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Achiron A, Trivizki O, Knyazer B, Elbaz U, Hecht I, Jeon S, Kanclerz P, Tuuminen R. The Effect of Blue-light Filtering Intraocular Lenses on the Development and Progression of Macular Atrophy in Eyes With Neovascular Age-related Macular Degeneration. Am J Ophthalmol 2024; 266:135-143. [PMID: 38692502 DOI: 10.1016/j.ajo.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE To assess the effect of blue-light filtering (BLF) intraocular lenses (IOLs) on the development and progression of macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD). DESIGN Retrospective, clinical cohort study. METHODS The study included patients with nAMD with anti-vascular endothelial growth factor (VEGF) injections who underwent uneventful cataract surgery between 2007 and 2018 with follow-up until June 2023. Subsequent MA rates were compared between subjects who received a BLF IOL or a non-BLF IOL. All optical coherence tomography scans were manually reviewed in a masked manner regarding patient baseline variables and IOL status by an experienced research technician. By using Heidelberg software, the area of MA was manually evaluated and calculated (mm2) by the program. The overall risk of developing new-onset MA and the effect of IOL type on disease progression were assessed. Death was included as a censoring event. RESULTS Included were 373 eyes of 373 patients (mean age, 78.6 ± 6.7 years at surgery; 67.4% were female). BLF IOLs were implanted in 206 eyes, and non-BLF IOLs were implanted in 167 eyes with comparable follow-up times (3164 ± 1420 days vs 3180 ± 1403 days, respectively, P = .908) and other baseline parameters (age, gender, corrected distance visual acuity, macular thickness, cumulative number of anti-VEGF injections). Nine preexisting and 77 new-onset MA cases were detected, with similar distribution between BLF and non-BLF eyes (P = .598 and P = .399, respectively). Both univariate Kaplan-Meier (P = .366) and multivariate Cox regression analyses adjusted for age and gender showed that BLF-IOLs were comparable to non-BLF IOLs regarding hazard for new-onset MA (hazard ratio [HR], 1.236; 95% CI, 0.784-1.949; P = .363). Final MA area at the last visit was 5.14 ± 4.71 mm2 for BLF IOLs and 8.56 ± 9.17 mm2 for non-BLF IOLs (P = .028), with the mean annual MA area increase of 0.78 ± 0.84 mm2 and 1.26 ± 1.32 mm2, respectively (P = .042). CONCLUSIONS BLF IOLs did not show added benefit over non-BLF IOLs in terms of MA-free survival but were associated with less progression over time in a cohort of patients with nAMD.
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Affiliation(s)
- Asaf Achiron
- School of Medicine, Tel Aviv University, (A.A., O.T., U.E., I.H.) Tel Aviv, Israel; Department of Ophthalmology, Tel Aviv Medical Center, (A.A., O.T.) Tel Aviv, Israel
| | - Omer Trivizki
- School of Medicine, Tel Aviv University, (A.A., O.T., U.E., I.H.) Tel Aviv, Israel; Department of Ophthalmology, Tel Aviv Medical Center, (A.A., O.T.) Tel Aviv, Israel
| | - Boris Knyazer
- Faculty of Health Sciences, Ben-Gurion University of the Negev, (B.K., R.T.) Beer-Sheva, Israel; Department of Ophthalmology, Soroka University Medical Center, (B.K.) Beer-Sheva, Israel
| | - Uri Elbaz
- School of Medicine, Tel Aviv University, (A.A., O.T., U.E., I.H.) Tel Aviv, Israel; Department of Ophthalmology, Rabin Medical Center, Petach-Tikva, (U.E.) Tel Aviv, Israel
| | - Idan Hecht
- School of Medicine, Tel Aviv University, (A.A., O.T., U.E., I.H.) Tel Aviv, Israel; Department of Ophthalmology, Shamir Medical Center, (I.H.) Tel Aviv, Israel; Helsinki Retina Research Group, Faculty of Medicine, University of Helsinki, (I.H., P.K., R.T.) Helsinki, Finland
| | - Sohee Jeon
- Keye Eye Center, (S.J.) Gangnam-gu, Seoul, South Korea
| | - Piotr Kanclerz
- Helsinki Retina Research Group, Faculty of Medicine, University of Helsinki, (I.H., P.K., R.T.) Helsinki, Finland; Hygeia Clinic, (P.K.) Gdańsk, Poland
| | - Raimo Tuuminen
- Faculty of Health Sciences, Ben-Gurion University of the Negev, (B.K., R.T.) Beer-Sheva, Israel; Helsinki Retina Research Group, Faculty of Medicine, University of Helsinki, (I.H., P.K., R.T.) Helsinki, Finland; Department of Ophthalmology, Kymenlaakso Central Hospital, (R.T.) Kotka, Finland.
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Pan RL, Tan QQ, Liao X, Xie LX, Qin SY, Tang YL, Lan CJ. Effect of decentration and tilt on the in vitro optical quality of monofocal and trifocal intraocular lenses. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06490-1. [PMID: 38643424 DOI: 10.1007/s00417-024-06490-1] [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: 10/30/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 04/22/2024] Open
Abstract
PURPOSE To evaluate and compare the effect of decentration and tilt on the optical quality of monofocal and trifocal intraocular lenses (IOL). METHODS Optical quality of a monofocal IOL (AcrySof IQ SN60WF; Alcon Laboratories, Inc., USA) and a trifocal IOL (AcrySof IQ PanOptix; Alcon Laboratories, Inc., USA) was assessed using an in vitro optical bench (OptiSpheric IOL R&D; Trioptics GmbH, Germany). At apertures of 3.0 mm and 4.5 mm, modulation transfer function (MTF) at spatial frequency of 50 lp/mm, MTF curve and the United States Air Force (USAF) resolution test chart of the two IOLs were measured and compared at their focus with different degrees of decentration and tilt. Optical quality at infinity, 60 cm and 40 cm and the through-focus MTF curves were compared when the two IOLs were centered at apertures of 3.0 mm and 4.5 mm. Spectral transmittance of the two IOLs was measured by the UV-visible spectrophotometer (UV 3300 PC; MAPADA, China). RESULTS The SN60WF and the PanOptix filtered blue light from 400 to 500 nm. Both IOLs at the far focus and the PanOptix at the intermediate focus showed a decrease in optical quality with increasing decentration and tilt. The PanOptix demonstrated enhanced optical quality compared to the previous gradient at the near focus at a decentration range of 0.3-0.7 mm with a 3.0 mm aperture, and 0.5 mm with a 4.5 mm aperture, whereas other conditions exhibited diminished optical quality with increasing decentration and tilt at the focus of both IOLs. When the two IOLs were centered, the SN60WF had better optical quality at infinity, while the PanOptix had better optical quality at 60 cm and 40 cm defocus. The optical quality of the SN60WF exceeded that of the PanOptix at far focus, with a 3 mm aperture decentration up to 0.7 mm and a 4.5 mm aperture decentration up to 0.3 mm; this observation held true for all tilts, irrespective of aperture size. As both decentration and tilt increased, the optical quality of the SN60WF deteriorated more rapidly than that of the PanOptix at the far focal point. CONCLUSIONS The SN60WF showed a decrease in optical quality with increasing decentration and tilt. Optical quality of the PanOptix at the near focus increased in some decentration conditions and decreased in some conditions, while it showed a decrease at the other focuses with increasing decentration. While tilt only had a negative effect on optical quality. When both IOLs were centered, the PanOptix provided a wider range of vision, while the SN60WF provided better far distance vision. At the far focus, the SN60WF has better resistance to tilt than the PanOptix, but the optical quality degrades more quickly when decentered and tilted.
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Affiliation(s)
- Ruo-Lin Pan
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Qing-Qing Tan
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xuan Liao
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Li-Xuan Xie
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Su-Yun Qin
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yu-Ling Tang
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Chang-Jun Lan
- Chengdu Eastern Aier Eye Hospital, 388 Shuang Lin Road, Chengdu, 610051, Sichuan, China.
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Hecht I, Kanclerz P, Tuuminen R. Secondary outcomes of lens and cataract surgery: More than just “best-corrected visual acuity”. Prog Retin Eye Res 2022:101150. [DOI: 10.1016/j.preteyeres.2022.101150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/07/2022] [Accepted: 11/20/2022] [Indexed: 12/12/2022]
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Selective blue-filtering spectacle lens protected primary porcine RPE cells against light emitting diode-induced cell damage. PLoS One 2022; 17:e0268796. [PMID: 35609057 PMCID: PMC9129023 DOI: 10.1371/journal.pone.0268796] [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: 11/02/2021] [Accepted: 05/09/2022] [Indexed: 11/19/2022] Open
Abstract
This study aimed to investigate whether use of a selective-blue-filtering (S-BF) lens can protect cultured primary porcine RPE cells against photo-irradiation. Transmittance of S-BF and UV-filtering (UVF) lenses was characterised spectrophotometrically. RPE cells were exposed to 1700 lux of white (peak λ at 443 and 533 nm; 0.44 mW/cm2) or blue (peak λ at 448 and 523 nm; 0.85 mW/cm2) LED light for 16 h to evaluate the influence of light source on the culture. The effect of the S-BF and UVF ophthalmic lenses on RPE cell cultures under blue light irradiation was then investigated. Cell viability was compared using trypan blue and MTT assays. Intracellular ROS production was detected by a fluorescein probe CM-H2DCFDA. Expression levels of catalase and Prdx3 were analysed by western blot. Trypan blue staining showed blue light caused more cell death than no light (p = 0.001) or white light (p = 0.005). MTT assay supported the hypothesis that exposure to blue light damaged RPE cells more severely than no light (p = 0.002) or white light (p = 0.014). Under blue light, use of the S-BF lens, which blocked 17% more blue light than the UVF lens, resulted in higher cellular viability (S-BF: 93.4±1.4% vs UVF: 90.6±1.4%; p = 0.022; MTT: 1.2-fold; p = 0.029). Blue and white light both significantly increased ROS production. The S-BF lens protected cells, resulting in lower levels of ROS and higher expression of catalase and Prdx3. To conclude, blue LED light exposure resulted in significant cytotoxicity to RPE cells. Partial blockage of blue light by an S-BF lens led to protective effects against retinal phototoxicity, which were mediated by reduction of ROS and increased levels of antioxidant enzymes.
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Achiron A, Elbaz U, Hecht I, Spierer O, Einan-Lifshitz A, Karesvuo P, Laine I, Tuuminen R. The Effect of Blue-Light Filtering Intraocular Lenses on the Development and Progression of Neovascular Age-Related Macular Degeneration. Ophthalmology 2020; 128:410-416. [PMID: 32717342 DOI: 10.1016/j.ophtha.2020.07.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To assess the effect of blue-light filtering (BLF) intraocular lenses (IOLs) on the prevention of neovascular age-related macular degeneration (nAMD) after cataract surgery. DESIGN Cohort study. PARTICIPANTS Patients who underwent uneventful cataract surgery between 2007 and 2018 at the Ophthalmology Unit of Kymenlaakso Central Hospital, Kotka, Finland. METHODS Subsequent nAMD rates were compared between patients who received BLF IOLs and those who received non-BLF IOLs. Kaplan-Meier and Cox regression analyses for the overall risk of nAMD developing were assessed. Best-corrected visual acuity (BCVA), foveal thickness, treatment interval, and total number of intravitreal injections were secondary outcomes. A separate analysis was performed on patients with pre-existing nAMD to assess the effect of BLF IOLs on nAMD progression. A single eye of each patient was included. MAIN OUTCOME MEASURE Neovascular age-related macular degeneration-free survival. RESULTS Included were 11 397 eyes of 11 397 patients with a mean age of 75.4 ± 8.3 years (62.5% women). The BLF IOL was used in 5425 eyes (47.6%), and the non-BLF IOL was used in 5972 eyes (52.4%). During follow-up (BLF IOL group, 55.2 ± 34.1 months; non-BLF IOL group, 50.5 ± 30.1 months; P < 0.001), 164 cases of new-onset nAMD were recorded (BLF group, n = 88; non-BLF group, n = 76). The nAMD-free survival was similar between the groups (P = 0.465, log-rank test). In a Cox regression analysis controlling for age, gender, and a documented diagnosis of macular degeneration, the use of a BLF IOL was not predictive of nAMD development (hazard ratio [HR], 1.075; 95% confidence interval [CI], 0.79-1.47; P = 0.652). In nAMD patients, secondary clinical outcomes at 1 year were comparable for BCVA (0.57 ± 0.4 logarithm of the minimum angle of resolution vs. 0.45 ± 0.4 logarithm of the minimum angle of resolution; P = 0.136), foveal thickness (285 ± 109 μm vs. 299 ± 103μm; P = 0.527), number of anti-vascular endothelial growth factor injections (6.5 ± 2.5 vs. 6.2 ± 2.7; P = 0.548), and treatment interval (7.5 ± 2.4 weeks vs. 8.1 ± 2.4 weeks; P = 0.271) for BLF and non-BLF IOLs, respectively. Similarly to patients in whom nAMD developed after the surgery, among patients with nAMD before surgery (BLF, n = 71; non-BLF, n = 74), the clinical outcomes again were comparable (all P > 0.05). CONCLUSIONS In a large cohort of patients who underwent cataract surgery, the use of a BLF IOL resulted in no apparent advantage over a non-BLF IOL in the incidence of nAMD or its progression, nor in clinical variables related to nAMD severity.
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Affiliation(s)
- Asaf Achiron
- Department of Ophthalmology, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, and Bristol Eye Hospital, Bristol, United Kingdom
| | - Uri Elbaz
- Department of Ophthalmology, Rabin Medical Center, Petach-Tikva, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Idan Hecht
- Department of Ophthalmology, Shamir Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland
| | - Oriel Spierer
- Department of Ophthalmology, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, and Bristol Eye Hospital, Bristol, United Kingdom
| | - Adi Einan-Lifshitz
- Department of Ophthalmology, Shamir Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Petteri Karesvuo
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland
| | - Ilkka Laine
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland; Department of Automation and Electrical Engineering, Aalto University, Helsinki, Finland
| | - Raimo Tuuminen
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland; Eye Centre, Kymenlaakso Central Hospital, Kotka, Finland.
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Hammond BR, Sreenivasan V, Suryakumar R. The Effects of Blue Light-Filtering Intraocular Lenses on the Protection and Function of the Visual System. Clin Ophthalmol 2019; 13:2427-2438. [PMID: 31824137 PMCID: PMC6901063 DOI: 10.2147/opth.s213280] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/04/2019] [Indexed: 12/20/2022] Open
Abstract
Filtration of high-energy short-wave visible light (blue light) to improve vision and protect against damage has evolved both in aquatic animals and terrestrial species. In humans, pigments in the inner layer of the macula absorb wavelengths between 400 and 520 nm and function to improve visual performance. In patients who undergo cataract surgery, replacing cataractous lenses with artificial intraocular lenses (IOLs) that do not mimic normal healthy adult lenses could result in preventable negative visual effects, including glare disability. Blue light-filtering (BLF) IOLs were designed to filter short-wave light in addition to ultraviolet light and mimic the natural crystalline lens. Current studies indicate that BLF IOLs may provide protection from blue light-induced retinal damage and slow the development and progression of age-related macular degeneration. Additionally, BLF IOLs have been shown to improve chromatic contrast, reduce photostress recovery time, reduce glare disability and discomfort, and generally improve visual performance under glare conditions. Although a number of concerns have been raised about the relative risks versus the benefits of BLF IOLs, recent studies reported no adverse effects on visual function or contrast under photopic conditions, no long-term effects on color vision, and no detrimental effects on circadian rhythms with BLF IOLs. Based on the current understanding of the field, evidence suggests that BLF IOLs would be returning the eye to a more natural state compared with non-BLF lenses.
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Affiliation(s)
- Billy R Hammond
- Department of Psychology, Vision Sciences Laboratory, University of Georgia, Athens, GA, USA
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Vila N, Siblini A, Esposito E, Bravo-Filho V, Zoroquiain P, Aldrees S, Logan P, Arias L, Burnier MN. Blue-light filtering alters angiogenic signaling in human retinal pigmented epithelial cells culture model. BMC Ophthalmol 2017; 17:198. [PMID: 29096624 PMCID: PMC5667496 DOI: 10.1186/s12886-017-0592-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 10/25/2017] [Indexed: 12/21/2022] Open
Abstract
Background Light exposure and more specifically the spectrum of blue light contribute to the oxidative stress in Age-related macular degeneration (AMD). The purpose of the study was to establish whether blue light filtering could modify proangiogenic signaling produced by retinal pigmented epithelial (RPE) cells under different conditions simulating risk factors for AMD. Methods Three experiments were carried out in order to expose ARPE-19 cells to white light for 48 h with and without blue light-blocking filters (BLF) in different conditions. In each experiment one group was exposed to light with no BLF protection, a second group was exposed to light with BLF protection, and a control group was not exposed to light. The ARPE-19 cells used in each experiment prior to light exposure were cultured for 24 h as follows: Experiment 1) Normoxia, Experiment 2) Hypoxia, and Experiment 3) Lutein supplemented media in normoxia. The media of all groups was harvested after light exposure for sandwich ELISA-based assays to quantify 10 pro-angiogenic cytokines. Results A significant decrease in angiogenin secretion levels and a significant increase in bFGF were observed following light exposure, compared to dark conditions, in both normoxia and hypoxia conditions. With the addition of a blue light-blocking filter in normoxia, a significant increase in angiogenin levels was observed. Although statistical significance was not achieved, blue light filters reduce light-induced secretion of bFGF and VEGF to near normal levels. This trend is also observed when ARPE-19 cells are grown under hypoxic conditions and when pre-treated with lutein prior to exposure to experimental conditions. Conclusions Following light exposure, there is a decrease in angiogenin secretion by ARPE-19 cells, which was abrogated with a blue light - blocking filter. Our findings support the position that blue light filtering affects the secretion of angiogenic factors by retinal pigmented epithelial cells under normoxic, hypoxic, and lutein-pretreated conditions in a similar manner.
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Affiliation(s)
- Natalia Vila
- Henry C. Witelson Ocular Pathology Laboratory, Pathology Department, McGill University, Montreal, Canada. .,Hospital Universitari de Bellvitge, Ophthalmology Department, Barcelona University, Barcelona, Spain.
| | - Aya Siblini
- Henry C. Witelson Ocular Pathology Laboratory, Pathology Department, McGill University, Montreal, Canada
| | - Evangelina Esposito
- Henry C. Witelson Ocular Pathology Laboratory, Pathology Department, McGill University, Montreal, Canada
| | - Vasco Bravo-Filho
- Henry C. Witelson Ocular Pathology Laboratory, Pathology Department, McGill University, Montreal, Canada
| | - Pablo Zoroquiain
- Henry C. Witelson Ocular Pathology Laboratory, Pathology Department, McGill University, Montreal, Canada
| | - Sultan Aldrees
- Henry C. Witelson Ocular Pathology Laboratory, Pathology Department, McGill University, Montreal, Canada
| | - Patrick Logan
- Henry C. Witelson Ocular Pathology Laboratory, Pathology Department, McGill University, Montreal, Canada
| | - Lluis Arias
- Hospital Universitari de Bellvitge, Ophthalmology Department, Barcelona University, Barcelona, Spain
| | - Miguel N Burnier
- Henry C. Witelson Ocular Pathology Laboratory, Pathology Department, McGill University, Montreal, Canada
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Effect of photodynamic therapy based on indocyanine green on expression of apoptosis-related genes in human gingival fibroblast cells. Photodiagnosis Photodyn Ther 2017; 19:33-36. [DOI: 10.1016/j.pdpdt.2017.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/04/2017] [Accepted: 04/09/2017] [Indexed: 11/21/2022]
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Ultraviolet or blue-filtering intraocular lenses: what is the evidence? Eye (Lond) 2016; 30:215-21. [PMID: 26742866 DOI: 10.1038/eye.2015.267] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 11/25/2015] [Indexed: 11/08/2022] Open
Abstract
Cataract surgery was revolutionised by the introduction of modern intraocular lenses in the late 1940's. By the late 1960's to 1970's evidence had emerged that short-wavelength light caused phototoxicity at the retina and retinal pigment epithelium. By the early 1980's ultraviolet filters had been incorporated into intraocular lenses. This caused intense controversy, as there was concern that the UV-filtering chromophore might leach out into the eye causing toxicity. With the arrival of blue-filtering intraocular lenses (BFIOLs) in 1990's, a further debate was ignited as to their safety and potential disadvantages. Selecting the optimal performing intraocular lens to obtain the best visual performance with the fewest potential drawbacks has become complex and challenging for cataract surgeons and their patients with the wide choice of lenses available. Choosing a personalised lens to address astigmatism, presbyopia, spherical aberration, chromatic aberration, and potentially to shield the retina from short-wavelength light is now possible. The potential benefits and possible side effects of these different innovations emphasise the importance of assessing the evidence for their clinical utility, allowing the surgeon and the patient to weigh-up the risk benefit ratio and make an informed decision. The BFIOLs were developed to reduce cyanopsia, address chromatic aberration, and improve contrast sensitivity in different lighting conditions, as well as to prevent short-wavelength light reaching the retina thus potentially reducing the risk of developing age-related macular degeneration. Further design development of the BFIOLs was to mimic the natural crystalline lens absorption and transmittance properties in adulthood. Multiple publications have reported on the potential benefits and pitfalls of implanting a blue-filtering lens. The potential disadvantages raised in the literature over the last 25 years since their introduction, regarding compromise of visual function and disruption of the circadian system, have been largely dispelled. The clear benefits of protecting the retina from short-wavelength light make a BFIOLs a sensible choice. The purpose of this article presented at the Cambridge symposium 2015 is to review the literature on this subject.
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Lavric A, Pompe MT. Do Blue-Light Filtering Intraocular Lenses Affect Visual Function? Optom Vis Sci 2014; 91:1348-54. [DOI: 10.1097/opx.0000000000000390] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hammond BR, Johnson BA, George ER. Oxidative photodegradation of ocular tissues: beneficial effects of filtering and exogenous antioxidants. Exp Eye Res 2014; 129:135-50. [PMID: 25236792 DOI: 10.1016/j.exer.2014.09.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/11/2014] [Accepted: 09/13/2014] [Indexed: 01/17/2023]
Abstract
The fact that light is necessary for life is generally accepted as an axiom. The extent to which light interacts and influences human biology, however, is often not fully appreciated. Exposure to sunlight, for instance, can both promote and degrade human health. There is now general scientific consensus that, although the eye evolved to respond to light, it is also damaged by excessive exposure. Light-mediated ocular damage is involved in the pathophysiology of many common forms of blindness. The type of ocular tissue damage induced by light exposure depends on the extent of exposure and wavelength. The tissues of the lens, cornea, and retina contain specific chemical moieties that have been proven to exhibit light-mediated oxidative degradation. Proteins and lipids present in the cornea, lens, and retina, meet all of the physical requirements known to initiate the process of oxidative photodegradation upon exposure to solar radiation. As such, different mechanisms have evolved in the lens, cornea, and retina to ameliorate such light-mediated oxidative damage. It appears, however, that such mechanisms are ill-matched to handle modern conditions: namely, poor diet and longer life-spans (and the degenerative diseases that accompany them). Hence, steps must be taken to protect the eye from the damaging effects of light. Preventative measures include minimizing actinic light exposure, providing exogenous filtering (e.g., through the use of protective lenses), and enhancing antioxidant defenses (e.g., through increased dietary intake of antioxidants). These strategies may yield long-term benefits in terms of reducing oxidative photodegradation of the ocular tissues.
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Affiliation(s)
- Billy R Hammond
- Vision Sciences Laboratory, University of Georgia, Athens, GA 30602-3013, USA.
| | - Bart A Johnson
- Johnson & Johnson Vision Care, Inc., 7500 Centurion Parkway, R&D 3rd Floor W3A, Jacksonville, FL 33256, USA
| | - Eric R George
- Johnson & Johnson Vision Care, Inc., 7500 Centurion Parkway, R&D 3rd Floor W3A, Jacksonville, FL 33256, USA.
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Chamorro E, Bonnin-Arias C, Pérez-Carrasco MJ, Alvarez-Rementería L, Villa-Collar C, Armadá-Maresca F, Sánchez-Ramos C. [Macular thickness measured by optical coherence tomography in pseudoaphakic eyes with clear vs yellow implant]. ACTA ACUST UNITED AC 2014; 89:136-42. [PMID: 24548791 DOI: 10.1016/j.oftal.2013.12.010] [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: 07/12/2010] [Revised: 11/25/2013] [Accepted: 12/16/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To study the use of optical coherence tomography (OCT), for measuring the macular thickness variations produced over time in elderly pseudophakic subjects implanted with a clear intraocular lens (IOL) in one eye, and a yellow IOL in the other eye. METHODS Macular thickness measurements were obtained in the 36 eyes of 18 subjects over 65 years, with cataracts surgically removed from both eyes and implanted with different absorbance (clear and yellow) IOLs in 2 separate surgeries. Stratus-OCT was used to determine the macular thickness in 2 sessions with 5 years of difference. RESULTS After 5 years of follow-up, the eyes implanted with clear IOLs revealed a significant decrease in macular thickness. However, in eyes implanted with yellow IOLs the macular thickness remained stable. The mean overall decrease in macular thickness in eyes implanted with clear IOLs was 5 ± 8 μm (P=.02), and foveal thickness reduction was 10 ± 17 μm (P=.02). CONCLUSIONS The macular thickness changes produced in eyes implanted with a yellow IOL differ from those with a clear IOL. These observation point to a possible protective effect of yellow IOL against the harmful effects of light in elderly pseudophakic subjects. However, studies with a longer follow-up are still needed to confirm that the protection provided by this IOL model is clinically significant.
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Affiliation(s)
- E Chamorro
- Grupo de Neurocomputación y Neurorrobótica, Universidad Complutense, Madrid, España.
| | - C Bonnin-Arias
- Grupo de Neurocomputación y Neurorrobótica, Universidad Complutense, Madrid, España
| | - M J Pérez-Carrasco
- Grupo de Neurocomputación y Neurorrobótica, Universidad Complutense, Madrid, España
| | | | - C Villa-Collar
- Departamento Óptica y Optometría, Universidad Europea, Madrid, España
| | - F Armadá-Maresca
- Departamento Oftalmología, Hospital Universitario La Paz, Madrid, España
| | - C Sánchez-Ramos
- Grupo de Neurocomputación y Neurorrobótica, Universidad Complutense, Madrid, España
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Arnault E, Barrau C, Nanteau C, Gondouin P, Bigot K, Viénot F, Gutman E, Fontaine V, Villette T, Cohen-Tannoudji D, Sahel JA, Picaud S. Phototoxic action spectrum on a retinal pigment epithelium model of age-related macular degeneration exposed to sunlight normalized conditions. PLoS One 2013; 8:e71398. [PMID: 24058402 PMCID: PMC3751948 DOI: 10.1371/journal.pone.0071398] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 06/28/2013] [Indexed: 11/19/2022] Open
Abstract
Among the identified risk factors of age-related macular degeneration, sunlight is known to induce cumulative damage to the retina. A photosensitive derivative of the visual pigment, N-retinylidene-N-retinylethanolamine (A2E), may be involved in this phototoxicity. The high energy visible light between 380 nm and 500 nm (blue light) is incriminated. Our aim was to define the most toxic wavelengths in the blue-green range on an in vitro model of the disease. Primary cultures of porcine retinal pigment epithelium cells were incubated for 6 hours with different A2E concentrations and exposed for 18 hours to 10 nm illumination bands centered from 380 to 520 nm in 10 nm increments. Light irradiances were normalized with respect to the natural sunlight reaching the retina. Six hours after light exposure, cell viability, necrosis and apoptosis were assessed using the Apotox-Glo Triplex™ assay. Retinal pigment epithelium cells incubated with A2E displayed fluorescent bodies within the cytoplasm. Their absorption and emission spectra were similar to those of A2E. Exposure to 10 nm illumination bands induced a loss in cell viability with a dose dependence upon A2E concentrations. Irrespective of A2E concentration, the loss of cell viability was maximal for wavelengths from 415 to 455 nm. Cell viability decrease was correlated to an increase in cell apoptosis indicated by caspase-3/7 activities in the same spectral range. No light-elicited necrosis was measured as compared to control cells maintained in darkness. Our results defined the precise spectrum of light retinal toxicity in physiological irradiance conditions on an in vitro model of age-related macular degeneration. Surprisingly, a narrow bandwidth in blue light generated the greatest phototoxic risk to retinal pigment epithelium cells. This phototoxic spectrum may be advantageously valued in designing selective photoprotection ophthalmic filters, without disrupting essential visual and non-visual functions of the eye.
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Affiliation(s)
- Emilie Arnault
- Institut de la Vision, UPMC Univ Paris 06, UMR_S 968, Paris, France
- INSERM, U968, Paris, France
- CNRS, UMR_7210, Paris, France
| | | | - Céline Nanteau
- Institut de la Vision, UPMC Univ Paris 06, UMR_S 968, Paris, France
- INSERM, U968, Paris, France
- CNRS, UMR_7210, Paris, France
| | - Pauline Gondouin
- Institut de la Vision, UPMC Univ Paris 06, UMR_S 968, Paris, France
- INSERM, U968, Paris, France
- CNRS, UMR_7210, Paris, France
| | - Karine Bigot
- Institut de la Vision, UPMC Univ Paris 06, UMR_S 968, Paris, France
- INSERM, U968, Paris, France
- CNRS, UMR_7210, Paris, France
| | | | - Emmanuel Gutman
- Institut de la Vision, UPMC Univ Paris 06, UMR_S 968, Paris, France
- INSERM, U968, Paris, France
- CNRS, UMR_7210, Paris, France
| | - Valérie Fontaine
- Institut de la Vision, UPMC Univ Paris 06, UMR_S 968, Paris, France
- INSERM, U968, Paris, France
- CNRS, UMR_7210, Paris, France
| | | | | | - José-Alain Sahel
- Institut de la Vision, UPMC Univ Paris 06, UMR_S 968, Paris, France
- INSERM, U968, Paris, France
- CNRS, UMR_7210, Paris, France
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 503, Paris, France
- Institute of Ophthalmology, University College of London, London, United Kingdom
- Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
- Académie des Sciences-Institut de France, Paris, France
| | - Serge Picaud
- Institut de la Vision, UPMC Univ Paris 06, UMR_S 968, Paris, France
- INSERM, U968, Paris, France
- CNRS, UMR_7210, Paris, France
- Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
- * E-mail:
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Parmeggiani F, Sato G, De Nadai K, Romano MR, Binotto A, Costagliola C. Clinical and Rehabilitative Management of Retinitis Pigmentosa: Up-to-Date. Curr Genomics 2012; 12:250-9. [PMID: 22131870 PMCID: PMC3131732 DOI: 10.2174/138920211795860125] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 04/11/2011] [Accepted: 04/29/2011] [Indexed: 11/22/2022] Open
Abstract
The term retinitis pigmentosa (RP) indicates a heterogeneous group of genetic rare ocular diseases in which either rods or cones are prevalently damaged. RP represents the most common hereditary cause of blindness in people from 20 to 60 years old. In general, the different RP forms consist of progressive photo-receptorial neuro-degenerations, which are characterized by variable visual disabilities and considerable socio-sanitary burden. Sometimes, RP patients do not become visually impaired or legally blind until their 40-50 years of age and/or maintain a quite acceptable sight for all their life. Other individuals with RP become completely blind very early or in middle childhood. Although there is no treatment that can effectively cure RP, in some case-series the disease's progression seems to be reducible by specific preventive approaches. In the most part of RP patients, the quality of vision can be considerably increased by means of nanometer-controlled filters. In the present review, the main aspects of the routine clinical and rehabilitative managements for RP patients are described, particularly focusing on the importance of specific referral Centers to practice a real multidisciplinary governance of these dramatic diseases.
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Kara-Junior N, Espindola RF, Gomes BA, Ventura B, Smadja D, Santhiago MR. Effects of blue light–filtering intraocular lenses on the macula, contrast sensitivity, and color vision after a long-term follow-up. J Cataract Refract Surg 2011; 37:2115-9. [DOI: 10.1016/j.jcrs.2011.06.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 05/31/2011] [Accepted: 06/04/2011] [Indexed: 11/25/2022]
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Blueberry anthocyanins: protection against ageing and light-induced damage in retinal pigment epithelial cells. Br J Nutr 2011; 108:16-27. [PMID: 22018225 DOI: 10.1017/s000711451100523x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Retinal pigment epithelium (RPE) cells are vital for retinal health. However, they are susceptible to injury with ageing and exposure to excessive light, including UV (100-380 nm) and visible (380-760 nm) radiation. To evaluate the protective effect of blueberry anthocyanins on RPE cells, in vitro cell models of replicative senescent and light-induced damage were established in the present study. After purification and fractionation, blueberry anthocyanin extracts (BAE) were yielded with total anthocyanin contents of 31·0 (SD 0·5) % and were used in this study. Replicative senescence of RPE cells was induced by repeatedly passaging cells from the fourth passage to the tenth. From the fifth passage, cultured RPE cells began to enter a replicative senescence, exhibiting reduced cell proliferation along with an increase in the number of β-galactosidase-positive cells. RPE cells maintained high cell viability (P < 0·01) and a low (P < 0·01) percentage of β-galactosidase-positive cells when treated with 0·1 μg/ml BAE. In contrast, after exposure to 2500 (SD 500) lx light (420-800 nm) for 12 h, RPE cells in the positive control (light exposure, no BAE treatment) exhibited premature senescence, low (P < 0·01) cell viability and increased (P < 0·01) vascular endothelial growth factor (VEGF) release compared with negative control cells, which were not subjected to light irradiation and BAE exposure. Correspondingly, BAE is beneficial to RPE cells by protecting these cells against light-induced damage through the suppression of ageing and apoptosis as well as the down-regulation of the over-expressed VEGF to normal level. These results demonstrate that BAE is efficacious against senescence and light-induced damage of RPE cells.
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Recent studies provide an updated clinical perspective on blue light-filtering IOLs. Graefes Arch Clin Exp Ophthalmol 2011; 249:957-68. [PMID: 21584764 PMCID: PMC3124647 DOI: 10.1007/s00417-011-1697-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 04/07/2011] [Accepted: 04/08/2011] [Indexed: 11/10/2022] Open
Abstract
Background Recent reviews of blue light-filtering intraocular lenses (IOLs) have stated their potential risks for scotopic vision and circadian photoentrainment. Some authors have challenged the rationale for retinal photoprotection that these IOLs might provide. Our objective is to address these issues by providing an updated clinical perspective based on the results of the most recent studies. Methods This article evaluates the currently available published papers assessing the potential risks and benefits of blue light-filtering IOLs. It summarizes the results of seven clinical and two computational studies on photoreception, and several studies related to retinal photoprotection, all of which were not available in the previous reviews. These results provide a clinical risk/benefit analysis for an updated review for these IOLs. Results Most clinical studies comparing IOLs with and without the blue light-filtering feature have found no difference in clinical performance for; visual acuity, contrast sensitivity, color vision, or glare. For blue light-filtering IOLs, three comparative clinical studies have shown improved contrast sensitivity and glare reduction; but one study, while it showed satisfactory overall color perception, demonstrated some compromise in mesopic comparative blue color discrimination. Comparative results of two recent clinical studies have also shown improved performance for simulated driving under glare conditions and reduced glare disability, better heterochromatic contrast threshold, and faster recovery from photostress for blue light-filtering IOLs. Two computational and five clinical studies found no difference in performance between IOLs with or without blue light-filtration for scotopic vision performance and photo entrainment of the circadian rhythm. The rationale for protection of the pseudophakic retina against phototoxicity is discussed with supporting results of the most recent computational, in-vitro, animal, clinical, and epidemiological investigations. Conclusions This analysis provides an updated clinical perspective which suggests the selection of blue light-filtering IOLs for patients of any age, but especially for pediatric and presbyopic lens exchange patients with a longer pseudophakic life. Without clinically substantiated potential risks, these patients should experience the benefit of overall better quality of vision, reduced glare disability at least in some conditions, and better protection against retinal phototoxicity and its associated potential risk for AMD. Electronic supplementary material The online version of this article (doi:10.1007/s00417-011-1697-6) contains supplementary material, which is available to authorized users.
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Cataract is a self-defence reaction to protect the retina from oxidative damage. Med Hypotheses 2011; 76:741-4. [DOI: 10.1016/j.mehy.2011.02.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 01/12/2011] [Accepted: 02/04/2011] [Indexed: 12/26/2022]
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Light effects on mitochondrial photosensitizers in relation to retinal degeneration. Neurochem Res 2010; 35:2027-34. [PMID: 20927586 DOI: 10.1007/s11064-010-0273-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2010] [Indexed: 12/20/2022]
Abstract
The retina captures and converts light between 400-760 nm into electrical signals that are sent to the brain by way of the optic nerve and in the process helps to translate these electrical signals into what is known as vision. The same light that allows vision to occur is nevertheless also potentially toxic to retinal cells in certain situations. The shorter wavelengths of light are known to interact with chromophores in photoreceptors and pigment epithelial cells to cause oxidative stress and severe damage. Indeed it is generally accepted that short wavelength light effects is one cause for loss of photoreceptor function in age-related macular degeneration. Recent studies have demonstrated that light may be a contributing factor for the death of retinal ganglion cells in certain situations. Light as impinging on the retina, especially the short wavelength form, affect mitochondrial chromophores and can result in neurone death. Importantly ganglion cell axons within the eye are laden with mitochondria and unlike the outer retina are not protected from short wavelength light by macular pigments. It has therefore been proposed that when ganglion cell function is already compromised, as in glaucoma, then light impinging on their mitochondria might be a contributor to their eventual demise.
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20
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Cuthbertson FM, Peirson SN, Wulff K, Foster RG, Downes SM. Blue light–filtering intraocular lenses: Review of potential benefits and side effects. J Cataract Refract Surg 2009; 35:1281-97. [DOI: 10.1016/j.jcrs.2009.04.017] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Revised: 02/20/2009] [Accepted: 04/07/2009] [Indexed: 11/16/2022]
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Kernt M, Hirneiss C, Neubauer A, Lackerbauer C, Eibl K, Wolf A, Ulbig MW, Kampik A. Protektive Wirkung Blaulicht absorbierender IOLs auf das menschliche retinale Pigmentepithel. Ophthalmologe 2009; 107:150-7. [DOI: 10.1007/s00347-009-1945-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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22
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Effects of 400nm, 420nm, and 435.8nm radiations on cultured human retinal pigment epithelial cells. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2009; 95:64-70. [DOI: 10.1016/j.jphotobiol.2009.01.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Revised: 11/28/2008] [Accepted: 01/06/2009] [Indexed: 11/24/2022]
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Reply. Retina 2009. [DOI: 10.1097/iae.0b013e318197ad5f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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