both T2345 and BPL maintained IOP at or below clinically meaningful values for the duration of the study. T2345 showed a favorable safety profile, with numerically lower incidences of ocular TEAEs than BPL.
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Affiliation(s)
| | | | | | | | | | - Christophe Baudouin
- Quinze-Vingts National Ophthalmology Hospital & Vision Institute, Paris Saclay-Versailles-Saint Quentin University, IHU Foresight, Paris, France
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Young J, Entwistle L, DeSousa JL, Haigh M, MacDonald F, Hill K. Evaluation of a nurse-led glaucoma assessment clinic for non-complex patients. J Clin Nurs 2023; 32:6743-6750. [PMID: 36869616 DOI: 10.1111/jocn.16670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/17/2022] [Accepted: 02/06/2023] [Indexed: 03/05/2023]
Abstract
AIMS AND OBJECTIVES The purpose of this study was to assess the safety, feasibility and effectiveness of a nurse-led glaucoma assessment clinic service. BACKGROUND Glaucoma is a group of serious, irreversible optic neuropathies that progressively damage the optic nerve resulting in blindness. Over 64.3 million people globally are affected by glaucoma with numbers projected to increase to 111.8 million by 2040. Glaucoma is a major public health concern that requires the development of innovative models of care to meet current and future health care demands. METHODS/DESIGN A mixed method design was used to evaluate the assessment of non-complex glaucoma patients attending a new nurse-led clinic. Under an ophthalmologist's supervision, the glaucoma nurse completed 100 hof clinical training and assessment to ensure they were competent in completing and interpreting the required glaucoma assessment protocols. Interrater reliability between the glaucoma nurse and ophthalmology doctor was undertaken. Glaucoma patient waitlist appointment data were also compared before and after the introduction of the nurse-led clinics. This study adhered to the SQUIRE checklist for the reporting of excellence with quality improvement projects. PATIENT CONTRIBUTION Patients contributed to the evaluation of this new nurse-led service by providing follow-up feedback on their experience. RESULTS Agreement between clinicians for appropriate follow-up appointment times was high with 93% (n = 315) agreement achieved. Furthermore in 297 (87.5%) cases, both clinicians agreed on the patient being referred to the doctor for follow-up review. Glaucoma consultations were shown to increase from 3,115 appointments in 2019/20 to 3,504 appointments in 2020/21 after the introduction of the nurse-led clinic. The nurse-led clinics accounted for 14.5% (n = 512) of clinic appointments. CONCLUSIONS The introduction of the nurse-led glaucoma assessment clinic service allowed patients to be reviewed safely, efficiently and satisfactorily. This new service subsequently allowed for more complex glaucoma patients to be seen by the ophthalmologists. RELEVANCE TO CLINICAL PRACTICE Findings revealed that suitably trained glaucoma nurses are able to clinically assess and safely monitor stable non-complex glaucoma patients. Highlights the need for appropriate investment in clinical training and supervision to ensure that glaucoma assessment nurses are adequately prepared to undertake this new practice role.
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Affiliation(s)
- Jeanne Young
- Royal Perth Bentley Group (RPBG) Organisational Learning and Development, Perth, Australia
| | - Lauren Entwistle
- Outpatients Department, Royal Perth Bentley Group (RPBG), Perth, Australia
| | - Jean-Louis DeSousa
- Department of Ophthalmology, Royal Perth Bentley Group (RPBG), Perth, Australia
| | - Meredyth Haigh
- Royal Perth Bentley Group (RPBG) Organisational Learning and Development, Perth, Australia
| | - Fiona MacDonald
- Royal Perth Bentley Group (RPBG) Organisational Learning and Development, Perth, Australia
| | - Kim Hill
- Outpatients Department, Royal Perth Bentley Group (RPBG), Perth, Australia
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Monavarfeshani A, Yan W, Pappas C, Odenigbo KA, He Z, Segrè AV, van Zyl T, Hageman GS, Sanes JR. Transcriptomic analysis of the ocular posterior segment completes a cell atlas of the human eye. Proc Natl Acad Sci U S A 2023; 120:e2306153120. [PMID: 37566633 PMCID: PMC10450437 DOI: 10.1073/pnas.2306153120] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/29/2023] [Indexed: 08/13/2023] Open
Abstract
Although the visual system extends through the brain, most vision loss originates from defects in the eye. Its central element is the neural retina, which senses light, processes visual signals, and transmits them to the rest of the brain through the optic nerve (ON). Surrounding the retina are numerous other structures, conventionally divided into anterior and posterior segments. Here, we used high-throughput single-nucleus RNA sequencing (snRNA-seq) to classify and characterize cells in six extraretinal components of the posterior segment: ON, optic nerve head (ONH), peripheral sclera, peripapillary sclera (PPS), choroid, and retinal pigment epithelium (RPE). Defects in each of these tissues are associated with blinding diseases-for example, glaucoma (ONH and PPS), optic neuritis (ON), retinitis pigmentosa (RPE), and age-related macular degeneration (RPE and choroid). From ~151,000 single nuclei, we identified 37 transcriptomically distinct cell types, including multiple types of astrocytes, oligodendrocytes, fibroblasts, and vascular endothelial cells. Our analyses revealed a differential distribution of many cell types among distinct structures. Together with our previous analyses of the anterior segment and retina, the data presented here complete a "Version 1" cell atlas of the human eye. We used this atlas to map the expression of >180 genes associated with the risk of developing glaucoma, which is known to involve ocular tissues in both anterior and posterior segments as well as the neural retina. Similar methods can be used to investigate numerous additional ocular diseases, many of which are currently untreatable.
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Affiliation(s)
- Aboozar Monavarfeshani
- Center for Brain Science, Harvard University, Cambridge, MA02138
- F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Boston, MA02115
| | - Wenjun Yan
- Center for Brain Science, Harvard University, Cambridge, MA02138
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA02138
| | - Christian Pappas
- Sharon Eccles Steele Center for Translational Medicine, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT84132
- Department of Ophthalmology & Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT84132
| | - Kenechukwu A. Odenigbo
- Center for Brain Science, Harvard University, Cambridge, MA02138
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA02138
| | - Zhigang He
- F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Boston, MA02115
| | - Ayellet V. Segrè
- Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear, Boston, MA02114
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, MA02142
| | - Tavé van Zyl
- Center for Brain Science, Harvard University, Cambridge, MA02138
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA02138
- Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear, Boston, MA02114
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT065101
| | - Gregory S. Hageman
- Sharon Eccles Steele Center for Translational Medicine, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT84132
- Department of Ophthalmology & Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT84132
| | - Joshua R. Sanes
- Center for Brain Science, Harvard University, Cambridge, MA02138
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA02138
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Tanihara H, Yamamoto T, Aihara M, Koizumi N, Minami H, Kojima S, Isobe T, Kanazawa M, Suganami H. Crossover Randomized Study of Pharmacologic Effects of Ripasudil-Brimonidine Fixed-Dose Combination Versus Ripasudil or Brimonidine. Adv Ther 2023; 40:3559-3573. [PMID: 37330927 PMCID: PMC10329961 DOI: 10.1007/s12325-023-02534-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/27/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION Multidrug regimens for glaucoma treatment often result in adherence issues due to inconvenience; these issues may be improved with fixed-dose combination drugs. The ophthalmic solution of ripasudil-brimonidine fixed-dose combination (RBFC; K-232) is the first treatment combining a Rho kinase inhibitor and an α2-adrenoceptor agonist, and has demonstrated ability to lower intraocular pressure (IOP) and have various effects on conjunctival hyperemia and corneal endothelial cell morphology. This study evaluates the pharmacologic effects of RBFC treatment versus its separate components-ripasudil or brimonidine. METHODS This single-center, prospective, randomized, open-label, blinded endpoint study with 3 × 3 crossover design randomly assigned healthy adult men to three groups (1:1:1) to undergo consecutive 8-day administration phases (with drug-free intervals of at least 5 days). Subjects received twice-daily instillation of RBFC → ripasudil → brimonidine (group A), ripasudil → brimonidine → RBFC (group B), or brimonidine → RBFC → ripasudil (group C). Endpoints included change in IOP, severity of conjunctival hyperemia, corneal endothelial cell morphology, pupil diameter, and pharmacokinetics. RESULTS Eighteen subjects were assigned in total (six to each group). RBFC significantly reduced IOP from baseline at 1 h post-instillation on days 1 and 8 (12.7 vs. 9.1 and 9.0 mmHg, respectively; both P < 0.001), and provided significantly greater IOP reductions than ripasudil or brimonidine at several time points. The most common adverse drug reaction with all three treatments was mild conjunctival hyperemia, which transiently increased in severity with RBFC or ripasudil, peaking at 15 min post-instillation. In post hoc analyses, conjunctival hyperemia scores were lower with RBFC than with ripasudil at several time points. Transient morphologic changes in corneal endothelial cells occurred for up to several hours with RBFC or ripasudil, but not with brimonidine. Pupil diameter did not change with RBFC. CONCLUSION RBFC significantly reduced IOP compared with each agent alone. A combination of each agent's pharmacologic profile was observed in that of RBFC. TRIAL REGISTRATION Japan Registry of Clinical Trials; Registration No. jRCT2080225220.
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Affiliation(s)
- Hidenobu Tanihara
- Department of Ophthalmology, Biei Municipal Hospital, 3-8-35 Naka-machi, Biei Town, Kamikawa-gun, Hokkaido, 071-0207, Japan.
| | - Tetsuya Yamamoto
- Prof. Kazuo Iwata Memorial Kaijin Glaucoma Center, Kaiya Eye Clinic, Shizuoka, Japan
| | - Makoto Aihara
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Noriko Koizumi
- Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyoto, Japan
| | - Hiroomi Minami
- Pharmaceutical Clinical Development Management Department, Kowa Company, Ltd., Tokyo, Japan
| | - Satoshi Kojima
- Pharmaceutical Clinical Development Management Department, Kowa Company, Ltd., Tokyo, Japan
| | - Tomoyuki Isobe
- Tokyo New Drug Research Laboratories, Kowa Company, Ltd., Tokyo, Japan
| | - Mizuho Kanazawa
- Medical Affairs Department, Kowa Company, Ltd., Tokyo, Japan
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Khan J, Shaw S. Risk of cataract and glaucoma among older persons with diabetes in India: a cross-sectional study based on LASI, Wave-1. Sci Rep 2023; 13:11973. [PMID: 37488196 PMCID: PMC10366202 DOI: 10.1038/s41598-023-38229-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 07/05/2023] [Indexed: 07/26/2023] Open
Abstract
According to the International Diabetes Federation-2019 estimates, India is home to 77 million diabetic individuals which is projected to grow up to 147.2 million by 2045. Diabetes being a progressive health disorder leads to multiple morbidities and complications including eye diseases and visual impairments. As the burden of diabetes mellitus is increasing, eye problems like cataracts and glaucoma are commonly cited problems among the older adults. In this context, this study aims to provide the public health evidences on diabetes associated burden and risk of developing cataracts and glaucoma among older adults aged 60 and above in India. The analytical sample of this cross-sectional study comprised of 31,464 individuals aged 60 and above. Bivariate cross-tabulation and chi-square test were performed to understand the differential in the prevalence of cataracts and glaucoma by diabetes mellitus including the socio-economic and demographic characteristics of the individuals. Binary logistic regression estimation was executed to estimate the adjusted odds ratio for each of the outcome variables within a multivariate framework. The cataract problem affects more than one-fifth of the older people, while glaucoma affects 2% of them. The prevalence of cataract and glaucoma is 29% among diabetic older adults compared to 22% among non-diabetic persons. In terms of gender, the cataract prevalence is comparatively higher among females (25%) than males (21%). It is important to note that while adjusting for socio-economic and demographic characteristics, the likelihood of cataract (AOR 1.495; p-value < 0.01) and glaucoma (AOR 1.554; p-value < 0.01) is significantly higher among older adults with diabetes than among their counterparts. Medical practitioners should conduct prognosis for diabetic eye problems among patients and raise awareness about the potential risks of developing vision loss, such as cataracts and glaucoma, which are more prevalent among individuals with diabetes.
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Affiliation(s)
- Junaid Khan
- Department of Population and Development, International Institute for Population Sciences, Mumbai, India
| | - Subhojit Shaw
- Department of Population and Development, International Institute for Population Sciences, Mumbai, India.
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Nair VS, Srivastava V, Bhavana V, Yadav R, Rajana N, Singh SB, Mehra NK. Exploring Penetration Ability of Carbonic Anhydrase Inhibitor-Loaded Ultradeformable Bilosome for Effective Ocular Application. AAPS PharmSciTech 2023; 24:157. [PMID: 37470885 DOI: 10.1208/s12249-023-02617-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/01/2023] [Indexed: 07/21/2023] Open
Abstract
Brinzolamide is an effective carbonic anhydrase inhibitor widely used in glaucoma therapy but limits its application due to inadequate aqueous solubility and permeability. The aim of the present research work is the development and characterization of brinzolamide-loaded ultradeformable bilosomes to enhance the corneal permeation of the drug. These ultradeformable bilosomes were prepared by ethanol injection method and evaluated for physicochemical properties, particle size, morphology, drug release, ultra-deformability, corneal permeation, and irritation potential. The optimized formulation exhibited an average particle size of 205.4 ± 2.04 nm with mono-dispersity (0.109 ± 0.002) and showed entrapment efficiency of 75.02 ± 0.017%, deformability index of 3.91, and release the drug in a sustained manner. The brinzolamide-loaded ultradeformable bilosomes released 76.29 ± 3.77% of the drug in 10 h that is 2.25 times higher than the free drug solution. The bilosomes were found non-irritant to eyes with a potential irritancy score of 0 in Hen's egg-chorioallantoic membrane assay. Brinzolamide-loaded ultradeformable bilosomes showed 83.09 ± 5.1% of permeation in 6 h and trans-corneal permeability of 8.78 ± 0.14 cm/h during the ex vivo permeation study. The acquired findings clearly revealed that the brinzolamide-loaded ultradeformable bilosomes show promising output and are useful in glaucoma therapy.
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Affiliation(s)
- Vishnumaya S Nair
- Pharmaceutical Nanotechnology Research Laboratory, Department of Pharmaceutics, Ministry of Chemical and Family Welfare, National Institute of Pharmaceutical Education and Research (NIPER), Telangana, 500 037, Hyderabad, India
| | - Vaibhavi Srivastava
- Pharmaceutical Nanotechnology Research Laboratory, Department of Pharmaceutics, Ministry of Chemical and Family Welfare, National Institute of Pharmaceutical Education and Research (NIPER), Telangana, 500 037, Hyderabad, India
| | - Valamla Bhavana
- Pharmaceutical Nanotechnology Research Laboratory, Department of Pharmaceutics, Ministry of Chemical and Family Welfare, National Institute of Pharmaceutical Education and Research (NIPER), Telangana, 500 037, Hyderabad, India
| | - Rati Yadav
- Pharmaceutical Nanotechnology Research Laboratory, Department of Pharmaceutics, Ministry of Chemical and Family Welfare, National Institute of Pharmaceutical Education and Research (NIPER), Telangana, 500 037, Hyderabad, India
| | - Naveen Rajana
- Pharmaceutical Nanotechnology Research Laboratory, Department of Pharmaceutics, Ministry of Chemical and Family Welfare, National Institute of Pharmaceutical Education and Research (NIPER), Telangana, 500 037, Hyderabad, India
| | - Shashi Bala Singh
- Department of Biological Science, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana, India
| | - Neelesh Kumar Mehra
- Pharmaceutical Nanotechnology Research Laboratory, Department of Pharmaceutics, Ministry of Chemical and Family Welfare, National Institute of Pharmaceutical Education and Research (NIPER), Telangana, 500 037, Hyderabad, India.
- Pharmaceutical Nanotechnology Research Laboratory, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research Hyderabad, Telangana, India.
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Hodrea J, Tran MN, Besztercei B, Medveczki T, Szabo AJ, Őrfi L, Kovacs I, Fekete A. Sigma-1 Receptor Agonist Fluvoxamine Ameliorates Fibrotic Response of Trabecular Meshwork Cells. Int J Mol Sci 2023; 24:11646. [PMID: 37511406 PMCID: PMC10380218 DOI: 10.3390/ijms241411646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Primary open-angle glaucoma remains a global issue, lacking a definitive treatment. Increased intraocular pressure (IOP) is considered the primary risk factor of the disease and it can be caused by fibrotic-like changes in the trabecular meshwork (TM) such as increased tissue stiffness and outflow resistance. Previously, we demonstrated that the sigma-1 receptor (S1R) agonist fluvoxamine (FLU) has anti-fibrotic properties in the kidney and lung. In this study, the localization of the S1R in TM cells was determined, and the anti-fibrotic efficacy of FLU was examined in both mouse and human TM cells. Treatment with FLU reduced the F-actin rearrangement, inhibited cell proliferation and migration induced by the platelet-derived growth factor and decreased the levels of fibrotic proteins. The protective role of the S1R in fibrosis was confirmed by a more pronounced increase in alpha smooth muscle actin and F-actin bundle and clump formation in primary mouse S1R knockout TM cells. Furthermore, FLU demonstrated its protective effects by increasing the production of nitric oxide and facilitating the degradation of the extracellular matrix through the elevation of cathepsin K. These findings suggest that the S1R could be a novel target for the development of anti-fibrotic drugs and offer a new therapeutic approach for glaucoma.
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Affiliation(s)
- Judit Hodrea
- MTA-SE Lendület "Momentum" Diabetes Research Group, Semmelweis University, 1083 Budapest, Hungary
- Pediatric Center, MTA Center of Excellence, Faculty of Medicine, Semmelweis University, 1083 Budapest, Hungary
| | - Minh Ngoc Tran
- MTA-SE Lendület "Momentum" Diabetes Research Group, Semmelweis University, 1083 Budapest, Hungary
- Pediatric Center, MTA Center of Excellence, Faculty of Medicine, Semmelweis University, 1083 Budapest, Hungary
- Department of Biochemistry, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 72712, Vietnam
| | - Balazs Besztercei
- Institute of Clinical Experimental Research, Semmelweis University, 1094 Budapest, Hungary
| | - Timea Medveczki
- MTA-SE Lendület "Momentum" Diabetes Research Group, Semmelweis University, 1083 Budapest, Hungary
- Pediatric Center, MTA Center of Excellence, Faculty of Medicine, Semmelweis University, 1083 Budapest, Hungary
| | - Attila J Szabo
- Pediatric Center, MTA Center of Excellence, Faculty of Medicine, Semmelweis University, 1083 Budapest, Hungary
| | - Laszlo Őrfi
- Department of Pharmaceutical Chemistry, Semmelweis University, 1092 Budapest, Hungary
| | - Illes Kovacs
- Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary
- Department of Clinical Ophthalmology, Faculty of Health Sciences, Semmelweis University, 1085 Budapest, Hungary
| | - Andrea Fekete
- MTA-SE Lendület "Momentum" Diabetes Research Group, Semmelweis University, 1083 Budapest, Hungary
- Pediatric Center, MTA Center of Excellence, Faculty of Medicine, Semmelweis University, 1083 Budapest, Hungary
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Liu H, Chen C, Chen Z, Li Q, Li Q, Liu W. Factors associated with delayed first ophthalmological consultation for primary glaucoma: a qualitative interview study. Front Med (Lausanne) 2023; 10:1161980. [PMID: 37529241 PMCID: PMC10390307 DOI: 10.3389/fmed.2023.1161980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/22/2023] [Indexed: 08/03/2023] Open
Abstract
Background Glaucoma has an insidious onset with non-specific early symptoms, often leading patients to delay in seeking help. However, postponing the first ophthalmological consultation can result in delayed diagnosis and treatment, with adverse effects on vision. This study explored the factors associated with delayed first ophthalmological consultation in patients with primary glaucoma, with the overarching aim of informing measures to reduce delayed consultation and avoid the consequent adverse outcomes. Methods We adopted a phenomenological approach. Semi-structured interviews were conducted with patients admitted to a tertiary eye hospital in Tianjin, China, from January 2021 to April 2021. Data were analyzed by Colaizzi's seven-step method. Results We identified 46 patients with primary glaucoma who delayed their first ophthalmological consultation for various reasons. There were four major themes and 16 sub-themes. The major themes were as follows: (1) occult symptoms that are difficult to identify; (2) insufficient knowledge and understanding of glaucoma-related risks and harm; (3) perceived difficulties in accessing medical care; and (4) inadequate support system. Conclusion In order to avoid patient delay and consequent irreversible damage to the visual field in patients with primary glaucoma, it is essential that medical staff identify symptoms more effectively, change habitual medical behavior of the patients, adopt a medical union model, and promote the use of a social medical support system to address practical difficulties in delivering adequate care.
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Affiliation(s)
| | | | | | | | | | - Wei Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
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Yadgari M, Yazdani MO, Karbasi P, Naseripour M, Shojaei A. The Effect of Early Posttrabeculectomy Bleb Leakage on Surgical Outcome: A Prospective Cohort Study. J Curr Ophthalmol 2023; 35:238-243. [PMID: 38681697 PMCID: PMC11047809 DOI: 10.4103/joco.joco_132_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/27/2023] [Accepted: 10/16/2023] [Indexed: 05/01/2024] Open
Abstract
Purpose To evaluate the effect of early posttrabeculectomy bleb leakage on trabeculectomy surgery outcomes and success rate. Methods The present prospective cohort study was conducted on 203 eyes of 203 patients who underwent trabeculectomy at Torfeh and Imam Hossein Medical Centers, Tehran, Iran, between 2016 and 2021. Patients were divided into two groups: those with early bleb leakage (within the 1st month of surgery) and those without bleb leakage. The success rate of surgery was compared 12, 18, and 24 months after surgery in the two groups. The average intraocular pressure (IOP) and the need for medications in patients 1, 3, 6, 9, 12, 18, and 24 months after the trabeculectomy were also compared. Results Bleb leakage was detected in 33 eyes during the 1st month after a trabeculectomy (16.3%). The mean decrease in IOP in the group with leakage was significantly lower than in patients without leakage at 1, 6, 9, 12, 18, and 24 months after surgery (P < 0.05). The need for antiglaucoma medication was significantly higher among patients with bleb leakage at 3 months (P = 0.04) and 9 months (P = 0.047) after surgery (P < 0.05). The success rate at 12, 18, and 24 months after surgery was significantly lower in the group with leakage than the group without. Conclusions The results of our study suggest that early posttrabeculectomy bleb leakage negatively impacts surgery success. Furthermore, IOP reduction was lower in patients with early leakage.
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Affiliation(s)
- Maryam Yadgari
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Oraee Yazdani
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pantea Karbasi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahya Naseripour
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Shojaei
- Basir Eye Health Research Center, Iran University of Medical Sciences, Tehran, Iran
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Nichols JJ, Morgan PB, Jones LW, Efron N. Bibliometric Analysis of Ophthalmic Journals. JAMA Ophthalmol 2023; 141:651-657. [PMID: 37261835 PMCID: PMC10236325 DOI: 10.1001/jamaophthalmol.2023.2062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/07/2023] [Indexed: 06/02/2023]
Abstract
Importance The primary vehicle for reporting and testing advances in eye care is refereed ophthalmic journals, which can be characterized using targeted bibliometric analyses. Objective To identify all ophthalmic journals and evaluate citation metrics relating to articles, journals, authors, institutions, and countries published therein. Design and Setting A bibliometric analysis was undertaken of all ophthalmic journals included in the Scopus database (Elsevier). The search was restricted to all article types published in ophthalmic journals in English from inception through November 18, 2022. After excluding general medical journals, journals published in a language other than English, and spurious titles unrelated to the ophthalmic field, the Scopus database was found to list 335 ophthalmic journal titles that have published 471 184 articles, constituting the data set for this analysis. The 20 most highly cited articles were identified. Rank-order lists by article count were assembled for journals, authors, institutions, and countries. Main Outcomes and Measures An h-index for ophthalmic journal articles was derived from citations and article counts for each constituent of each category. Results The h-index for ophthalmic journal articles was determined to be 494. The journal with the highest h-index was Ophthalmology (h-index, 297). The journal with the greatest number of articles was American Journal of Ophthalmology (38 441 articles). The most highly cited article was by Quigley and Broman, 2006 (5147 citations), concerning the epidemiology of glaucoma. The author with the highest h-index for ophthalmic journal articles was Ronald Klein, MD (h-index, 126), and the most prolific was Carol L. Shields, MD (1400 articles). Johns Hopkins University (h-index, 215) was the institution with the highest h-index for ophthalmic journal articles, and Harvard University was the most prolific (10 071 articles). The United States was the nation with the highest h-index for ophthalmic journal articles (h-index, 444) and was the most prolific (180 017 articles). Conclusions and Relevance In this study, the most highly cited articles published in ophthalmic journals were revealed, as well as the leading journals, authors, institutions, and countries. While excluding ophthalmology articles in general medical journals, this investigation affords a means of identifying highly cited authors, institutions, and countries which individuals or institutions can use as a guide regarding contributions to the field.
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Affiliation(s)
- Jason J. Nichols
- School of Optometry, The University of Alabama at Birmingham, Birmingham
| | - Philip B. Morgan
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Manchester, United Kingdom
| | - Lyndon W. Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Nathan Efron
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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Haja SA, Mahadevappa V. Advancing glaucoma detection with convolutional neural networks: a paradigm shift in ophthalmology. Rom J Ophthalmol 2023; 67:222-237. [PMID: 37876506 PMCID: PMC10591431 DOI: 10.22336/rjo.2023.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 10/26/2023] Open
Abstract
A leading cause of irreversible vision loss, glaucoma needs early detection for effective management. Intraocular Pressure (IOP) is a significant risk factor for glaucoma. Convolutional Neural Networks (CNN) demonstrate exceptional capabilities in analyzing retinal fundus images, a non-invasive and cost-effective imaging technique widely used in glaucoma diagnosis. By learning from large datasets of annotated images, CNN can identify subtle changes in the optic nerve head and retinal structures indicative of glaucoma. This enables early and precise glaucoma diagnosis, empowering clinicians to implement timely interventions. CNNs excel in analyzing complex medical images, detecting subtle changes indicative of glaucoma with high precision. Another valuable diagnostic tool for glaucoma evaluation, Optical Coherence Tomography (OCT), provides high-resolution cross-sectional images of the retina. CNN can effectively analyze OCT scans and extract meaningful features, facilitating the identification of structural abnormalities associated with glaucoma. Visual field testing, performed using devices like the Humphrey Field Analyzer, is crucial for assessing functional vision loss in glaucoma. The integration of CNN with retinal fundus images, OCT scans, visual field testing, and IOP measurements represents a transformative approach to glaucoma detection. These advanced technologies have the potential to revolutionize ophthalmology by enabling early detection, personalized management, and improved patient outcomes. CNNs facilitate remote expert opinions and enhance treatment monitoring. Overcoming challenges such as data scarcity and interpretability can optimize CNN utilization in glaucoma diagnosis. Measuring retinal nerve fiber layer thickness as a diagnostic marker proves valuable. CNN implementation reduces healthcare costs and improves access to quality eye care. Future research should focus on optimizing architectures and incorporating novel biomarkers. CNN integration in glaucoma detection revolutionizes ophthalmology, improving patient outcomes and access to care. This review paves the way for innovative CNN-based glaucoma detection methods. Abbreviations: CNN = Convolutional Neural Networks, AI = Artificial Intelligence, IOP = Intraocular Pressure, OCT = Optical Coherence Tomography, CLSO = Confocal Scanning Laser Ophthalmoscopy, AUC-ROC = Area Under the Receiver Operating Characteristic Curve, RNFL = Retinal Nerve Fiber Layer, RNN = Recurrent Neural Networks, VF = Visual Field, AP = Average Precision, MD = Mean Defect, sLV = square-root of Loss Variance, NN = Neural Network, WHO = World Health Organization.
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Affiliation(s)
- Shafeeq Ahmed Haja
- Department of Ophthalmology, Bangalore Medical College and Research Institute, India
| | - Vidyadevi Mahadevappa
- Department of Ophthalmology, Bangalore Medical College and Research Institute, India
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Puangarom S, Twinvitoo A, Sangchocanonta S, Munthuli A, Phienphanich P, Itthipanichpong R, Ratanawongphaibul K, Chansangpetch S, Manassakorn A, Tantisevi V, Rojanapongpun P, Tantibundhit C. 3-LbNets: Tri-Labeling Deep Convolutional Neural Network for the Automated Screening of Glaucoma, Glaucoma Suspect, and No Glaucoma in Fundus Images. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-5. [PMID: 38083236 DOI: 10.1109/embc40787.2023.10340102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Early detection of glaucoma, a widespread visual disease, can prevent vision loss. Unfortunately, ophthalmologists are scarce and clinical diagnosis requires much time and cost. Therefore, we developed a screening Tri-Labeling deep convolutional neural network (3-LbNets) to identify no glaucoma, glaucoma suspect, and glaucoma cases in global fundus images. 3-LbNets extracts important features from 3 different labeling modals and puts them into an artificial neural network (ANN) to find the final result. The method was effective, with an AUC of 98.66% for no glaucoma, 97.54% for glaucoma suspect, and 97.19% for glaucoma when analysing 206 fundus images evaluated with unanimous agreement from 3 well-trained ophthalmologists (3/3). When analysing 178 difficult to interpret fundus images (with majority agreement (2/3)), this method had an AUC of 80.80% for no glaucoma, 69.52% for glaucoma suspect, and 82.74% for glaucoma cases.Clinical relevance-This establishes a robust global fundus image screening network based on the ensemble method that can optimize glaucoma screening to alleviate the toll on those with glaucoma and prevent glaucoma suspects from developing the disease.
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Khatib W, Zyoud R. Quality of Life among Patients with Glaucoma in the West Bank, Palestine: A Cross-Sectional Study. Ethiop J Health Sci 2023; 33:581-590. [PMID: 38784204 PMCID: PMC11111182 DOI: 10.4314/ejhs.v33i4.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/27/2023] [Indexed: 05/25/2024] Open
Abstract
Background Glaucoma is a serious eye disease that impairs eyesight and negatively impacts quality of life. If left untreated, glaucoma can lead to blindness. This study aims at assessing the quality of life among glaucoma patients in the West Bank (WB) of Palestine and main influencing the factors. Methods This is a cross-sectional study and included two questionnaires; the Short-Form 36 Health Survey (SF-36) and Glaucoma Quality of Life-15 (GQL-15). Data were collected from a systematically randomized 100 glaucoma patients in the WB. ANOVA test was used to compare means of continuous variables at a statistically significant P value ≤ to 0.05. Results The overall quality of life among glaucoma patients was relatively suboptimal. The analysis revealed that the glaucoma quality of life is worse among older patients (mean=3.55±0.64), patients who are less educated (mean=3.91±0.77), among patients who were unemployed (mean=3.44±0.86), and patients who were treated in private clinics (3.57±0.8). Patients with good health (mean=2.48±0.94), type of glaucoma (close glaucoma; mean=3.22±0.9), less than 5 years duration of glaucoma (mean=2.88±1.13), and less than 5 years duration of cryonic diseases (mean=2.48±0.73 have a better glaucoma quality of life. Conclusions This study revealed numerous factors that can impact the quality of life of glaucoma patients in WB. Health professionals, specialists, ophthalmologists, and health educators should be aware of how various socioeconomic and general health factors impact the quality of life of glaucoma patients in order to better diagnose, manage, guide, and educate patients for better health outcomes.
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Affiliation(s)
- Wejdan Khatib
- Faculty of Graduate Studies, Arab American University-Palestine, West Bank-Palestine
| | - Raj'a Zyoud
- Nursing Faculty, Arab American University-Palestine, West Bank-Palestine
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Wagner IV, Ang B, Checo L, Simsek D, Draper C, Dorairaj S. Spotlight on Schlemm's Canal MicroStent Injection in Patients with Glaucoma. Clin Ophthalmol 2023; 17:1557-1564. [PMID: 37288002 PMCID: PMC10243342 DOI: 10.2147/opth.s388293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023] Open
Abstract
Minimally invasive glaucoma surgery (MIGS) has revolutionized glaucoma care with its favorable safety profile and ability to delay or minimize the need for traditional, bleb-based procedures. Microstent device implantation is a type of angle-based MIGS, which reduces intraocular pressure (IOP) through bypass of the juxtacanalicular trabecular meshwork (TM) and facilitation of aqueous outflow into the Schlemm's canal. Although there are limited microstent devices on the market, multiple studies have evaluated the safety and efficacy of iStent® (Glaukos Corp.), iStent Inject® (Glaukos Corp.), and Hydrus® Microstent (Alcon) in the treatment of mild-to-moderate open-angle glaucoma, with and without concurrent phacoemulsification. This review attempts to provide a comprehensive evaluation of injectable angle-based microstent MIGS devices in the treatment of glaucoma.
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Affiliation(s)
| | - Bryan Ang
- Department of Ophthalmology, Tan Tock Seng Hospital, Singapore
| | - Leticia Checo
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA
| | - Derya Simsek
- Department of Ophthalmology, Baskent University Medical School, Ankara, Turkey
| | | | - Syril Dorairaj
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA
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Chapa González C, Martínez Saráoz JV, Roacho Pérez JA, Olivas Armendáriz I. Lipid nanoparticles for gene therapy in ocular diseases. Daru 2023; 31:75-82. [PMID: 36790734 PMCID: PMC10238339 DOI: 10.1007/s40199-023-00455-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/03/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVES Lipid nanoparticles, as a nucleic acid delivery system, have been used as an alternative to treat ocular diseases, since they can cross the ocular barrier and efficiently transfecting nucleic acids to various cells of the eye. The size influences the transfection of genes, biological distribution, diffusion, and cellular uptake. It is therefore important to establish a relationship between size, formulation, and encapsulation percentage. EVIDENCE ACQUISITION In this review, we used a search strategy to compare studies of nanomedicine systems aimed at eye diseases where the size of the nanoparticles and the efficiency of encapsulation of genetic material are reported based on the criteria of Preferred Reporting Items for Systematic Reviews (PRISMA ScR 2020 guidelines). RESULTS Out of the initial 5932, 169 studies met the inclusion criteria and were included to form the basis of the analysis. Nanoparticles reported are composed mainly of PEG-modified lipids, cholesterol, and cationic lipids, that in combination with messenger or interference RNA, allow the formulation of a nanoparticle with an encapsulation efficiency greater than 95%. The diseases treated mainly focus on conditions related to the retina and cornea. Certain characteristics of nanoparticles increase encapsulation efficiency, such as the size of the nanoparticle and the charge of the outer layer of the nanoparticle. CONCLUSION It is still unknown what characteristics lipid nanoparticles should have to successfully treat human eye illnesses. The in vitro and in vivo investigations covered in this review, however, present encouraging results. To improve encapsulation effectiveness and disease gene silencing, nanoparticle formulation is essential. The most stable nanoparticles are those made mostly of cationic lipids, PEG lipids, and cholesterol, which also effectively encapsulate RNA. The encapsulation efficiency is not only influenced by size, but also by other factors such as methods of preparation.
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Affiliation(s)
- Christian Chapa González
- Grupo de Investigación en Nanomedicina, Instituto de Ingeniería y Tecnología de la Universidad Autónoma de Ciudad Juárez, 32310, Ciudad Juárez, Chih, Mexico.
| | - Jessica Victoria Martínez Saráoz
- Grupo de Investigación en Nanomedicina, Instituto de Ingeniería y Tecnología de la Universidad Autónoma de Ciudad Juárez, 32310, Ciudad Juárez, Chih, Mexico
- Centro de Investigación en Materiales Avanzados, 66600, Apodaca, Nuevo León, Mexico
| | - Jorge Alberto Roacho Pérez
- Grupo de Investigación en Nanomedicina, Instituto de Ingeniería y Tecnología de la Universidad Autónoma de Ciudad Juárez, 32310, Ciudad Juárez, Chih, Mexico
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina de la Universidad Autónoma de Nuevo León, 64460, Monterrey, Nuevo León, Mexico
| | - Imelda Olivas Armendáriz
- Departamento de Física y Matemáticas de la Universidad Autónoma de Ciudad Juárez, 32310, Ciudad Juárez, Chih, Mexico
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Pham JH, Stankowska DL. Mitochondria-associated endoplasmic reticulum membranes (MAMs) and their role in glaucomatous retinal ganglion cell degeneration-a mini review. Front Neurosci 2023; 17:1198343. [PMID: 37250427 PMCID: PMC10213334 DOI: 10.3389/fnins.2023.1198343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Glaucoma is a leading cause of blindness worldwide, commonly associated with elevated intraocular pressure (IOP), leading to degeneration of the optic nerve and death of retinal ganglion cells, the output neurons in the eye. In recent years, many studies have implicated mitochondrial dysfunction as a crucial player in glaucomatous neurodegeneration. Mitochondrial function has been an increasingly researched topic in glaucoma, given its vital role in bioenergetics and propagation of action potentials. One of the most metabolically active tissues in the body characterized by high oxygen consumption is the retina, particularly the retinal ganglion cells (RGCs). RGCs, which have long axons that extend from the eyes to the brain, rely heavily on the energy generated by oxidative phosphorylation for signal transduction, rendering them more vulnerable to oxidative damage. In various glaucoma models, mitochondrial dysfunction and stress from protein aggregates in the endoplasmic reticulum (ER) have been observed in the RGCs. However, it has been shown that the two organelles are connected through a network called mitochondria-associated ER membranes (MAMs); hence this crosstalk in a pathophysiological condition such as glaucoma should be evaluated. Here, we review the current literature suggestive of mitochondrial and ER stress related to glaucoma, indicating potential cross-signaling and the potential roles of MAMs.
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Affiliation(s)
- Jennifer H. Pham
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, United States
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Dorota L. Stankowska
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, United States
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX, United States
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Monavarfeshani A, Yan W, Pappas C, Odenigbo KA, He Z, Segrè AV, van Zyl T, Hageman GS, Sanes JR. Transcriptomic Analysis of the Ocular Posterior Segment Completes a Cell Atlas of the Human Eye. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.26.538447. [PMID: 37162855 PMCID: PMC10168356 DOI: 10.1101/2023.04.26.538447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Although the visual system extends through the brain, most vision loss originates from defects in the eye. Its central element is the neural retina, which senses light, processes visual signals, and transmits them to the rest of the brain through the optic nerve (ON). Surrounding the retina are numerous other structures, conventionally divided into anterior and posterior segments. Here we used high-throughput single nucleus RNA sequencing (snRNA-seq) to classify and characterize cells in the extraretinal components of the posterior segment: ON, optic nerve head (ONH), peripheral sclera, peripapillary sclera (PPS), choroid, and retinal pigment epithelium (RPE). Defects in each of these tissues are associated with blinding diseases - for example, glaucoma (ONH and PPS), optic neuritis (ON), retinitis pigmentosa (RPE), and age-related macular degeneration (RPE and choroid). From ∼151,000 single nuclei, we identified 37 transcriptomically distinct cell types, including multiple types of astrocytes, oligodendrocytes, fibroblasts, and vascular endothelial cells. Our analyses revealed a differential distribution of many cell types among distinct structures. Together with our previous analyses of the anterior segment and retina, the new data complete a "Version 1" cell atlas of the human eye. We used this atlas to map the expression of >180 genes associated with the risk of developing glaucoma, which is known to involve ocular tissues in both anterior and posterior segments as well as neural retina. Similar methods can be used to investigate numerous additional ocular diseases, many of which are currently untreatable.
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Affiliation(s)
- Aboozar Monavarfeshani
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138
- F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Boston, MA, USA
- Equal contributions
| | - Wenjun Yan
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138
- Equal contributions
| | - Christian Pappas
- Sharon Eccles Steele Center for Translational Medicine, John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
| | - Kenechukwu A. Odenigbo
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138
| | - Zhigang He
- F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Boston, MA, USA
| | - Ayellet V. Segrè
- Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear, Boston, MA 02114
- Broad Institute of Harvard and MIT, Cambridge, MA
| | - Tavé van Zyl
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138
- Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear, Boston, MA 02114
- Present address: Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT 06510
| | - Gregory S. Hageman
- Sharon Eccles Steele Center for Translational Medicine, John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
| | - Joshua R. Sanes
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138
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72
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Lai CF, Shiau FJ. Enhanced and Extended Ophthalmic Drug Delivery by pH-Triggered Drug-Eluting Contact Lenses with Large-Pore Mesoporous Silica Nanoparticles. ACS APPLIED MATERIALS & INTERFACES 2023; 15:18630-18638. [PMID: 37023369 DOI: 10.1021/acsami.2c22860] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Drug-eluting contact lenses (DCLs) have attracted considerable attention as potential therapeutic ophthalmic drug delivery devices. In this study, we propose, fabricate, and investigate pH-triggered DCLs that are combined with large-pore mesoporous silica nanoparticles (LPMSNs). Compared to reference DCLs, LPMSN-laden DCLs can prolong the residence time of glaucoma drugs in an artificial lacrimal fluid (ALF) environment at pH 7.4. Additionally, LPMSN-laden DCLs do not require drug preloading and are compatible with current contact lens manufacturing processes. LPMSN-laden DCLs soaked at pH 6.5 exhibit better drug loading than reference DCLs due to their specific adsorption. The sustained and extended release of glaucoma drugs by LPMSN-laden DCLs was successfully monitored in ALF, and the drug release mechanism was further explained. We also evaluated the cytotoxicity of LPMSN-laden DCLs, and qualitative and quantitative results showed no cytotoxicity. Our experimental results demonstrate that LPMSNs are excellent nanocarriers that have the potential to be used as safe and stable nanocarriers for the delivery of glaucoma drugs or other drugs. pH-triggered LPMSN-laden DCLs can significantly improve drug loading efficiency and control prolonged drug release, indicating that they have great potential for future biomedical applications.
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Affiliation(s)
- Chun-Feng Lai
- Department of Photonics, Feng Chia University, No. 100, Wenhwa Road, Seatwen, Taichung 40724, Taiwan
| | - Fu-Jia Shiau
- Department of Photonics, Feng Chia University, No. 100, Wenhwa Road, Seatwen, Taichung 40724, Taiwan
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73
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Neacșu AM, Anton N, Lăpușneanu L, Mușat O, Andrei MC, Coșman M, Țovănac NA, Ferechide D. Dynamics of the association between visual and auditory functional changes in glaucoma. Preliminary results. Rom J Ophthalmol 2023; 67:117-127. [PMID: 37522019 PMCID: PMC10385703 DOI: 10.22336/rjo.2023.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Glaucoma is a multifactorial degenerative optic neuropathy characterized by the irreversible loss of retinal ganglion cells. Vascular, genetic, anatomical and immune factors are present in etiopathogenic mechanisms. Being the second cause of blindness worldwide after cataract, and with an irreversible character, glaucoma has turned into a disease with a significant impact on public health. Patients with primary open-angle glaucoma (POAG) may have central neurodegenerative changes, such as sensorineural hearing loss and static changes. Aim: The aim of this study was to estimate the connections between visual and auditory functional changes in glaucoma. The subjects were grouped as follows: patients with glaucoma compared with patients without glaucoma, while trying to identify the functional defect of the optic nerve (visual field) and a hearing testing (audiogram). Materials and methods: The prospective, cross-sectional study included 32 eyes of 16 subjects with POAG in a group of study and 24 eyes of 12 healthy subjects in the other group, with a mean age of both groups between 61,64 ± 6,53 years old. Both groups were examined from ophthalmological, audiological and radioimaging perspectives with Pure-tone audiometry (PTA) and magnetic resonance imaging (MRI) for brain. All patients had ophthalmologic assessments according to a standardized protocol. Moreover, auditory functional parameters (audiometry) were recorded. Results: Female cases, over 65 years old, with residency in a city, predominated in the group of study. Compared to the control group, patients in the group of study had average levels of the PTA and modified visual field (VF) parameters. Multivariate analysis demonstrated that the correlation of PTA was indirect, reduced in intensity, both with MD (r = -0.108; p = 0.585), Cal HOV (r = -0.268; p = 0.168) and the slope profile of the right eye. Multivariate analysis demonstrated that there was a correlation of the right PTA, which was indirect, reduced in intensity, both with MD (r = -0.108; p = 0.585), Cal HOV (r = -0.268; p = 0.168) and the slope profile of the right eye. The left ear PTA correlation was indirect, moderate in intensity, statistically significant with both MD (r = -0.584; p = 0.001) and slope profile (r = -0.377; p = 0.048) and reduced as intensity with Cal HOV (r = -0.147; p = 0.456) of the left eye. Conclusions: Patients with POAG showed changes in audiometry in connection with ophthalmological parameters, a fact suggesting that the auditory system might have been affected in POAG. This study highlighted the interdisciplinarity of the medical field with the aim of ensuring the quality of life of glaucoma patients. A good collaboration between the ophthalmologist and the otolaryngologist was very important for our patients. Abbreviations: RE = Right eye, LE = Left Eye, POAG = Primitive Open Angle Glaucoma, PTA = Pure-tone audiometry, VF = visual field, MRI = magnetic resonance imaging, IOP = Intraocular pressure, BVAC = best visual acuity corrected, MD = mean defect, CNS = central nervous system, SAP = standard automated perimetry, CCT = central corneal thickness, ONH = Optic nerve head, CDR = Cup/ Disc ratio, RNFL = Retinal fiber layers.
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Affiliation(s)
- Alina Mihaela Neacșu
- Department of Ophthalmology, Clinical County Emergency Hospital, Brăila, Romania
| | - Nicoleta Anton
- Department of Ophthalmology, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | - Lucian Lăpușneanu
- Department of Otolaryngology, Clinical County Emergency Hospital, Brăila, Romania
| | - Ovidiu Mușat
- Department of Ophthalmology, "Dr. Carol Davila" Central Military Emergency Hospital, Bucharest, Romania
| | | | - Mihaela Coșman
- Department of Neurosurgery, Clinical County Emergency Hospital, Brăila, Romania
| | | | - Dumitru Ferechide
- Physiology Department, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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74
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Gapeeva A, Qiu H, Cojocaru A, Arndt C, Riaz T, Schütt F, Selhuber-Unkel C, Mishra YK, Tura A, Sonntag S, Gniesmer S, Grisanti S, Kaps S, Adelung R. Tetrapodal ZnO-Based Composite Stents for Minimally Invasive Glaucoma Surgery. ACS Biomater Sci Eng 2023; 9:1352-1361. [PMID: 36776118 DOI: 10.1021/acsbiomaterials.2c01203] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
The glaucoma burden increases continuously and is estimated to affect more than 100 million people by 2040. As there is currently no cure to restore the optic nerve damage caused by glaucoma, the only controllable parameter is the intraocular pressure (IOP). In recent years, minimally invasive glaucoma surgery (MIGS) has emerged as an alternative to traditional treatments. It uses micro-sized drainage stents that are inserted through a small incision, minimizing the trauma to the tissue and reducing surgical and postoperative recovery time. However, a major challenge for MIGS devices is foreign body reaction and fibrosis, which can lead to a complete failure of the device. In this work, the antifibrotic potential of tetrapodal ZnO (t-ZnO) microparticles used as an additive is elucidated by using rat embryonic fibroblasts as a model. A simple, direct solvent-free process for the fabrication of stents with an outer diameter of 200-400 μm is presented, in which a high amount of t-ZnO particles (45-75 wt %) is mixed into polydimethylsiloxane (PDMS) and a highly viscous polymer/particle mixture is extruded. The fabricated stents possess increased elastic modulus compared to pure PDMS while remaining flexible to adapt to the curvature of an eye. In vitro experiments showed that the fibroblast cell viability was inhibited to 43 ± 3% when stents with 75 wt % t-ZnO were used. The results indicate that cell inhibiting properties can be attributed to an increased amount of protruding t-ZnO particles on the stent surface, leading to an increase in local contacts with cells and a disruption of the cell membrane. As a secondary mechanism, the released Zn ions could also contribute to the cell-inhibiting properties in the close vicinity of the stent surface. Overall, the fabrication method and the antifibrotic and mechanical properties of developed stents make them promising for application in MIGS.
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Affiliation(s)
- Anna Gapeeva
- Functional Nanomaterials, Institute for Materials Science, Faculty of Engineering, Kiel University, Kaiserstr. 2, D-24143 Kiel, Germany
| | - Haoyi Qiu
- Functional Nanomaterials, Institute for Materials Science, Faculty of Engineering, Kiel University, Kaiserstr. 2, D-24143 Kiel, Germany
- Phi-Stone AG, Kaiserstr. 2, D-24143 Kiel, Germany
| | - Ala Cojocaru
- Functional Nanomaterials, Institute for Materials Science, Faculty of Engineering, Kiel University, Kaiserstr. 2, D-24143 Kiel, Germany
- Phi-Stone AG, Kaiserstr. 2, D-24143 Kiel, Germany
| | - Christine Arndt
- Functional Nanomaterials, Institute for Materials Science, Faculty of Engineering, Kiel University, Kaiserstr. 2, D-24143 Kiel, Germany
- Institute for Molecular Systems Engineering and Advanced Materials (IMSEAM), Heidelberg University, INF 225, D-69120 Heidelberg, Germany
| | - Tehseen Riaz
- Functional Nanomaterials, Institute for Materials Science, Faculty of Engineering, Kiel University, Kaiserstr. 2, D-24143 Kiel, Germany
| | - Fabian Schütt
- Functional Nanomaterials, Institute for Materials Science, Faculty of Engineering, Kiel University, Kaiserstr. 2, D-24143 Kiel, Germany
| | - Christine Selhuber-Unkel
- Institute for Molecular Systems Engineering and Advanced Materials (IMSEAM), Heidelberg University, INF 225, D-69120 Heidelberg, Germany
| | - Yogendra Kumar Mishra
- Mads Clausen Institute, NanoSYD, University of Southern Denmark, DK-6400 Sønderborg, Denmark
| | - Aysegül Tura
- Department of Ophthalmology, University of Lübeck, University Clinic Schleswig-Holstein, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - Svenja Sonntag
- Department of Ophthalmology, University of Lübeck, University Clinic Schleswig-Holstein, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - Stefanie Gniesmer
- Department of Ophthalmology, University of Lübeck, University Clinic Schleswig-Holstein, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - Salvatore Grisanti
- Department of Ophthalmology, University of Lübeck, University Clinic Schleswig-Holstein, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - Sören Kaps
- Functional Nanomaterials, Institute for Materials Science, Faculty of Engineering, Kiel University, Kaiserstr. 2, D-24143 Kiel, Germany
| | - Rainer Adelung
- Functional Nanomaterials, Institute for Materials Science, Faculty of Engineering, Kiel University, Kaiserstr. 2, D-24143 Kiel, Germany
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75
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Rossi A, Rahimi M, Le D, Son T, Heiferman MJ, Chan RVP, Yao X. Portable widefield fundus camera with high dynamic range imaging capability. BIOMEDICAL OPTICS EXPRESS 2023; 14:906-917. [PMID: 36874492 PMCID: PMC9979689 DOI: 10.1364/boe.481096] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Fundus photography is indispensable for the clinical detection and management of eye diseases. Low image contrast and small field of view (FOV) are common limitations of conventional fundus photography, making it difficult to detect subtle abnormalities at the early stages of eye diseases. Further improvements in image contrast and FOV coverage are important for early disease detection and reliable treatment assessment. We report here a portable, wide FOV fundus camera with high dynamic range (HDR) imaging capability. Miniaturized indirect ophthalmoscopy illumination was employed to achieve the portable design for nonmydriatic, widefield fundus photography. Orthogonal polarization control was used to eliminate illumination reflectance artifacts. With independent power controls, three fundus images were sequentially acquired and fused to achieve HDR function for local image contrast enhancement. A 101° eye-angle (67° visual-angle) snapshot FOV was achieved for nonmydriatic fundus photography. The effective FOV was readily expanded up to 190° eye-angle (134° visual-angle) with the aid of a fixation target without the need for pharmacologic pupillary dilation. The effectiveness of HDR imaging was validated with both normal healthy and pathologic eyes, compared to a conventional fundus camera.
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Affiliation(s)
- Alfa Rossi
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Mojtaba Rahimi
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - David Le
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Taeyoon Son
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Michael J. Heiferman
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - R. V. Paul Chan
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL 60607, USA
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Xincheng Yao
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL 60607, USA
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
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Glaucoma medical treatment as a predictor of XEN45 subconjunctival gel implant hypotensive efficacy. Graefes Arch Clin Exp Ophthalmol 2023; 261:521-533. [PMID: 35986778 DOI: 10.1007/s00417-022-05810-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/13/2022] [Accepted: 08/10/2022] [Indexed: 01/17/2023] Open
Abstract
PURPOSE The aim of this study was to determine the preoperative characteristics influencing hypotensive efficacy of the XEN45 gel stent in patients with open-angle glaucoma at one-year follow-up. MATERIALS AND METHODS This was a retrospective multicentre study. All patients who underwent XEN45 gel stent implantation between January 2017 and January 2021 were included. The main study outcome was the assessment of one-year postoperative intraocular pressure (IOP) and glaucoma medication differences according to the number and type of preoperative topical treatments or glaucoma surgery, glaucoma stage and time since diagnosis. Follow-up period was 1-year post-surgery in all cases. IOP reduction and surgery success (not requiring reoperation or pressure failures [IOP > 18 mmHg and < 20% reduction in IOP]), safety and cost savings in topical glaucoma therapy after surgery were secondarily assessed. Linear regression analysis to determine the preoperative parameters influence on 1-year postoperative results was performed. RESULTS XEN45 gel stent was implanted in 85 patients. One-year postoperative mean IOP dropped from 20.6 ± 4.1 to 13.7 ± 2.8 mmHg (p < 0.0001). Likewise, mean number of topical treatments decreased from 2.05 ± 0.9 to 0.36 ± 0.65 (p < 0.001). Both were mainly influenced by the number of preoperative glaucoma treatments, such that for each one-glaucoma medication increase, postoperative intraocular pressure increased by 1.18 mmHg (95% CI 0.56-1.79, p < 0.0001) and number of glaucoma medications increased by 0.3 (95% CI 0.16-0.43, p < 0.001). Overall success rates (with and without supplemental glaucoma medication use) were 97.6% (95% CI 94.5-100%), 87.1% (95% CI 80.2-87.1%) and 61.2% (95% CI 51.6-72.5%) at 3, 6 months and 1 year after surgery. No sight-threatening adverse events were reported. Mean annual cost savings on medical treatment since surgery reached EUR 251.19 ± 169. 93 euros. CONCLUSIONS One year after surgery, XEN45 gel implant significantly reduced IOP and number of topical medications with an adequate safety profile being both mainly influenced by the number of preoperative glaucoma treatments.
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77
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Cantor L, Lindfield D, Ghinelli F, Świder AW, Torelli F, Steeds C, Dickerson Jr JE, Nguyen DQ. Systematic Literature Review of Clinical, Economic, and Humanistic Outcomes Following Minimally Invasive Glaucoma Surgery or Selective Laser Trabeculoplasty for the Treatment of Open-Angle Glaucoma with or Without Cataract Extraction. Clin Ophthalmol 2023; 17:85-101. [PMID: 36636619 PMCID: PMC9831079 DOI: 10.2147/opth.s389406] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/23/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Selective laser trabeculoplasty (SLT) and minimally invasive glaucoma surgery (MIGS) are increasingly used options for mild-to-moderate open-angle glaucoma (OAG) care. While most MIGS devices are indicated for use in combination with cataract surgery only, with phacoemulsification playing a role in lowering IOP, newer technologies can also be used as standalone glaucoma surgery. Methods This systematic literature review (SLR) aimed to assess the clinical, economic, and humanistic outcomes of MIGS and SLT for the treatment of OAG and was conducted according to PRISMA guidelines. Studies that assessed MIGS or SLT in at least one treatment arm versus any other glaucoma treatment in adults with mild-to-moderate OAG were included. Clinical, humanistic (health-related quality of life [HRQoL] and patient burden), and economic data were extracted, and the methodological quality of included studies was evaluated. Results A total of 2720 articles were screened, and 81 publications were included. Fifty-eight reported clinical outcomes. The majority assessed iStent or iStent inject (n=41), followed by OMNI (n=9), gonioscopy-assisted transluminal trabeculotomy (GATT) or the Kahook Dual Blade (KDB) (n=7), Hydrus (n=6), SLT (n=5), Xen Gel Stent (n=2), PreserFlo (n=1), and iTrack (n=1). IOP reduction was observed across prospective studies, varying from -31% to -13.7% at month 6 and from -39% to -11.4% at year 1 versus baseline. Most adverse events were transient and non-serious. Limited humanistic and economic data were identified. Conclusion Given their established efficacy and safety, there is a rationale for wider use of MIGS in mild-to-moderate OAG. Of the MIGS devices, iStent and OMNI have the largest clinical evidence base supporting their sustained effectiveness.
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Affiliation(s)
- Louis Cantor
- Eugene and Marilyn Glick Eye Institute, Indiana School of Medicine, Indianapolis, IN, USA
| | - Dan Lindfield
- Royal Surrey County Hospital, Guildford, England, UK
| | | | | | - Francesca Torelli
- Valid Insight, Macclesfield, England, UK,Correspondence: Francesca Torelli, Valid Insight, Ropewalks, Newton St, Macclesfield, SK11 6QJ, UK, Tel +44 203 750 9833 Ext 703, Email
| | | | - Jaime E Dickerson Jr
- Sight Sciences, Menlo Park, CA, USA,North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Dan Q Nguyen
- Mid-Cheshire Hospitals NHS Foundation Trust, Crewe, UK
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78
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Fırat P, Dikci S, Can A, Türkoğlu E. Evaluation of medication adherence of glaucoma patients during the COVID-19 pandemic. J Fr Ophtalmol 2023; 46:11-18. [PMID: 36435659 PMCID: PMC9671694 DOI: 10.1016/j.jfo.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate changes in the medication adherence of glaucoma patients during the COVID-19 pandemic and the factors influencing medication adherence. MATERIALS AND METHODS This cross-sectional study included a total of 197 glaucoma patients who were followed for at least six months in the Glaucoma Unit of the Ophthalmology Department of Inonu University, Faculty of Medicine. Patients were given a 28-item questionnaire, including the eight-item Morisky Medication Adherence Questionnaire, to evaluate medication adherence. Demographic and clinical data were recorded. P<0.05 was considered statistically significant. RESULTS Interruption of glaucoma clinic visits during the pandemic was reported by 82 (41.6%) patients. Nonadherence was reported by 56 patients (28.4%) (95% confidence interval: 22.1-34.7). For these patients, the most common reasons for nonadherence were forgetfulness (50%), the inability to receive a prescription for the drug (10.7%) and being busy (10.7%). Factors influencing nonadherence were determined to be younger age, female gender, interruption of glaucoma clinic visits and high-income levels (P˂0.05). CONCLUSION Interruption of glaucoma clinic visits during the COVID-19 pandemic and the resulting inability to have medications prescribed resulted in patient nonadherence with medication use.
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Affiliation(s)
- P.G. Fırat
- Inonu University, Faculty of Medicine, Department of Ophthalmology, Malatya, Turkey
| | - S. Dikci
- Inonu University, Faculty of Medicine, Department of Ophthalmology, Malatya, Turkey,Corresponding author
| | - A. Can
- Inonu University, Faculty of Medicine, Department of Ophthalmology, Malatya, Turkey
| | - E.B. Türkoğlu
- Akdeniz University, Faculty of Medicine, Department of Ophthalmology, Antalya, Turkey
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79
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Douglass A, Dattilo M, Feola AJ. Evidence for Menopause as a Sex-Specific Risk Factor for Glaucoma. Cell Mol Neurobiol 2023; 43:79-97. [PMID: 34981287 PMCID: PMC9250947 DOI: 10.1007/s10571-021-01179-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/03/2021] [Indexed: 01/07/2023]
Abstract
Glaucoma is a leading cause of irreversible blindness worldwide and is characterized by progressive loss of visual function and retinal ganglion cells (RGC). Current epidemiological, clinical, and basic science evidence suggest that estrogen plays a role in the aging of the optic nerve. Menopause, a major biological life event affecting all women, coincides with a decrease in circulating sex hormones, such as estrogen. While 59% of the glaucomatous population are females, sex is not considered a risk factor for developing glaucoma. In this review, we explore whether menopause is a sex-specific risk factor for glaucoma. First, we investigate how menopause is defined as a sex-specific risk factor for other pathologies, including cardiovascular disease, osteoarthritis, and bone health. Next, we discuss clinical evidence that highlights the potential role of menopause in glaucoma. We also highlight preclinical studies that demonstrate larger vision and RGC loss following surgical menopause and how estrogen is protective in models of RGC injury. Lastly, we explore how surgical menopause and estrogen signaling are related to risk factors associated with developing glaucoma (e.g., intraocular pressure, aqueous outflow resistance, and ocular biomechanics). We hypothesize that menopause potentially sets the stage to develop glaucoma and therefore is a sex-specific risk factor for this disease.
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Affiliation(s)
- Amber Douglass
- grid.484294.7Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA USA
| | - Michael Dattilo
- grid.189967.80000 0001 0941 6502Department of Ophthalmology, Emory Eye Center, Emory University School of Medicine, B2503, Clinic B Building, 1365B Clifton Road NE, Atlanta, GA 30322 USA ,grid.414026.50000 0004 0419 4084Department of Ophthalmology, Atlanta Veterans Affairs Medical Center, Atlanta, GA USA ,grid.213917.f0000 0001 2097 4943Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA USA
| | - Andrew J. Feola
- grid.484294.7Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA USA ,grid.189967.80000 0001 0941 6502Department of Ophthalmology, Emory Eye Center, Emory University School of Medicine, B2503, Clinic B Building, 1365B Clifton Road NE, Atlanta, GA 30322 USA ,grid.213917.f0000 0001 2097 4943Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA USA
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80
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Scelsi HF, Hill KR, Barlow BM, Martin MD, Lieberman RL. Quantitative differentiation of benign and misfolded glaucoma-causing myocilin variants on the basis of protein thermal stability. Dis Model Mech 2023; 16:dmm049816. [PMID: 36579626 PMCID: PMC9844228 DOI: 10.1242/dmm.049816] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/28/2022] [Indexed: 12/30/2022] Open
Abstract
Accurate predictions of the pathogenicity of mutations associated with genetic diseases are key to the success of precision medicine. Inherited missense mutations in the myocilin (MYOC) gene, within its olfactomedin (OLF) domain, constitute the strongest genetic link to primary open-angle glaucoma via a toxic gain of function, and thus MYOC is an attractive precision-medicine target. However, not all mutations in MYOC cause glaucoma, and common variants are expected to be neutral polymorphisms. The Genome Aggregation Database (gnomAD) lists ∼100 missense variants documented within OLF, all of which are relatively rare (allele frequency <0.001%) and nearly all are of unknown pathogenicity. To distinguish disease-causing OLF variants from benign OLF variants, we first characterized the most prevalent population-based variants using a suite of cellular and biophysical assays, and identified two variants with features of aggregation-prone familial disease variants. Next, we considered all available biochemical and clinical data to demonstrate that pathogenic and benign variants can be differentiated statistically based on a single metric: the thermal stability of OLF. Our results motivate genotyping MYOC in patients for clinical monitoring of this widespread, painless and irreversible ocular disease.
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Affiliation(s)
- Hailee F. Scelsi
- School of Chemistry & Biochemistry, Georgia Institute of Technology, 901 Atlantic Dr. NW, Atlanta, GA 30332-0400, USA
| | - Kamisha R. Hill
- School of Chemistry & Biochemistry, Georgia Institute of Technology, 901 Atlantic Dr. NW, Atlanta, GA 30332-0400, USA
| | - Brett M. Barlow
- School of Chemistry & Biochemistry, Georgia Institute of Technology, 901 Atlantic Dr. NW, Atlanta, GA 30332-0400, USA
| | - Mackenzie D. Martin
- School of Chemistry & Biochemistry, Georgia Institute of Technology, 901 Atlantic Dr. NW, Atlanta, GA 30332-0400, USA
| | - Raquel L. Lieberman
- School of Chemistry & Biochemistry, Georgia Institute of Technology, 901 Atlantic Dr. NW, Atlanta, GA 30332-0400, USA
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81
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Pitale PM, Shen G, Sigireddi RR, Polo-Prieto M, Park YH, Gibson SE, Westenskow PD, Channa R, Frankfort BJ. Selective vulnerability of the intermediate retinal capillary plexus precedes retinal ganglion cell loss in ocular hypertension. Front Cell Neurosci 2022; 16:1073786. [PMID: 36545655 PMCID: PMC9760765 DOI: 10.3389/fncel.2022.1073786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/15/2022] [Indexed: 12/08/2022] Open
Abstract
Introduction: Glaucoma, a disease of retinal ganglion cell (RGC) injury and potentially devastating vision loss, is associated with both ocular hypertension (OHT) and reduced ocular blood flow. However, the relationship between OHT and retinal capillary architecture is not well understood. In this project, we studied microvasculature damage in mice exposed to mild levels of induced OHT. Methods: Mild OHT was induced with the microbead model for 2 weeks. At this time point, some retinas were immunostained with CD31 (endothelium), Collagen IV (basement membrane), and RBPMS (RGCs) for z-stack confocal microscopy. We processed these confocal images to distinguish the three retinal capillary plexi (superficial, intermediate, and deep). We manually counted RGC density, analyzed vascular complexity, and identified topographical and spatial vascular features of the retinal capillaries using a combination of novel manual and automated workflows. Other retinas were dissociated and immunopanned to isolate RGCs and amacrine cells (ACs) for hypoxia gene array analysis. Results: RGC counts were normal but there was decreased overall retinal capillary complexity. This reduced complexity could be explained by abnormalities in the intermediate retinal capillary plexus (IRCP) that spared the other plexi. Capillary junction density, vessel length, and vascular area were all significantly reduced, and the number of acellular capillaries was dramatically increased. ACs, which share a neurovascular unit (NVU) with the IRCP, displayed a marked increase in the relative expression of many hypoxia-related genes compared to RGCs from the same preparations. Discussion: We have discovered a rapidly occurring, IRCP-specific, OHT-induced vascular phenotype that precedes RGC loss. AC/IRCP NVU dysfunction may be a mechanistic link for early vascular remodeling in glaucoma.
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Affiliation(s)
- Priyamvada M. Pitale
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Guofu Shen
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Rohini R. Sigireddi
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Maria Polo-Prieto
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Yong H. Park
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Solomon E. Gibson
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States,Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States
| | - Peter D. Westenskow
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Roomasa Channa
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Benjamin J. Frankfort
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States,Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States,*Correspondence: Benjamin J. Frankfort
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Moreno-Montañés J, Gándara E, Moreno-Galarraga L, Hershey MS, López-Gil JF, Kales S, Bes-Rastrollo M, Martínez-González MÁ, Fernandez-Montero A. ACE-Vitamin Index and Risk of Glaucoma: The SUN Project. Nutrients 2022; 14:nu14235129. [PMID: 36501162 PMCID: PMC9735492 DOI: 10.3390/nu14235129] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/24/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous studies regarding antioxidant consumption and glaucoma have shown contradictory results. The aim of this study was to analyze the combined effect of the consumption of three vitamins (A, C and E) on the incidence of glaucoma in the SUN Project. METHODS For this study, 18,669 participants were included. The mean follow-up was 11.5 years. An index including vitamins A, C and E (ACE-Vitamin Index) was calculated. Vitamin intake was extracted from participants' dietary data and vitamin supplements, if taken. Information on glaucoma incidence was collected by previously validated self-reported questionnaires. The association between glaucoma and vitamin intake was assessed by repeated-measures Cox regression using multi-adjusted hazard ratios. RESULTS A total of 251 (1.3%) cases of glaucoma were detected. Participants with a higher ACE-Vitamin Index presented a reduced risk of glaucoma compared to participants with lower consumption (adjusted HR = 0.73; 95% CI, (0.55-0.98)). When each vitamin was analyzed individually, none of them had a significant protective effect. The protective effect of the ACE-Vitamin Index was higher in men and older participants (≥55 year). CONCLUSIONS The consumption of vitamins A, C and E considered separately do not seem to exert a protective effect against glaucoma, but when these vitamins are considered together, they are associated with a lower risk of glaucoma.
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Affiliation(s)
- Javier Moreno-Montañés
- Department of Ophthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Elsa Gándara
- Department of Ophthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Laura Moreno-Galarraga
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Department of Pediatrics, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, 31008 Pamplona, Spain
| | - Maria S. Hershey
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| | - José Francisco López-Gil
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
- Health and Social Research Center, University of Castilla-La Mancha, 16071 Cuenca, Spain
| | - Stefanos Kales
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA 02115, USA
| | - Maira Bes-Rastrollo
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Miguel Ángel Martínez-González
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| | - Alejandro Fernandez-Montero
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
- Department of Occupational Medicine, University of Navarra, 31008 Pamplona, Spain
- Correspondence:
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83
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Xu Q, Rydz C, Nguyen Huu VA, Rocha L, Palomino La Torre C, Lee I, Cho W, Jabari M, Donello J, Lyon DC, Brooke RT, Horvath S, Weinreb RN, Ju W, Foik A, Skowronska‐Krawczyk D. Stress induced aging in mouse eye. Aging Cell 2022; 21:e13737. [PMID: 36397653 PMCID: PMC9741506 DOI: 10.1111/acel.13737] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/17/2022] [Accepted: 10/23/2022] [Indexed: 11/21/2022] Open
Abstract
Aging, a universal process that affects all cells in an organism, is a major risk factor for a group of neuropathies called glaucoma, where elevated intraocular pressure is one of the known stresses affecting the tissue. Our understanding of molecular impact of aging on response to stress in retina is very limited; therefore, we developed a new mouse model to approach this question experimentally. Here we show that susceptibility to response to stress increases with age and is primed on chromatin level. We demonstrate that ocular hypertension activates a stress response that is similar to natural aging and involves activation of inflammation and senescence. We show that multiple instances of pressure elevation cause aging of young retina as measured on transcriptional and DNA methylation level and are accompanied by local histone modification changes. Our data show that repeated stress accelerates appearance of aging features in tissues and suggest chromatin modifications as the key molecular components of aging. Lastly, our work further emphasizes the importance of early diagnosis and prevention as well as age-specific management of age-related diseases, including glaucoma.
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Affiliation(s)
- Qianlan Xu
- Department of Physiology and Biophysics, Center for Translational Vision Research, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
| | - Cezary Rydz
- Department of Physiology and Biophysics, Center for Translational Vision Research, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
| | - Viet Anh Nguyen Huu
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Lorena Rocha
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Claudia Palomino La Torre
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Irene Lee
- Department of Physiology and Biophysics, Center for Translational Vision Research, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
| | - William Cho
- Department of Physiology and Biophysics, Center for Translational Vision Research, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
| | - Mary Jabari
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - John Donello
- Department of Physiology and Biophysics, Center for Translational Vision Research, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
| | - David C. Lyon
- Department of Anatomy and Neurobiology, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
| | | | - Steve Horvath
- Epigenetic Clock Development FoundationTorranceCaliforniaUSA
| | - Robert N. Weinreb
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Won‐Kyu Ju
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Andrzej Foik
- Department of Anatomy and Neurobiology, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
- International Centre for Translational Eye Research, Institute of Physical ChemistryPolish Academy of SciencesWarsawPoland
| | - Dorota Skowronska‐Krawczyk
- Department of Physiology and Biophysics, Department of Ophthalmology, Center for Translational Vision Research, School of MedicineUniversity of California, IrvineCaliforniaUSA
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Castro-Castaneda CR, Altamirano-Lamarque F, Ortega-Macías AG, Santa Cruz-Pavlovich FJ, Gonzalez-De la Rosa A, Armendariz-Borunda J, Santos A, Navarro-Partida J. Nutraceuticals: A Promising Therapeutic Approach in Ophthalmology. Nutrients 2022; 14:5014. [PMID: 36501043 PMCID: PMC9740859 DOI: 10.3390/nu14235014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/27/2022] Open
Abstract
Oxidative stress represents one of the main factors driving the pathophysiology of multiple ophthalmic conditions including presbyopia, cataracts, dry eye disease (DED), glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy (DR). Currently, different studies have demonstrated the role of orally administered nutraceuticals in these diseases. For instance, they have demonstrated to improve lens accommodation in presbyopia, reduce protein aggregation in cataracts, ameliorate tear film stability, break up time, and tear production in dry eye, and participate in the avoidance of retinal neuronal damage and a decrease in intraocular pressure in glaucoma, contribute to the delayed progression of AMD, or in the prevention or treatment of neuronal death in diabetic retinopathy. In this review, we summarized the nutraceuticals which have presented a positive impact in ocular disorders, emphasizing the clinical assays. The characteristics of the different types of nutraceuticals are specified along with the nutraceutical concentration used to achieve a therapeutic outcome in ocular diseases.
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Affiliation(s)
| | | | - Alan Gabriel Ortega-Macías
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Campus Guadalajara, Zapopan 45138, Mexico
| | | | - Alejandro Gonzalez-De la Rosa
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Campus Guadalajara, Zapopan 45138, Mexico
- Centro de Retina Medica y Quirurgica, S.C., Hospital Puerta de Hierro, Zapopan 45116, Mexico
| | - Juan Armendariz-Borunda
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Campus Guadalajara, Zapopan 45138, Mexico
- Department of Molecular Biology and Genomics, Institute for Molecular Biology and Gene Therapy, University of Guadalajara, Guadalajara 44340, Mexico
| | - Arturo Santos
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Campus Guadalajara, Zapopan 45138, Mexico
- Centro de Retina Medica y Quirurgica, S.C., Hospital Puerta de Hierro, Zapopan 45116, Mexico
| | - Jose Navarro-Partida
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Campus Guadalajara, Zapopan 45138, Mexico
- Centro de Retina Medica y Quirurgica, S.C., Hospital Puerta de Hierro, Zapopan 45116, Mexico
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85
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Pham JH, Johnson GA, Rangan RS, Amankwa CE, Acharya S, Stankowska DL. Neuroprotection of Rodent and Human Retinal Ganglion Cells In Vitro/Ex Vivo by the Hybrid Small Molecule SA-2. Cells 2022; 11:cells11233741. [PMID: 36497005 PMCID: PMC9735605 DOI: 10.3390/cells11233741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
The mechanisms underlying the neuroprotective effects of the hybrid antioxidant-nitric oxide donating compound SA-2 in retinal ganglion cell (RGC) degeneration models were evaluated. The in vitro trophic factor (TF) deprivation model in primary rat RGCs and ex vivo human retinal explants were used to mimic glaucomatous neurodegeneration. Cell survival was assessed after treatment with vehicle or SA-2. In separate experiments, tert-Butyl hydroperoxide (TBHP) and endothelin-3 (ET-3) were used in ex vivo rat retinal explants and primary rat RGCs, respectively, to induce oxidative damage. Mitochondrial and intracellular reactive oxygen species (ROS) were assessed following treatments. In the TF deprivation model, SA-2 treatment produced a significant decrease in apoptotic and dead cell counts in primary RGCs and a significant increase in RGC survival in ex vivo human retinal explants. In the oxidative stress-induced models, a significant decrease in the production of ROS was observed in the SA-2-treated group compared to the vehicle-treated group. Compound SA-2 was neuroprotective against various glaucomatous insults in the rat and human RGCs by reducing apoptosis and decreasing ROS levels. Amelioration of mitochondrial and cellular oxidative stress by SA-2 may be a potential therapeutic strategy for preventing neurodegeneration in glaucomatous RGCs.
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Affiliation(s)
- Jennifer H. Pham
- Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- The North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Gretchen A. Johnson
- Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- The North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Rajiv S. Rangan
- Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- The North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Charles E. Amankwa
- Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- The North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Suchismita Acharya
- Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- The North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Correspondence: (S.A.); (D.L.S.)
| | - Dorota L. Stankowska
- Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- The North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Correspondence: (S.A.); (D.L.S.)
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86
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Du R, Li D, Zhu M, Zheng L, Ren K, Han D, Li L, Ji J, Fan Y. Cell senescence alters responses of porcine trabecular meshwork cells to shear stress. Front Cell Dev Biol 2022; 10:1083130. [PMID: 36478743 PMCID: PMC9721263 DOI: 10.3389/fcell.2022.1083130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/04/2022] [Indexed: 10/05/2024] Open
Abstract
Mechanical microenvironment and cellular senescence of trabecular meshwork cells (TMCs) are suspected to play a vital role in primary open-angle glaucoma pathogenesis. However, central questions remain about the effect of shear stress on TMCs and how aging affects this process. We have investigated the effect of shear stress on the biomechanical properties and extracellular matrix regulation of normal and senescent TMCs. We found a more significant promotion of Fctin formation, a more obvious realignment of F-actin fibers, and a more remarkable increase in the stiffness of normal cells in response to the shear stress, in comparison with that of senescent cells. Further, as compared to normal cells, senescent cells show a reduced extracellular matrix turnover after shear stress stimulation, which might be attributed to the different phosphorylation levels of the extracellular signal-regulated kinase. Our results suggest that TMCs are able to sense and respond to the shear stress and cellular senescence undermines the mechanobiological response, which may lead to progressive failure of cellular TM function with age.
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Affiliation(s)
- Ruotian Du
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Dongyan Li
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Meng Zhu
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Lisha Zheng
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Keli Ren
- Lab for Biological Imaging and Nanomedicine, National Center for Nanoscience and Technology, Beijing, China
| | - Dong Han
- Lab for Biological Imaging and Nanomedicine, National Center for Nanoscience and Technology, Beijing, China
| | - Long Li
- State Key Laboratory of Nonlinear Mechanics and Beijing Key Laboratory of Engineered Construction and Mechanobiology, Institute of Mechanics, Chinese Academy of Sciences, Beijing, China
| | - Jing Ji
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Yubo Fan
- Key Laboratory of Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
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87
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Luo J, Tan G, Thong KX, Kafetzis KN, Vallabh N, Sheridan CM, Sato Y, Harashima H, Tagalakis AD, Yu-Wai-Man C. Non-Viral Gene Therapy in Trabecular Meshwork Cells to Prevent Fibrosis in Minimally Invasive Glaucoma Surgery. Pharmaceutics 2022; 14:pharmaceutics14112472. [PMID: 36432663 PMCID: PMC9693853 DOI: 10.3390/pharmaceutics14112472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022] Open
Abstract
The primary cause of failure for minimally invasive glaucoma surgery (MIGS) is fibrosis in the trabecular meshwork (TM) that regulates the outflow of aqueous humour, and no anti-fibrotic drug is available for intraocular use in MIGS. The myocardin-related transcription factor/serum response factor (MRTF/SRF) pathway is a promising anti-fibrotic target. This study aims to utilise a novel lipid nanoparticle (LNP) to deliver MRTF-B siRNA into human TM cells and to compare its effects with those observed in human conjunctival fibroblasts (FF). Two LNP formulations were prepared with and without the targeting peptide cΥ, and with an siRNA concentration of 50 nM. We examined the biophysical properties and encapsulation efficiencies of the LNPs, and evaluated the effects of MRTF-B silencing on cell viability, key fibrotic genes expression and cell contractility. Both LNP formulations efficiently silenced MRTF-B gene and were non-cytotoxic in TM and FF cells. The presence of cΥ made the LNPs smaller and more cationic, but had no significant effect on encapsulation efficiency. Both TM and FF cells also showed significantly reduced contractibility after transfection with MRTF-B siRNA LNPs. In TM cells, LNPs with cΥ achieved a greater decrease in contractility compared to LNPs without cΥ. In conclusion, we demonstrate that the novel CL4H6-LNPs are able to safely and effectively deliver MRTF-B siRNA into human TM cells. LNPs can serve as a promising non-viral gene therapy to prevent fibrosis in MIGS.
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Affiliation(s)
- Jinyuan Luo
- Faculty of Life Sciences & Medicine, King’s College London, London SE1 7EH, UK
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Greymi Tan
- Faculty of Life Sciences & Medicine, King’s College London, London SE1 7EH, UK
| | - Kai Xin Thong
- Faculty of Life Sciences & Medicine, King’s College London, London SE1 7EH, UK
| | | | - Neeru Vallabh
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK
| | - Carl M. Sheridan
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK
| | - Yusuke Sato
- Faculty of Pharmaceutical Sciences, Hokkaido University, Kita-12, Nishi-6, Kita-ku, Sapporo 060-0812, Japan
| | - Hideyoshi Harashima
- Faculty of Pharmaceutical Sciences, Hokkaido University, Kita-12, Nishi-6, Kita-ku, Sapporo 060-0812, Japan
| | - Aristides D. Tagalakis
- Department of Biology, Edge Hill University, Ormskirk L39 4QP, UK
- Correspondence: (A.D.T.); (C.Y.-W.-M.); Tel.: +44-(0)1695-650923 (A.D.T.); +44-(0)2071-881504 (C.Y.-W.-M.)
| | - Cynthia Yu-Wai-Man
- Faculty of Life Sciences & Medicine, King’s College London, London SE1 7EH, UK
- Correspondence: (A.D.T.); (C.Y.-W.-M.); Tel.: +44-(0)1695-650923 (A.D.T.); +44-(0)2071-881504 (C.Y.-W.-M.)
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Peng Q, Qu B, Sznajder KK, Chen Q, Fu J, He S, Yang X. Exploring the Association Between Resilience and Quality of Life Among Glaucoma Patients: Sleep Disturbance as a Mediating Factor. Front Med (Lausanne) 2022; 9:842864. [PMID: 36438057 PMCID: PMC9682153 DOI: 10.3389/fmed.2022.842864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/18/2022] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Patients with glaucoma may experience many symptoms such as blindness, which seriously affect their quality of life (QoL). Resilience is playing a vital role in enhancing the QoL and well-being of patients with chronic diseases. In addition, sleep disturbance is common in patients with glaucoma, leading to a decline in their QoL. However, there is a dearth of research on whether sleep disturbance plays a mediating role between resilience and QoL among glaucoma patients. OBJECTIVE The aim of this study is to explore the role of sleep disturbance in the relationship between resilience and QoL among glaucoma patients. METHODS From July to December 2019, a cross-sectional survey was conducted on 215 glaucoma patients in an ophthalmic hospital in Liaoning Province. Hierarchical multiple regression (HMR) analyses and structural equation modeling (SEM) were conducted to examine the factors related to QoL and to test the hypothesis that sleep disturbance mediates the relationship between resilience and QoL among glaucoma patients. RESULTS The average QoL score among glaucoma patients was 43.85 ± 14.97 as reported by the Glaucoma Quality of Life-15 (GQL-15) scale, where a higher scores indicating a poorer QoL. Resilience was found to be linked with a lower QoL score (P < 0.01), while sleep disturbance was associated with a higher QoL score (P < 0.01). When sleep disturbance was included in the model as partial mediator, the path coefficients for the association between resilience and QoL score was significantly decreased (a*b = -0.1, BCa95% CI: -0.154∼-0.045). CONCLUSION Findings of this study reflected that QoL among glaucoma patients in China was poor. Resilience was found to be an important positive factor, which could result in the improvement of QoL. Furthermore, sleep disturbance mediated the relationship between resilience and QoL among patients with glaucoma, thereby reducing the positive impact of resilience on QoL in glaucoma patients. Efforts to improve QoL among glaucoma patients may benefit from interventions that enhance the levels of resilience and promote healthy sleep.
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Affiliation(s)
- Qinqi Peng
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Bo Qu
- Department of Ophthalmology, Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Laboratory of Lens Research of Liaoning Province, Shenyang, China
| | - Kristin K. Sznajder
- Department of Public Health, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Qiongli Chen
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Jiahui Fu
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Shan He
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Xiaoshi Yang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
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89
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Turner ML, Taha AM, Yonamine S, Yu Y, Saifee M, Yang M, Ying GS, Han Y, Oatts JT. Clinical and Visual Field Outcomes Following Minimally Invasive Glaucoma Surgery Combined with Cataract Surgery. Clin Ophthalmol 2022; 16:3193-3203. [PMID: 36199804 PMCID: PMC9529010 DOI: 10.2147/opth.s381368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/21/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the change in Humphrey visual field and clinical parameters after minimally invasive glaucoma surgery combined with cataract surgery. Patients and Methods Patients undergoing minimally invasive glaucoma surgery combined with cataract surgery in a multicenter retrospective case series between 2013 and 2021 with reliable preoperative and 12 to 18 month postoperative visual field measurements were included. Devices included iStent, XEN, and Hydrus. Clinical parameters were compared with a generalized linear model with generalized estimating equations between preoperative and postoperative visits including best corrected visual acuity, intraocular pressure, number of glaucoma medications and visual fields. Visual field metrics included mean deviation (MD), pattern standard deviation (PSD), visual field index (VFI), and Collaborative Initial Glaucoma Treatment Study (CIGTS) score of total deviation probability and pattern deviation probability. Results Forty-four eyes from 39 patients were included. During the follow up period, visual acuity improved from 0.23±0.17 to 0.10±0.14 logMAR (mean ± standard deviation, p<0.001), number of glaucoma medications was reduced from 2.68±1.06 to 1.46±1.32 (p<0.001), and intraocular pressure decreased from 17.08±4.23 mmHg to 14.92±3.13 mmHg (p=0.003). Differences across devices were negligible. The only significant difference was a greater reduction in number of glaucoma medications in the XEN group (p<0.001). There were no significant changes in the global parameters of VFI, MD, PSD, or CIGTS. Conclusion Overall, minimally invasive glaucoma surgery combined with cataract surgery appears to be effective at stabilizing visual field function, reducing intraocular pressure, reducing number of glaucoma medications, and improving visual acuity over a 12 to 18 month follow-up period across MIGS devices.
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Affiliation(s)
- Marcus L Turner
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA
| | - Abu M Taha
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA
| | - Sean Yonamine
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA
| | - Yinxi Yu
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Murtaza Saifee
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA
| | - Mike Yang
- Prism Eye Institute, Oakville, ON, Canada
| | - Gui-Shuang Ying
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ying Han
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA
| | - Julius T Oatts
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA,Correspondence: Julius T Oatts, Department of Ophthalmology, University of California, San Francisco, 490 Illinois Street, San Francisco, CA, 94158, USA, Tel +1 415 353 2800, Fax +1 415 353 2468, Email
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Soundararajan A, Wang T, Sundararajan R, Wijeratne A, Mosley A, Harvey FC, Bhattacharya S, Pattabiraman PP. Multiomics analysis reveals the mechanical stress-dependent changes in trabecular meshwork cytoskeletal-extracellular matrix interactions. Front Cell Dev Biol 2022; 10:874828. [PMID: 36176278 PMCID: PMC9513235 DOI: 10.3389/fcell.2022.874828] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 08/12/2022] [Indexed: 11/29/2022] Open
Abstract
Trabecular meshwork (TM) tissue is subjected to constant mechanical stress due to the ocular pulse created by the cardiac cycle. This brings about alterations in the membrane lipids and associated cell-cell adhesion and cell-extracellular matrix (ECM) interactions, triggering intracellular signaling responses to counter mechanical insults. A loss of such response can lead to elevated intraocular pressure (IOP), a major risk factor for primary open-angle glaucoma. This study is aimed to understand the changes in signaling responses by TM subjected to mechanical stretch. We utilized multiomics to perform an unbiased mRNA sequencing to identify changes in transcripts, mass spectrometry- (MS-) based quantitative proteomics for protein changes, and multiple reaction monitoring (MRM) profiling-based MS and high-performance liquid chromatography (HPLC-) based MS to characterize the lipid changes. We performed pathway analysis to obtain an integrated map of TM response to mechanical stretch. The human TM cells subjected to mechanical stretch demonstrated an upregulation of protein quality control, oxidative damage response, pro-autophagic signal, induction of anti-apoptotic, and survival signaling. We propose that mechanical stretch-induced lipid signaling via increased ceramide and sphingomyelin potentially contributes to increased TM stiffness through actin-cytoskeleton reorganization and profibrotic response. Interestingly, increased phospholipids and diacylglycerol due to mechanical stretch potentially enable cell membrane remodeling and changes in signaling pathways to alter cellular contractility. Overall, we propose the mechanistic interplay of macromolecules to bring about a concerted cellular response in TM cells to achieve mechanotransduction and IOP regulation when TM cells undergo mechanical stretch.
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Affiliation(s)
- Avinash Soundararajan
- Department of Ophthalmology, Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Ting Wang
- Department of Ophthalmology, Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, United States
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Rekha Sundararajan
- Department of Ophthalmology, Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Aruna Wijeratne
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, United States
- Center for Proteome Analysis, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Amber Mosley
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, United States
- Center for Proteome Analysis, Indiana University School of Medicine, Indianapolis, IN, United States
- Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Faith Christine Harvey
- Bascom Palmer Eye Institute, Miller School of Medicine at University of Miami, Miami, FL, United States
- Miami Integrative Metabolomics Research Center, Miami, FL, United States
| | - Sanjoy Bhattacharya
- Bascom Palmer Eye Institute, Miller School of Medicine at University of Miami, Miami, FL, United States
- Miami Integrative Metabolomics Research Center, Miami, FL, United States
| | - Padmanabhan Paranji Pattabiraman
- Department of Ophthalmology, Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, United States
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, United States
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91
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Study to Identify and Evaluate Predictor Factors for Primary Open-Angle Glaucoma in Tertiary Prophylactic Actions. J Pers Med 2022; 12:jpm12091384. [PMID: 36143169 PMCID: PMC9506575 DOI: 10.3390/jpm12091384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/04/2022] [Accepted: 08/24/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this study is to develop a predictive model with several explanatory variables that can guide ophthalmologists to make a more objective assessment of the evolution of open-angle glaucoma (OAG) during tertiary prevention. Objectives: The evaluation of risk factors and different predictors of symptom progression between patients with POAG and non-glaucoma patients (NG), as well as between primary open-angle glaucoma with high intraocular pressure (POAG) and primary open-angle glaucoma with normal intraocular pressure (NTG), in tertiary prophylactic activities. Methods: This research is an analytical epidemiological study of a prospective cohort. For the study, we took into account personal medical history, physical ophthalmological examination, intraocular pressure (IOP) values, and visual field (VF) parameters, examined with the Opto AP-300 Automated Perimeter using the “fast threshold” strategy. The results of gonioscopy were inconsistently recorded; they were not considered in the study due to missing values, the processing of which would have seriously distorted the statistical analysis. Ophthalmological examination was completed with a dichotomous questionnaire entitled “Symptom Inventory”, made according to the accusations of patients resulting from a “focus group” study. The study was carried out in the ophthalmology office within the Integrated Outpatient Clinic of the Emergency Clinical Hospital of Oradea, Bihor County (IOCECHO) between January−December 2021. The threshold of statistical significance was defined for p value < 0.05. The obtained results were statistically processed with specialized software SPSS 22. Results: The study included 110 people, of which 71 (64.54%) had POAG (IOP > 21 mmHg) and 39 people (35.46%) had NTG (IOP < 21 mmHg), the two groups being statistically significantly different (χ2 = 9.309, df = 1, p = 0.002). For the POAG group, glaucomatous loss was early, AD < −6 dB, according to the staging of glaucomatous disease, HODAPP classification. In addition, the groups of POAG and NTG patients was compared with a group of 110 NG patients, these three groups being statistically significantly different (χ2 = 34.482, df = 2, p = 0.000). Analysis of confounding factors (age, sex, residence, marital status) shows a statistically significant relationship only for age (F = 2.381, df = 40, p = 0.000). Sex ratio for the study groups = 5.11 for OAG and =5.87 for NG. After treatment (prostaglandin analogues and neuroprotective drugs) IOP decreased statistically significantly for both POAG and NTG. Conclusions: this study identified possible predictors of OAG, at the 5% level (risk factors and symptoms as independent variables) using a dichotomous questionnaire tool with a complementary role in tertiary prophylactic activities. The implementation of the focus group interview results as a socio-human research technique will be supportive to clinicians.
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Singh A, Kumar T, Velagala VR, Thakre S, Joshi A. The Actions of Lithium on Glaucoma and Other Senile Neurodegenerative Diseases Through GSK-3 Inhibition: A Narrative Review. Cureus 2022; 14:e28265. [PMID: 36158406 PMCID: PMC9491486 DOI: 10.7759/cureus.28265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 08/22/2022] [Indexed: 11/27/2022] Open
Abstract
Glaucoma can be described as a set of progressive optic neuropathies. They cause a gradual, irreversible loss of the field of view, which concludes in complete blindness. Evidence suggests that patients who have glaucoma face a greater risk of suffering from senile dementia. Dementia is a group of conditions that occur in old age individuals. Neurodegeneration is a characteristic pathological feature of dementia, the progression of which causes a decline in cognition, which may be accompanied by memory loss. Severe dementia in old individuals usually presents as Alzheimer’s disease, which significantly contributes to a load of dementia in India. Parkinsonism is another common neurodegenerative disease that is known to occur in the elderly. The WNT (Wingless-related integration site)/β-catenin pathway is a multistep process that is responsible for the regulation of various cellular functions. Lithium can up-regulate this pathway by disrupting Glycogen synthase kinase-3β (GSK-3β). This action of Lithium can effectively counteract neuroinflammation and neurodegeneration. The current use of Lithium remains majorly confined to its use for episodes of mania in bipolar disorder (BD). However, recent literature gives insight into how Lithium can improve the visual field in glaucomatous eyes. Symptomatic improvement after lithium administration is seen as it has neuroprotective actions on the retinal ganglion cells (RGCs). Prolonged lithium use improves axonal regeneration and neuronal survival. Lithium also improves the worsening of symptoms in other dementia-related neurodegenerative diseases like Alzheimer’s and Parkinsonism. The physiological actions of Lithium can be utilized in providing effective, holistic therapy options in pathologically related senile degenerative disorders. Significantly better results can be obtained if Lithium therapy is given in conjunction with the drugs used to manage these disorders.
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93
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Krzysztofik M, Zygadło D, Trybek P, Jarosz J, Zając A, Rolnick N, Wilk M. Resistance Training with Blood Flow Restriction and Ocular Health: A Brief Review. J Clin Med 2022; 11:4881. [PMID: 36013119 PMCID: PMC9410392 DOI: 10.3390/jcm11164881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/06/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the many health benefits of resistance training, it has been suggested that high-intensity resistance exercise is associated with acute increases in intraocular pressure which is a significant risk factor for the development of glaucomatous optic nerve damage. Therefore, resistance training using a variety of forms (e.g., resistance bands, free weights, weight machines, and bodyweight) may be harmful to patients with or at risk of glaucoma. An appropriate solution for such people may involve the combination of resistance training and blood flow restriction (BFR). During the last decade, the BFR (a.k.a. occlusion or KAATSU training) method has drawn great interest among health and sports professionals because of the possibility for individuals to improve various areas of fitness and performance at lower exercise intensities. In comparison to studies evaluating the efficiency of BFR in terms of physical performance and body composition changes, there is still a paucity of empirical studies concerning safety, especially regarding ocular health. Although the use of BFR during resistance training seems feasible for glaucoma patients or those at risk of glaucoma, some issues must be investigated and resolved. Therefore, this review provides an overview of the available scientific data describing the influence of resistance training combined with BFR on ocular physiology and points to further directions of research.
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Affiliation(s)
- Michał Krzysztofik
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland
| | - Dorota Zygadło
- Faculty of Science and Technology, University of Silesia in Katowice, 41-500 Chorzów, Poland
| | - Paulina Trybek
- Faculty of Science and Technology, University of Silesia in Katowice, 41-500 Chorzów, Poland
| | - Jakub Jarosz
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland
| | - Adam Zając
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland
| | - Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, Bronx, New York, NY 10468, USA
| | - Michał Wilk
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland
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94
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Musa I, Bansal S, Kaleem MA. Barriers to Care in the Treatment of Glaucoma: Socioeconomic Elements That Impact the Diagnosis, Treatment, and Outcomes in Glaucoma Patients. CURRENT OPHTHALMOLOGY REPORTS 2022; 10:85-90. [PMID: 35911786 PMCID: PMC9325663 DOI: 10.1007/s40135-022-00292-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 11/27/2022]
Abstract
Purpose of Review This article reviews socioeconomic elements that impact the access to glaucoma care, early intervention in susceptible patients, and longevity of treatment and patient compliance in various demographic groups. Recent Findings Socioeconomic factors such as insurance eligibility, education, income, marital status, and access to technology can deeply impact the diagnosis and long-term treatment of glaucoma patients. Depending on the severity, and/or urgency of care, many individuals who face these barriers forgo annual eye exams, leading to a higher incidence of untreated glaucoma. Summary Early intervention and regular follow-up are essential for patient compliance in the management of glaucoma. Routine eye care leads to earlier detection and can improve management options and reduce the severity of disease burden.
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Affiliation(s)
| | - Surbhi Bansal
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA USA
| | - Mona A Kaleem
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD USA
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95
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Lommatzsch C, Rothaus K, Schopmeyer L, Feldmann M, Bauer D, Grisanti S, Heinz C, Kasper M. Elevated endothelin-1 levels as risk factor for an impaired ocular blood flow measured by OCT-A in glaucoma. Sci Rep 2022; 12:11801. [PMID: 35821224 PMCID: PMC9276731 DOI: 10.1038/s41598-022-15401-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022] Open
Abstract
The purpose of this study was to ascertain whether a correlation exists between glaucoma-associated alteration of ocular vascular haemodynamics and endothelin-1 (ET-1) levels exist. Eyes of patients with cataract (n = 30) or glaucoma (n = 68) were examined with optical coherence tomography (OCT) and OCT-angiography (OCT-A; AngioVue™-RTVue-XR; Optovue, Fremont, California, USA). The peripapillary and the macular vessel density (VD) values were measured. Inferior and superior retinal nerve fibre layer (RNFL) thickness loss was used for further OCT staging. Aqueous humour of the examined eye and plasma were sampled during cataract or glaucoma surgery and analysed by means of ELISA to determine their ET-1 level. Glaucoma eyes are characterised by reductions in RNFL thickness and VD that correlate significantly with the OCT GSS score. Peripheral and ocular ET-1 level were significantly elevated in patients with glaucoma and correlate positively with the OCT-GSS score of the entire study population. Peripapillary and macula VD of glaucoma patients correlates negatively with plasma ET-1 levels. Multivariable analysis showed a subordinate role of intraocular pressure predictive factor for impaired retinal blood flow compared with plasma ET-1 level in glaucoma. Peripheral ET-1 level serves as risk factor for detection of ocular blood flow changes in the optic nerve head region of glaucomatous eyes.
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Affiliation(s)
- Claudia Lommatzsch
- Department of Ophthalmology and Ophtha Lab at St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany. .,Department of Ophthalmology, University of Luebeck, Luebeck, Germany.
| | - Kai Rothaus
- Department of Ophthalmology and Ophtha Lab at St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany
| | | | - Maria Feldmann
- Department of Ophthalmology, Braunschweig Hospital, Braunschweig, Germany
| | - Dirk Bauer
- Department of Ophthalmology and Ophtha Lab at St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany
| | - Swaantje Grisanti
- Department of Ophthalmology, University of Luebeck, Luebeck, Germany
| | - Carsten Heinz
- Department of Ophthalmology and Ophtha Lab at St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany.,Department of Ophthalmology, University of Essen, Essen, Germany
| | - Maren Kasper
- Department of Ophthalmology and Ophtha Lab at St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany
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96
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Dyer KIC, Sanfilippo PG, Yazar S, Craig JE, Hewitt AW, Newnham JP, Mackey DA, Lee SSY. The Relationship Between Fetal Growth and Retinal Nerve Fiber Layer Thickness in a Cohort of Young Adults. Transl Vis Sci Technol 2022; 11:8. [PMID: 35819290 PMCID: PMC9287618 DOI: 10.1167/tvst.11.7.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/30/2022] [Indexed: 12/05/2022] Open
Abstract
Purpose To explore relationships between patterns of fetal anthropometric growth, as reflective of fetal wellbeing, and global retinal nerve fiber layer (RNFL) thickness measured in young adulthood. Methods Participants (n = 481) from within a Western Australian pregnancy cohort study underwent five serial ultrasound scans during gestation, with fetal biometry measured at each scan. Optic disc parameters were measured via spectral-domain optical coherence tomography imaging at a 20-year follow-up eye examination. Generalized estimating equations were used to evaluate differences in global RNFL thickness between groups of participants who had undergone similar growth trajectories based on fetal head circumference (FHC), abdominal circumference (FAC), femur length (FFL), and estimated fetal weight (EFW). Results Participants with consistently large FHCs throughout gestation had significantly thicker global RNFLs than those with any other pattern of FHC growth (P = 0.023), even after adjustment for potential confounders (P = 0.037). Based on model fit statistics, FHC growth trajectory was a better predictor of global RNFL thickness than birth weight or head circumference at birth. RNFL thickness did not vary significantly between groups of participants with different growth trajectories based on FAC, FFL, or EFW. Conclusions FHC growth is associated with RNFL thickness in young adulthood and, moreover, is a better predictor than either birth weight or head circumference at birth. Translational Relevance This research demonstrates an association between intrauterine growth and long-term optic nerve health, providing a basis for further exploring the extent of the influence of fetal wellbeing on clinical conditions linked to RNFL thinning.
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Affiliation(s)
- Kathleen I C Dyer
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Nedlands, Australia
| | - Paul G Sanfilippo
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Nedlands, Australia
- Single Cell and Computational Genomics Laboratory, Garvan Institute of Medical Research, Darlinghurst, Australia
| | - Jamie E Craig
- Eye and Vision, Flinders Health and Medical Institute, Flinders University, Adelaide, Australia
| | - Alex W Hewitt
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Nedlands, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
- School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - John P Newnham
- School of Women's and Infants' Health, The University of Western Australia, Perth, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Nedlands, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
- School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - Samantha S Y Lee
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Nedlands, Australia
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97
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Sabouri S, Pourahmad S, Vermeer KA, Lemij HG, Yousefi S. Pointwise and Region-Wise Course of Visual Field Loss in Patients With Glaucoma. Transl Vis Sci Technol 2022; 11:20. [PMID: 35877094 PMCID: PMC9339695 DOI: 10.1167/tvst.11.7.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose Accurate assessment of visual field (VF) trend may help clinicians devise the optimum treatment regimen. This study was conducted to investigate the behavior of VF sequences using pointwise and region-wise linear, exponential, and sigmoid regression models. Materials and Methods In a retrospective cohort study, 277 eyes of 139 patients with glaucoma who had been followed for at least 7 years were investigated. Linear, exponential, and sigmoid regression models were fitted for each VF test location and Glaucoma Hemifield Test (GHT) region to model the trend of VF loss. The model with the lowest root mean square error (RMSE) was selected as the best fit. Results The mean age (standard deviation [SD]) of the patients was 59.9 years (9.8) with a mean follow-up time of 9.3 (0.7) years. The exponential regression had the best fit based on pointwise and region-wise approaches in 39.3% and 38.1% of eyes, respectively. The results showed a better performance based on sigmoid regression in patients with initial VF sensitivity threshold greater than 22 dB (71.6% in pointwise and 62.2% in region-wise approaches). The overall RMSE of the region-wise regression model was lower than the overall RMSE of the pointwise model. Conclusions In the current study, nonlinear regression models showed a better fit compared to the linear regression models in tracking VF loss behavior. Moreover, findings suggest region-wise analysis may provide a more appropriate approach for assessing VF deterioration. Translational Relevance Findings may confirm a nonlinear progression of VF deterioration in patients with glaucoma.
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Affiliation(s)
- Samaneh Sabouri
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeedeh Pourahmad
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Koenraad A Vermeer
- Rotterdam Ophthalmic Institute, the Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Hans G Lemij
- Rotterdam Ophthalmic Institute, the Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Siamak Yousefi
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Genetics, Genomics, and Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
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98
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Sarenac T, Bečić Turkanović A, Ferme P, Gračner T. A Review of Selective Laser Trabeculoplasty: "The Hype Is Real". J Clin Med 2022; 11:3879. [PMID: 35807163 PMCID: PMC9267824 DOI: 10.3390/jcm11133879] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 12/10/2022] Open
Abstract
Presently, there is no efficacious treatment for glaucomatous optic neuropathy; the current treatment is focused on lowering intraocular pressure (IOP). Studies have demonstrated the safety and efficacy of selective laser trabeculoplasty (SLT) in reducing the IOP in eyes with open-angle (OAG) glaucoma or ocular hypertension (OH). Moreover, the European Glaucoma Society has instated SLT as the first-line or adjunctive treatment in OAG or OH, reiterating its clinical significance. In this review, we outline the old and the new roles of SLT, with an emphasis on clinical practice, and look further into its renewed appeal and future developments.
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Affiliation(s)
- Tomislav Sarenac
- Department of Ophthalmology, University Medical Center Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.S.); (A.B.T.); (P.F.)
- Faculty of Medicine, University of Maribor, Taborska Ulica 8, 2000 Maribor, Slovenia
| | - Anela Bečić Turkanović
- Department of Ophthalmology, University Medical Center Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.S.); (A.B.T.); (P.F.)
| | - Peter Ferme
- Department of Ophthalmology, University Medical Center Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.S.); (A.B.T.); (P.F.)
| | - Tomaž Gračner
- Department of Ophthalmology, University Medical Center Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.S.); (A.B.T.); (P.F.)
- Faculty of Medicine, University of Maribor, Taborska Ulica 8, 2000 Maribor, Slovenia
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99
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Brusini P, Salvetat ML, Zeppieri M. It Is All about Pressure. J Clin Med 2022; 11:jcm11133640. [PMID: 35806926 PMCID: PMC9267730 DOI: 10.3390/jcm11133640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 02/05/2023] Open
Affiliation(s)
- Paolo Brusini
- Department of Ophthalmology, Policlinico “Città di Udine”, 33100 Udine, Italy;
| | - Maria Letizia Salvetat
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy;
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
- Correspondence: ; Tel.: +39-0432-552-743
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100
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Indrischek H, Hammer J, Machate A, Hecker N, Kirilenko B, Roscito J, Hans S, Norden C, Brand M, Hiller M. Vision-related convergent gene losses reveal SERPINE3's unknown role in the eye. eLife 2022; 11:77999. [PMID: 35727138 PMCID: PMC9355568 DOI: 10.7554/elife.77999] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/20/2022] [Indexed: 11/30/2022] Open
Abstract
Despite decades of research, knowledge about the genes that are important for development and function of the mammalian eye and are involved in human eye disorders remains incomplete. During mammalian evolution, mammals that naturally exhibit poor vision or regressive eye phenotypes have independently lost many eye-related genes. This provides an opportunity to predict novel eye-related genes based on specific evolutionary gene loss signatures. Building on these observations, we performed a genome-wide screen across 49 mammals for functionally uncharacterized genes that are preferentially lost in species exhibiting lower visual acuity values. The screen uncovered several genes, including SERPINE3, a putative serine proteinase inhibitor. A detailed investigation of 381 additional mammals revealed that SERPINE3 is independently lost in 18 lineages that typically do not primarily rely on vision, predicting a vision-related function for this gene. To test this, we show that SERPINE3 has the highest expression in eyes of zebrafish and mouse. In the zebrafish retina, serpine3 is expressed in Müller glia cells, a cell type essential for survival and maintenance of the retina. A CRISPR-mediated knockout of serpine3 in zebrafish resulted in alterations in eye shape and defects in retinal layering. Furthermore, two human polymorphisms that are in linkage with SERPINE3 are associated with eye-related traits. Together, these results suggest that SERPINE3 has a role in vertebrate eyes. More generally, by integrating comparative genomics with experiments in model organisms, we show that screens for specific phenotype-associated gene signatures can predict functions of uncharacterized genes.
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Affiliation(s)
- Henrike Indrischek
- Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany
| | - Juliane Hammer
- Center for Regenerative Therapies Dresden, TU Dresden, Dresden, Germany
| | - Anja Machate
- Center for Regenerative Therapies Dresden, TU Dresden, Dresden, Germany
| | - Nikolai Hecker
- Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany
| | | | - Juliana Roscito
- Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany
| | - Stefan Hans
- Center for Regenerative Therapies Dresden, TU Dresden, Dresden, Germany
| | - Caren Norden
- Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany
| | - Michael Brand
- Center for Regenerative Therapies Dresden, TU Dresden, Dresden, Germany
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