1
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Merle BM, Schweitzer C, Rougier MB, Cougnard-Grégoire A, Gayraud L, Delyfer MN, Korobelnik JF, Delcourt C. Associations of circulating vitamins with 10-year retinal neurodegeneration: the Alienor Study. J Nutr Health Aging 2024; 28:100286. [PMID: 38861880 DOI: 10.1016/j.jnha.2024.100286] [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: 04/05/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 06/13/2024]
Abstract
OBJECTIVE To investigate the associations between circulating vitamins A, D, E, B6, B9, B12 and longitudinal changes in retinal nerve fiber layer (RNFL) thickness. METHODS The Alienor study, a prospective population-based cohort (Bordeaux, France), includes 963 individuals aged 73 years or older at baseline. The present study included 646 participants with complete RNFL measurement and vitamins. Study period is from 2009 to 2020. Peripapillary RNFL thickness was measured using spectral domain optical coherence tomography (SD-OCT). Plasma vitamins A, D and E and, serum vitamins B6, B9 and B12 were measured from blood sample. We performed linear mixed models, adjusted for age, gender, axial length, family history of glaucoma, and alcohol consumption to evaluated associations between vitamins and RNFL thickness changes over time. RESULTS Individuals having higher concentrations of vitamin E, D and B9 had a slower RNFL thinning during the 10-years of follow-up. Indeed, a 1-standard deviation (SD) increase of vitamin E (10.8 μmol/L), D (17.6 nmol/L) and B9 (11 μmol/L) were associated with slower RNFL thinning by 0.14 μm/year (95% confidence interval (CI), 0.03-0.25, p = 0.01), 0.14 μm/year (95% CI, 0.02-0.27, p = 0.02) and 0.11 μm/year (95% CI: 0.007-0.21, p = 0.04), respectively. No significant associations were observed for vitamins A, B6 and B12 with RNFL thinning. CONCLUSIONS Higher levels of vitamins E, D and B9 were associated with a slower RNFL thickness on SD-OCT over time, suggesting that those vitamins may contribute to the neuroprotection of the retina.
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Affiliation(s)
| | - Cédric Schweitzer
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France; CHU de Bordeaux, Service d'Ophtalmologie, Bordeaux, France
| | | | | | - Laure Gayraud
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France
| | - Marie-Noëlle Delyfer
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France; CHU de Bordeaux, Service d'Ophtalmologie, Bordeaux, France
| | - Jean-François Korobelnik
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France; CHU de Bordeaux, Service d'Ophtalmologie, Bordeaux, France
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2
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Knecht KT, Chiriac G, Guan HD. The potential impact of a vegetarian diet on glaucoma. Surv Ophthalmol 2024:S0039-6257(24)00048-1. [PMID: 38768761 DOI: 10.1016/j.survophthal.2024.05.001] [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: 08/22/2023] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/22/2024]
Abstract
Treatment of primary open-angle glaucoma has centered on the lowering of intraocular pressure that damages the optic nerve; however, this strategy is not uniformly successful, especially in normal tension glaucoma, and there is interest in antioxidant, anti-inflammatory, and other neuroprotective strategies. Vegetarian diets are known to be rich in antioxidant and anti-inflammatory components and have a number of established health benefits. Thus, it would be reasonable to assume that vegetarian diets would be beneficial in glaucoma, but this approach has not been well studied. We examine the possible role of vegetarian diets and their components in the incidence and progression of glaucoma.
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Affiliation(s)
- Kathryn T Knecht
- Loma Linda University School of Pharmacy, Loma Linda, California, USA
| | - Gabriela Chiriac
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - Howard D Guan
- Loma Linda University Eye Institute, Loma Linda, California, USA.
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3
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Bou Ghanem GO, Wareham LK, Calkins DJ. Addressing neurodegeneration in glaucoma: Mechanisms, challenges, and treatments. Prog Retin Eye Res 2024; 100:101261. [PMID: 38527623 DOI: 10.1016/j.preteyeres.2024.101261] [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: 12/28/2023] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Abstract
Glaucoma is the leading cause of irreversible blindness globally. The disease causes vision loss due to neurodegeneration of the retinal ganglion cell (RGC) projection to the brain through the optic nerve. Glaucoma is associated with sensitivity to intraocular pressure (IOP). Thus, mainstay treatments seek to manage IOP, though many patients continue to lose vision. To address neurodegeneration directly, numerous preclinical studies seek to develop protective or reparative therapies that act independently of IOP. These include growth factors, compounds targeting metabolism, anti-inflammatory and antioxidant agents, and neuromodulators. Despite success in experimental models, many of these approaches fail to translate into clinical benefits. Several factors contribute to this challenge. Firstly, the anatomic structure of the optic nerve head differs between rodents, nonhuman primates, and humans. Additionally, animal models do not replicate the complex glaucoma pathophysiology in humans. Therefore, to enhance the success of translating these findings, we propose two approaches. First, thorough evaluation of experimental targets in multiple animal models, including nonhuman primates, should precede clinical trials. Second, we advocate for combination therapy, which involves using multiple agents simultaneously, especially in the early and potentially reversible stages of the disease. These strategies aim to increase the chances of successful neuroprotective treatment for glaucoma.
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Affiliation(s)
- Ghazi O Bou Ghanem
- Vanderbilt Eye Institute, Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Lauren K Wareham
- Vanderbilt Eye Institute, Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - David J Calkins
- Vanderbilt Eye Institute, Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
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4
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D’Angelo A, Vitiello L, Lixi F, Abbinante G, Coppola A, Gagliardi V, Pellegrino A, Giannaccare G. Optic Nerve Neuroprotection in Glaucoma: A Narrative Review. J Clin Med 2024; 13:2214. [PMID: 38673487 PMCID: PMC11050811 DOI: 10.3390/jcm13082214] [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: 03/15/2024] [Revised: 03/30/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
In recent years, researchers have been interested in neuroprotective therapies as a cutting-edge therapeutic strategy to treat neurodegenerative disorders by shielding the brain system from harmful events. Millions of individuals worldwide suffer from glaucoma, an ocular neurodegenerative disease characterized by gradual excavation of the optic nerve head, retinal axonal damage, and consequent visual loss. The pathology's molecular cause is still mostly unknown, and the current treatments are not able to alter the disease's natural progression. Thus, the modern approach to treating glaucoma consists of prescribing medications with neuroprotective properties, in line with the treatment strategy suggested for other neurodegenerative diseases. For this reason, several naturally derived compounds, including nicotinamide and citicoline, have been studied throughout time to try to improve glaucoma management by exploiting their neuroprotective properties. The purpose of this review is to examine the naturally derived compounds that are currently utilized in clinical practice for neuroprotection in glaucomatous patients based on scientific data, emphasizing these compounds' pivotal mechanism of action as well as their proven therapeutic and neuroprotective benefits.
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Affiliation(s)
- Angela D’Angelo
- Department of Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, NA, Italy;
| | - Livio Vitiello
- Eye Unit, “Luigi Curto” Hospital, Azienda Sanitaria Locale Salerno, 84035 Polla, SA, Italy; (G.A.); (A.C.); (V.G.); (A.P.)
| | - Filippo Lixi
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, CA, Italy; (F.L.); (G.G.)
| | - Giulia Abbinante
- Eye Unit, “Luigi Curto” Hospital, Azienda Sanitaria Locale Salerno, 84035 Polla, SA, Italy; (G.A.); (A.C.); (V.G.); (A.P.)
| | - Alessia Coppola
- Eye Unit, “Luigi Curto” Hospital, Azienda Sanitaria Locale Salerno, 84035 Polla, SA, Italy; (G.A.); (A.C.); (V.G.); (A.P.)
| | - Vincenzo Gagliardi
- Eye Unit, “Luigi Curto” Hospital, Azienda Sanitaria Locale Salerno, 84035 Polla, SA, Italy; (G.A.); (A.C.); (V.G.); (A.P.)
| | - Alfonso Pellegrino
- Eye Unit, “Luigi Curto” Hospital, Azienda Sanitaria Locale Salerno, 84035 Polla, SA, Italy; (G.A.); (A.C.); (V.G.); (A.P.)
| | - Giuseppe Giannaccare
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, CA, Italy; (F.L.); (G.G.)
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5
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Wang R, Rao S, Zhong Z, Xiao K, Chen X, Sun X. Emerging role of ferroptosis in diabetic retinopathy: a review. J Drug Target 2024; 32:393-403. [PMID: 38385350 DOI: 10.1080/1061186x.2024.2316775] [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: 11/08/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Diabetic retinopathy (DR) is a significant complication of diabetes and the primary cause of blindness among working age adults globally. The development of DR is accompanied by oxidative stress, characterised by an overproduction of reactive oxygen species (ROS) and a compromised antioxidant system. Clinical interventions aimed at mitigating oxidative stress through ROS scavenging or elimination are currently available. Nevertheless, these treatments merely provide limited management over the advanced stage of the illness. Ferroptosis is a distinctive form of cell death induced by oxidative stress, which is characterised by irondependent phospholipid peroxidation. PURPOSE This review aims to synthesise recent experimental evidence to examine the involvement of ferroptosis in the pathological processes of DR, as well as to explicate the regulatory pathways governing oxidative stress and ferroptosis in retina. METHODS We systematically reviewed literature available up to 2023. RESULTS This review included 12 studies investigating the involvement of ferroptosis in DR.
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Affiliation(s)
- Ruohong Wang
- Department of Ophthalmology Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan, China
| | - Suyun Rao
- Department of Ophthalmology Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan, China
| | - Zheng Zhong
- Department of Ophthalmology Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan, China
| | - Ke Xiao
- Department of Ophthalmology Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan, China
| | - Xuhui Chen
- Department of Ophthalmology Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan, China
| | - Xufang Sun
- Department of Ophthalmology Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan, China
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6
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Shi R, Wu Y, Chen H, Zhang Z, Bao S, Qu J, Zhou M. The causal effect of oxidative stress on the risk of glaucoma. Heliyon 2024; 10:e24852. [PMID: 38317903 PMCID: PMC10838757 DOI: 10.1016/j.heliyon.2024.e24852] [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: 06/15/2023] [Revised: 12/09/2023] [Accepted: 01/16/2024] [Indexed: 02/07/2024] Open
Abstract
Glaucoma is a complex multifactorial disease. Oxidative stress has been implicated in its pathogenesis. However, establishing a causal relationship between oxidative stress and glaucoma is challenging due to confounding and reverse causality. In this study, we performed bidirectional two-sample Mendelian randomization (MR) analyses based on genetic instrumental variables as proxies for 11 biomarkers of oxidative stress injury to investigate the causal relationship between oxidative stress and glaucoma. Eight significant associations were identified. Increased circulating levels of catalase (OR = 0.915, 95 % CI: 0.848-0.987, P = 0.022), retinol (OR = 0.481, 95 % CI: 0.248-0.932, P = 0.044) and superoxide dismutase (OR = 0.779, 95 % CI: 0. 616-0.986, P = 0.038) are associated with a decreased risk of glaucoma, whereas an increased myeloperoxidase level (OR = 2.145, 95 % CI: 1.119-4.111, P = 0.029) is associated with an increased risk of glaucoma. Glaucoma was causally associated with lower levels of total bilirubin (OR = 0.961, 95 % CI: 0.927-0.997, P = 0.039), glutathione peroxidase (OR = 0. 934, 95 % CI: 0.890-0.981, P = 0.006), paraoxonase (OR = 0.883, 95 % CI: 0.810-0.963, P = 0.005) and albumin (OR = 0.988, 95 % CI: 0.978-0.998, P = 0.014). The bidirectional MR analysis revealed a causal relationship between oxidative stress and glaucoma. These findings provide a greater understanding of the underlying mechanisms of glaucomatous neurodegeneration and imply a potential therapeutic approach for glaucoma through targeting oxidative stress pathways.
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Affiliation(s)
- Ronghua Shi
- School of Biomedical Engineering, School of Information and Communication Engineering, Hainan University, Haikou 570228, China
- Hainan Institute of Real World Data, Qionghai, 571437, China
| | - Yaxuan Wu
- School of Biomedical Engineering, School of Information and Communication Engineering, Hainan University, Haikou 570228, China
- Hainan Institute of Real World Data, Qionghai, 571437, China
| | - He Chen
- School of Biomedical Engineering, School of Information and Communication Engineering, Hainan University, Haikou 570228, China
- Hainan Institute of Real World Data, Qionghai, 571437, China
| | - Zicheng Zhang
- School of Biomedical Engineering, School of Information and Communication Engineering, Hainan University, Haikou 570228, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Hainan Institute of Real World Data, Qionghai, 571437, China
| | - Siqi Bao
- School of Biomedical Engineering, School of Information and Communication Engineering, Hainan University, Haikou 570228, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Hainan Institute of Real World Data, Qionghai, 571437, China
| | - Jia Qu
- School of Biomedical Engineering, School of Information and Communication Engineering, Hainan University, Haikou 570228, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Hainan Institute of Real World Data, Qionghai, 571437, China
| | - Meng Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
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7
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Xiong K, Zhang Q, Mao H, Congdon N, Liang Y. Assessment of Causality Between Diet-Derived Antioxidants and Primary Open-Angle Glaucoma: A Mendelian Randomization Study. Transl Vis Sci Technol 2024; 13:20. [PMID: 38411971 PMCID: PMC10910435 DOI: 10.1167/tvst.13.2.20] [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: 11/14/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024] Open
Abstract
Purpose This study aimed to investigate the genetic causal relationships among diet-derived circulating antioxidants, primary open-angle glaucoma (POAG), and glaucoma-related traits using two-sample Mendelian randomization (MR). Methods Genetic variants associated with diet-derived circulating antioxidants (retinol, ascorbate, β-carotene, lycopene, α-tocopherol, and γ-tocopherol) were assessed as absolute and metabolic instrumental variables. POAG and glaucoma-related traits data were derived from a large, recently published genome-wide association study database; these traits included intraocular pressure (IOP), macular retinal nerve fiber layer (mRNFL) thickness, macular ganglion cell-inner plexiform layer (mGCIPL) thickness, and vertical cup-to-disc ratio (vCDR). MR analyses were performed per outcome for each exposure. Results We found no causal association between six diet-derived antioxidants and POAG using the International Glaucoma Genetics Consortium data. For absolute antioxidants, the odds ratios (ORs) ranged from 1.011 (95% confidence interval [CI], 0.854-1.199; P = 0.895) per natural log-transformed β-carotene to 1.052 (95% CI, 0.911-1.215; P = 0.490) for 1 µmol/L of ascorbate. For antioxidant metabolites, the OR ranged from 0.998 (95% CI, 0.801-1.244; P = 0.989) for ascorbate to 1.210 (95% CI, 0.870-1.682; P = 0.257) for γ-tocopherol, using log-transformed levels. A similar result was obtained with the FinnGen Biobank. Furthermore, our results showed no significant genetic association between six diet-derived antioxidants and glaucoma-related traits. Conclusions Our study did not support a causal association among six diet-derived circulating antioxidants, POAG, and glaucoma-related traits. This suggests that the intake of antioxidants may not have a preventive effect on POAG and offers no protection to retinal nerve cells. Translational Relevance This study provides valid evidence regarding the use of diet-derived antioxidants for glaucoma patients.
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Affiliation(s)
- Kun Xiong
- Department of Glaucoma, National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qi'ao Zhang
- Department of Glaucoma, National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huiyan Mao
- Department of Glaucoma, National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Nathan Congdon
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Orbis International, New York, NY, USA
| | - Yuanbo Liang
- Department of Glaucoma, National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
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8
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Qian C, Nusinovici S, Thakur S, Soh ZD, Majithia S, Chee ML, Zhong H, Tham YC, Sabanayagam C, Hysi PG, Cheng CY. Machine learning identifying peripheral circulating metabolites associated with intraocular pressure alterations. Br J Ophthalmol 2023; 107:1275-1280. [PMID: 35613841 DOI: 10.1136/bjophthalmol-2021-320584] [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: 10/06/2021] [Accepted: 05/13/2022] [Indexed: 11/04/2022]
Abstract
AIMS To identify blood metabolite markers associated with intraocular pressure (IOP) in a population-based cross-sectional study. METHODS This study was conducted in a multiethnic Asian population (Chinese, n=2805; Indians, n=3045; Malays, n=3041 aged 40-80 years) in Singapore. All subjects underwent standardised systemic and ocular examinations, and biosamples were collected. Selected metabolites (n=228) in either serum or plasma were analysed and quantified using nuclear magnetic resonance spectroscopy. Least absolute shrinkage and selection operator regression was used for metabolites selection. Multivariable linear regression was used to evaluate the relationship between metabolites and IOP in each of the three ethnic groups, followed by a meta-analysis combining the three cohorts. RESULTS Six metabolites, including albumin, glucose, lactate, glutamine, ratio of saturated fatty acids to total fatty acids (SFAFA) and cholesterol esters in very large high-density lipoprotein (HDL), were significantly associated with IOP in all three cohorts. Higher levels of albumin (per SD, beta=0.24, p=0.002), lactate (per SD, beta=0.27, p=0.008), glucose (per SD, beta=0.11, p=0.010) and cholesterol esters in very large HDL (per SD, beta=0.47, p=0.006), along with lower levels of glutamine (per SD, beta=0.17, p<0.001) and SFAFA (per SD, beta=0.21, p=0.008) were associated with higher IOP levels. CONCLUSION We identify several novel blood metabolites associated with IOP. These findings may provide insight into the physiological and pathological processes underlying IOP control.
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Affiliation(s)
- Chaoxu Qian
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Simon Nusinovici
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Zhi Da Soh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Miao Li Chee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Hua Zhong
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Pirro G Hysi
- Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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9
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Engin KN, Harmancı Karagülle D, Durmaz Engin C, Kant M, Yaman A, Akış M, Özel Yıldız S, İşlekel H, Güner Akdoğan G, Söylev Bajin M. Is the clinical course of non-arteritic ischemic optic neuropathy associated with oxidative damage and the dynamics of the antioxidant response? Int Ophthalmol 2023; 43:2935-2945. [PMID: 37029212 DOI: 10.1007/s10792-023-02699-x] [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: 12/06/2021] [Accepted: 03/24/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE Oxidative stress is known to be a decisive factor in the wide etiopathogenesis of optic neuropathy. This study aimed to comprehensively evaluate the interaction of optic neuropathy's clinical course with systemic oxidative damage and antioxidant response dynamics in a large series. METHODS This case-controlled clinical study included 33 non-arteritic anterior ischemic optic neuropathy (NAION) patients and 32 healthy individuals. Extensive systemic oxidation profiles were statistically compared between the two groups, and correlations between the clinical and biochemical data in the study group were analyzed. RESULTS Vitamin E and malondialdehyde (MDA) levels were significantly higher in the study group. Significant correlations were observed in the analyses between clinical findings and oxidative stress parameters. Correlations between vitamin E and intraocular pressure (IOP), between B12 and cup-to-disk ratio (c/d), between antioxidant glutathione and superoxide dismutase (SOD) enzyme systems, and between uric acid (UA) and age were found to be very significant. As significant correlations were found in either clinical and biochemical data or in oxidative stress parameters, correlations between vitamin E and cholesterol, MDA were found to be very significant. CONCLUSIONS This study not only supplies significant information regarding oxidative damage and antioxidant response in NAION, but also points out the specific interactions of neuromodulators, like vitamin E, in intracellular signaling pathways and regulation mechanisms. A better reading of these connections may help improve diagnosis, follow-ups and treatment criteria and strategies.
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Affiliation(s)
- Kaya Nusret Engin
- Department of Ophthalmology, Ümraniyemraniye Education and Research Hospital, Sağlık University, Elmalıkent Mh. Ümraniye, 34764, Istanbul, Turkey.
| | - Duygu Harmancı Karagülle
- Graduate School of Health Science, Department of Molecular Genetics, Dokuz Eylül University, Izmir, Turkey
| | - Ceren Durmaz Engin
- Faculty of Medicine, Department of Ophthalmology, Dokuz Eylül University, Izmir, Turkey
| | - Melis Kant
- Faculty of Medicine, Department of Biochemistry, Dokuz Eylül University, Izmir, Turkey
| | - Aylin Yaman
- Faculty of Medicine, Department of Ophthalmology, Dokuz Eylül University, Izmir, Turkey
| | - Merve Akış
- Faculty of Medicine, Department of Biochemistry, Dokuz Eylül University, Izmir, Turkey
| | - Sevda Özel Yıldız
- Istanbul Faculty of Medicine, Department of Biostatistics, Istanbul University, Istanbul, Turkey
| | - Hüray İşlekel
- Graduate School of Health Science, Department of Molecular Genetics, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Biochemistry, Dokuz Eylül University, Izmir, Turkey
| | - Gül Güner Akdoğan
- Department of Medical Biochemistry, School of Medicine, Izmir University of Economics, Izmir, Turkey
| | - Meltem Söylev Bajin
- Faculty of Medicine, Department of Ophthalmology, Dokuz Eylül University, Izmir, Turkey
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10
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Li S, Jakobs TC. Vitamin C protects retinal ganglion cells via SPP1 in glaucoma and after optic nerve damage. Life Sci Alliance 2023; 6:e202301976. [PMID: 37160307 PMCID: PMC10172762 DOI: 10.26508/lsa.202301976] [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: 02/07/2023] [Revised: 04/29/2023] [Accepted: 05/01/2023] [Indexed: 05/11/2023] Open
Abstract
Glaucoma is a common neurodegenerative disorder characterized by retinal ganglion cell death, astrocyte reactivity in the optic nerve, and vision loss. Currently, lowering the intraocular pressure (IOP) is the first-line treatment, but adjuvant neuroprotective approaches would be welcome. Vitamin C possesses neuroprotective activities that are thought to be related to its properties as a co-factor of enzymes and its antioxidant effects. Here, we show that vitamin C promotes a neuroprotective phenotype and increases gene expression related to neurotropic factors, phagocytosis, and mitochondrial ATP production. This effect is dependent on the up-regulation of secreted phosphoprotein 1 (SPP1) in reactive astrocytes via the transcription factor E2F1. SPP1+ astrocytes in turn promote retinal ganglion cell survival in a mouse model of glaucoma. In addition, oral administration of vitamin C lowers the IOP in mice. This study identifies an additional neuroprotective pathway for vitamin C and suggests a potential therapeutic role of vitamin C in neurodegenerative diseases such as glaucoma.
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Affiliation(s)
- Song Li
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Boston, MA, USA
| | - Tatjana C Jakobs
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Boston, MA, USA
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11
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Mohammadi M, Yarmohammadi A, Salehi-Abargouei A, Ghasemirad H, Shirvani M, Ghoshouni H. Uric acid and glaucoma: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1159316. [PMID: 37575992 PMCID: PMC10422028 DOI: 10.3389/fmed.2023.1159316] [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: 02/05/2023] [Accepted: 07/07/2023] [Indexed: 08/15/2023] Open
Abstract
Background Glaucoma, the leading cause of irreversible blindness, is a common disorder that contributes to gradual optic nerve degeneration. The beneficial impacts of uric acid (UA) have been reported in some neurodegenerative conditions such as Parkinson's disease, Alzheimer's disease, and amyotrophic lateral sclerosis. But the results of current studies about the association between serum UA level and glaucoma are conflicting. The present meta-analysis was conducted to provide a better understanding of the association between serum UA level and glaucoma. Methods We searched the databases of PubMed, Scopus, Web of Science, and Google Scholar systematically until November 20, 2022 to identify case-control studies, comparing the serum UA concentrations of the patients with glaucoma and controls. The mean ± standard division difference was used to assess the difference in serum UA concentrations between the glaucoma patients and controls. Results Six studies involving 1,221 glaucoma patients and 1,342 control group were included in the present meta-analysis. This meta-analysis using a random effect model indicated that the mean UA level in glaucoma patients was 0.13 (I2 = 91.92%, 95% CI = -0.42 to 0.68) higher than the controls; however, it was not statistically significant. Conclusions Our findings provide evidence that glaucoma patients have a higher serum UA level compared to the controls, but this difference is not statistically significant. Prospective studies are needed to determine the possible association between increased UA and glaucoma pathogenesis. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022364055, identifier: CRD42022364055.
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Affiliation(s)
- Mohammad Mohammadi
- Students' Research and Technology Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- NeuroTRACT Association, Student's Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amin Salehi-Abargouei
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamidreza Ghasemirad
- Students' Research and Technology Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Shirvani
- Geriatric Ophthalmology Research Center, Shahid Sadoughi University of Medical Science, Yazd, Iran
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamed Ghoshouni
- Students' Research and Technology Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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12
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Pereira A, Adekunle RD, Zaman M, Wan MJ. Association Between Vitamin Deficiencies and Ophthalmological Conditions. Clin Ophthalmol 2023; 17:2045-2062. [PMID: 37489231 PMCID: PMC10363387 DOI: 10.2147/opth.s401262] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
Vitamin deficiencies can have adverse effects on health, including on the visual system. The ocular manifestations of a vitamin deficiency are related to the underlying biochemical function of the particular nutrient. While vitamin deficiencies are not common in developed counties, they are still prevalent in parts of the developing world and in specific, vulnerable populations. Vitamin deficiencies can cause or contribute to many ophthalmological conditions and eye diseases may even be the first presenting finding of a vitamin deficiency. As such, it is important for ophthalmologists to be aware of the ocular manifestations of vitamin deficiencies, especially given that the complications can be severe and effectively treated if identified early. This review summarizes the literature on the main vitamins known to have characteristic ocular manifestations: vitamins A, B1, B2, B9, B12, C, D, E and K. The function, epidemiology, manifestations, workup, and management of each vitamin is discussed in detail.
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Affiliation(s)
- Austin Pereira
- University of Toronto Department of Ophthalmology & Vision Sciences, Toronto, Ontario, Canada
| | - R Damilola Adekunle
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Michele Zaman
- Queen’s School of Medicine, Kingston, Ontario, Canada
| | - Michael J Wan
- University of Toronto Department of Ophthalmology & Vision Sciences, Toronto, Ontario, Canada
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13
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Xiong K, Gong X, Xie L, Wang L, Guo X, Li W, Zhong P, Liang X, Huang W, Wang W. Influence of Serum Uric Acid on Macular Choroidal Thickness and Ganglion Cell Inner Plexiform Layer Thickness. Transl Vis Sci Technol 2023; 12:13. [PMID: 37171795 PMCID: PMC10184778 DOI: 10.1167/tvst.12.5.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
Purpose The purpose of this study was to determine the influence of serum uric acid (UA) on macular choroidal and ganglion cell inner plexiform layer (GC-IPL) thickness. Methods This cross-sectional study enrolled adult individuals in communities in Guangzhou, China. All participants underwent a comprehensive ophthalmologic examination. They were divided into four groups according to UA quartiles. The choroidal and GC-IPL thickness was measured by swept-source optical coherence tomography (SS-OCT). Results A total of 719 subjects (1389 eyes) were included in the study. The average UA was 348.50 ± 86.16 mmol/L. The average choroidal and GC-IPL thickness decreased with UA quartiles (P < 0.001). Multivariate linear regression analyses showed that UA was negatively associated with average choroidal (β = -0.073, 95% confidence interval [CI] = -0.117 to -0.028, P = 0.001) and GC-IPL thickness (β = -0.006, 95% CI = -0.009 to -0.002, P = 0.001). After adjusting for confounding factors, the average choroidal thickness was decreased in quartile 4 as compared with quartile 1 by -14.737 µm (95% CI = -24.460 to -5.015, P = 0.003). The average GC-IPL thickness was decreased in quartile 4 versus quartile 1 by -1.028 (95% CI = -1.873 to -0.290, P = 0.007). Conclusions Higher UA levels were independently associated with macular choroid and GC-IPL thinning. These contribute to a better understanding of ocular pathological mechanisms. Translational Relevance The associated UA with choroidal and GC-IPL thickness helps to understand the ocular pathological and retinal neurodegenerative mechanism.
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Affiliation(s)
- Kun Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xia Gong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Liqiong Xie
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Lanhua Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiao Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Wangting Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Pingting Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaoling Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Wenyong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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14
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Musa M, Zeppieri M, Atuanya GN, Enaholo ES, Topah EK, Ojo OM, Salati C. Nutritional Factors: Benefits in Glaucoma and Ophthalmologic Pathologies. Life (Basel) 2023; 13:life13051120. [PMID: 37240765 DOI: 10.3390/life13051120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/17/2023] [Accepted: 04/26/2023] [Indexed: 05/19/2023] Open
Abstract
Glaucoma is a chronic optic neuropathy that can lead to irreversible functional and morphological damage if left untreated. The gold standard therapeutic approaches in managing patients with glaucoma and limiting progression include local drops, laser, and/or surgery, which are all geared at reducing intraocular pressure (IOP). Nutrients, antioxidants, vitamins, organic compounds, and micronutrients have been gaining increasing interest in the past decade as integrative IOP-independent strategies to delay or halt glaucomatous retinal ganglion cell degeneration. In our minireview, we examine the various nutrients and compounds proposed in the current literature for the management of ophthalmology diseases, especially for glaucoma. With respect to each substance considered, this minireview reports the molecular and biological characteristics, neuroprotective activities, antioxidant properties, beneficial mechanisms, and clinical studies published in the past decade in the field of general medicine. This study highlights the potential benefits of these substances in glaucoma and other ophthalmologic pathologies. Nutritional supplementation can thus be useful as integrative IOP-independent strategies in the management of glaucoma and in other ophthalmologic pathologies. Large multicenter clinical trials based on functional and morphologic data collected over long follow-up periods in patients with IOP-independent treatments can pave the way for alternative and/or coadjutant therapeutic options in the management of glaucoma and other ocular pathologies.
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Affiliation(s)
- Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Edo State, Nigeria
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | | | | | - Efioshiomoshi Kings Topah
- Department of Optometry, Faculty of Allied Health Sciences, College of Health Sciences Bayero University, Kano 700006, Kano State, Nigeria
| | - Oluwasola Michael Ojo
- School of Optometry and Vision Sciences, College of Health Sciences, University of Ilorin, Ilorin 240003, Kwara State, Nigeria
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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15
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Liu W, Guo R, Huang D, Ji J, Gansevoort RT, Snieder H, Jansonius NM. Co-occurrence of chronic kidney disease and glaucoma: Epidemiology and etiological mechanisms. Surv Ophthalmol 2023; 68:1-16. [PMID: 36088997 DOI: 10.1016/j.survophthal.2022.09.001] [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: 03/06/2022] [Revised: 08/26/2022] [Accepted: 09/02/2022] [Indexed: 02/01/2023]
Abstract
As the histology, physiology, and pathophysiology of eyes and kidneys show substantial overlap, it has been suggested that eye and kidney diseases, such as glaucoma and chronic kidney disease (CKD), may be closely interlinked. We review the relationship between CKD and various subtypes of glaucoma, including primary open-angle glaucoma, primary angle- closure glaucoma, normal tension glaucoma, pseudoexfoliation syndrome, and several glaucoma endophenotypes. We also discuss the underlying pathogenic mechanisms and common risk factors for CKD and glaucoma, including atherosclerosis, the renin-angiotensin system, genes and genetic polymorphisms, vitamin D deficiency, and erythropoietin. The prevalence of glaucoma appears elevated in CKD patients, and vice versa, and the literature points to many intriguing associations; however, the associations are not always confirmed, and sometimes apparently opposite observations are reported. Glaucoma and CKD are complex diseases, and their mutual influence is only partially understood.
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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; Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ruru Guo
- 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
| | - Dandan Huang
- Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jian Ji
- 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
| | - Ron T Gansevoort
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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16
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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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17
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Pang R, Feng S, Cao K, Sun Y, Guo Y, Ma D, Pang CP, Liu X, Qian J, Xie Y, Shi Y, He H, Peng J, Chen C, Cui J, Labisi SA, Zhang Y, Fu Y, Li J, Wan Y, Xin C, Liu H, Zhang Q, Weinreb RN, Wang H, Wang N. Association of serum retinol concentration with normal-tension glaucoma. Eye (Lond) 2022; 36:1820-1825. [PMID: 34385698 PMCID: PMC9391421 DOI: 10.1038/s41433-021-01740-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 07/22/2021] [Accepted: 07/30/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To evaluate the association between serum retinol concentration and normal-tension glaucoma (NTG). METHODS A total of 345 study subjects were recruited in a prospective cross-sectional study: 101 patients with NTG, 106 patients with high-pressure primary open-angle glaucoma (POAG) and 138 healthy control subjects. Serum retinol concentration in fasting blood samples was determined by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). All study subjects were given complete ophthalmic examinations and diagnosed by two glaucoma sub-specialists. RESULTS Serum retinol concentrations in NTG, POAG, and controls were 338.90 ± 103.23 ng/mL, 405.22 ± 114.12 ng/mL, and 408.84 ± 122.36 ng/mL respectively. NTG patients had lower serum retinol concentrations than POAG (p < 0.001) or healthy controls (p < 0.001). There was no statistical difference between the POAG and healthy controls (p = 0.780). Higher proportion of NTG patients (37.6%) than POAG (17.9%) or controls (21.7%) had serum retinol concentrations lower than 300 ng/mL. Serum retinol was positively correlated with optic nerve sheath diameter (ONSD) (r = 0.349, p = 0.001) in glaucoma patients and not associated with any other demographic features or ophthalmic biometric parameters in the NTG patients. Multivariate logistic regression showed that serum retinol (OR = 0.898, 95CI%: 0.851-0.947) was associated with incident NTG. CONCLUSIONS NTG patients had lower serum retinol concentrations. Serum retinol uniquely associated with NTG makes it a new potential option for the diagnosis and treatment of the disease.
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Affiliation(s)
- Ruiqi Pang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shuo Feng
- Departments of Pharmacy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yunxiao Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yiqin Guo
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Dandan Ma
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiangyi Liu
- Departments of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jingyu Qian
- Departments of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuan Xie
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yan Shi
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hailong He
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jun Peng
- Hangzhou Biozon Medical Lab Co Ltd, Hangzhou, China
| | - Congyan Chen
- Hangzhou Biozon Medical Lab Co Ltd, Hangzhou, China
| | - Jing Cui
- Physical Examination Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Siloka A Labisi
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yue Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yingdi Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jiaying Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yue Wan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Chen Xin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hanruo Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qing Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Robert N Weinreb
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Huaizhou Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
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18
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Sethi A, Vajaranant TS. Could the AREDS formula benefit patients with glaucoma? Eye (Lond) 2022; 36:918-920. [PMID: 35094029 PMCID: PMC9046418 DOI: 10.1038/s41433-022-01956-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/12/2022] [Accepted: 01/19/2022] [Indexed: 01/26/2023] Open
Affiliation(s)
- Abhishek Sethi
- Illinois Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Thasarat Sutabutr Vajaranant
- Illinois Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA.
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19
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Asian Race and Primary Open-Angle Glaucoma: Where Do We Stand? J Clin Med 2022; 11:jcm11092486. [PMID: 35566612 PMCID: PMC9099679 DOI: 10.3390/jcm11092486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 01/27/2023] Open
Abstract
Primary open-angle glaucoma (POAG) is an optic neuropathy characterized by irreversible retinal ganglion cell damage and visual field loss. The global POAG prevalence is estimated to be 3.05%, and near term is expected to significantly rise, especially within aging Asian populations. Primary angle-closure glaucoma disproportionately affects Asians, with up to four times greater prevalence of normal-tension glaucoma reported compared with high-tension glaucoma. Estimates for overall POAG prevalence in Asian populations vary, with Chinese and Indian populations representing the majority of future cases. Structural characteristics associated with glaucoma progression including the optic nerve head, retina, and cornea are distinct in Asians, serving as intermediates between African and European descent populations. Patterns in IOP suggest some similarities between races, with a significant inverse relationship between age and IOP only in Asian populations. Genetic differences have been suggested to play a role in these differences, however, a clear genetic pattern is yet to be established. POAG pathogenesis differs between Asians and other ethnicities, and it may differ within the broad classification of the Asian race. Greater awareness and further research are needed to improve treatment plans and outcomes for the increasingly high prevalence of normal tension glaucoma within aging Asian populations.
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20
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Hsueh YJ, Chen YN, Tsao YT, Cheng CM, Wu WC, Chen HC. The Pathomechanism, Antioxidant Biomarkers, and Treatment of Oxidative Stress-Related Eye Diseases. Int J Mol Sci 2022; 23:ijms23031255. [PMID: 35163178 PMCID: PMC8835903 DOI: 10.3390/ijms23031255] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 12/13/2022] Open
Abstract
Oxidative stress is an important pathomechanism found in numerous ocular degenerative diseases. To provide a better understanding of the mechanism and treatment of oxidant/antioxidant imbalance-induced ocular diseases, this article summarizes and provides updates on the relevant research. We review the oxidative damage (e.g., lipid peroxidation, DNA lesions, autophagy, and apoptosis) that occurs in different areas of the eye (e.g., cornea, anterior chamber, lens, retina, and optic nerve). We then introduce the antioxidant mechanisms present in the eye, as well as the ocular diseases that occur as a result of antioxidant imbalances (e.g., keratoconus, cataracts, age-related macular degeneration, and glaucoma), the relevant antioxidant biomarkers, and the potential of predictive diagnostics. Finally, we discuss natural antioxidant therapies for oxidative stress-related ocular diseases.
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Affiliation(s)
- Yi-Jen Hsueh
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (Y.-J.H.); (Y.-N.C.); (Y.-T.T.); (W.-C.W.)
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan
| | - Yen-Ning Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (Y.-J.H.); (Y.-N.C.); (Y.-T.T.); (W.-C.W.)
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
| | - Yu-Ting Tsao
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (Y.-J.H.); (Y.-N.C.); (Y.-T.T.); (W.-C.W.)
| | - Chao-Min Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30012, Taiwan;
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (Y.-J.H.); (Y.-N.C.); (Y.-T.T.); (W.-C.W.)
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
| | - Hung-Chi Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (Y.-J.H.); (Y.-N.C.); (Y.-T.T.); (W.-C.W.)
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
- Correspondence: ; Tel.: +886-3-328-1200 (ext. 7855); Fax: +886-3-328-7798
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21
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Tanito M. Reported evidence of vitamin E protection against cataract and glaucoma. Free Radic Biol Med 2021; 177:100-119. [PMID: 34695546 DOI: 10.1016/j.freeradbiomed.2021.10.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/15/2021] [Accepted: 10/16/2021] [Indexed: 11/25/2022]
Abstract
Cataract and glaucoma are the major causes of severe visual loss and blindness in older adults. This review article describes the currently available basic and clinical evidence regarding vitamin E protection against these eye diseases in the chronologic order of the publications. Experimental evidence has suggested both that oxidative stress due to the accumulation of free radicals plays a role in the pathogenesis of cataracts and glaucoma and that the process can be prevented or ameliorated by vitamin E. The results of observational studies have been inconsistent regarding the association between blood vitamin E levels and the risk of age-related cataract or glaucoma. Despite the encouraging effects of vitamin E from case series, case-control studies, and cross-sectional studies in humans, the effects on cataract formation and/or progression have not been consistent among prospective and randomized control studies; few randomized control studies have tested the effects of supplemental vitamin E on glaucoma development or progression. Given the high prevalence of cataract and glaucoma in the elderly population, even a modest reduction in the risk for these eye diseases would potentially have a substantial public health impact; however, the potential benefits of vitamin E on cataract or glaucoma remain inconclusive and need to be carefully considered.
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Affiliation(s)
- Masaki Tanito
- Department of Ophthalmology, Shimane University Faculty of Medicine, 89-1 Enya, Izumo, Shimane, 693-8501, Japan.
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22
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Non-drug interventions in glaucoma: Putative roles for lifestyle, diet and nutritional supplements. Surv Ophthalmol 2021; 67:675-696. [PMID: 34563531 DOI: 10.1016/j.survophthal.2021.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/15/2021] [Accepted: 09/20/2021] [Indexed: 02/06/2023]
Abstract
Glaucoma is a major ocular neurodegenerative disease characterized by progressive retinal ganglion cells degeneration and sight loss. Current treatment options have been limited to reducing intraocular pressure (IOP), known as the leading risk factor for this disease; however, glaucoma can develop even with low or normal IOP and progress despite controlling IOP values. Lifestyle, dietary habits, and supplementation may influence some of the risk factors and pathophysiological mechanisms underlying glaucoma development and progression; thus, the role of this complementary and alternative medicine in glaucoma has received great interest from both patients and ophthalmologists. We provide a summary of the current evidence concerning the relationship between lifestyle, dietary habits, and effects of supplements on the incidence and progression of glaucoma and their targets and associated mechanisms. The data suggest the existence of a therapeutic potential that needs to be further explored with both preclinical and rigorous clinical studies.
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23
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Gout and open-angle glaucoma risk in a veteran population. Graefes Arch Clin Exp Ophthalmol 2021; 259:3371-3379. [PMID: 34272610 DOI: 10.1007/s00417-021-05273-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/24/2021] [Accepted: 06/03/2021] [Indexed: 01/27/2023] Open
Abstract
PURPOSE A history of gout, arthritis due to hyperuricemia, has been associated with decreased risk for neurodegenerative diseases such as Parkinson's disease. We performed a population-based case-control study in the US Department of Veterans Affairs (VA) medical centers nationwide to assess if gout or hyperuricemia is similarly associated with the ocular neurodegenerative condition glaucoma. METHODS We used ICD-9 codes to identify a nationwide cohort of patients examined at VA healthcare eye clinics between 2000 and 2015 with a diagnosis of open-angle glaucoma (OAG) or of glaucoma suspect. We used incidence density matching to choose controls. We used multivariable logistic regression to examine associations between a history of gout and uric acid (UA) levels on relative risk of OAG or glaucoma suspect. RESULTS There were 1,144,428 OAG or glaucoma suspect cases and 1,144,428 matched controls. Veterans with a history of gout had a small significant decreased risk of OAG compared to controls (ORadjusted(adj) = 0.985, 95% CI: 0.974-0.996). Treated gout was similarly associated with small decreased risk (ORadj = 0.963, 95% CI: 0.950-0.976). A small subset of patients (11.9% of cases and 13.2% of controls) had UA labs available; veterans with the highest median UA levels (> 7.29 mg/dL) did not have statistically significant differences in relative OAG risk (ORadj = 1.014, 95% CI: 0.991-1.036). CONCLUSION Prospective research in other cohorts is needed to confirm our findings in veterans suggesting a history of gout is associated with a small decreased relative risk of glaucoma.
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Natural Products: Evidence for Neuroprotection to Be Exploited in Glaucoma. Nutrients 2020; 12:nu12103158. [PMID: 33081127 PMCID: PMC7602834 DOI: 10.3390/nu12103158] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 12/14/2022] Open
Abstract
Glaucoma, a leading cause of irreversible blindness worldwide, is an optic neuropathy characterized by the progressive death of retinal ganglion cells (RGCs). Elevated intraocular pressure (IOP) is recognized as the main risk factor. Despite effective IOP-lowering therapies, the disease progresses in a significant number of patients. Therefore, alternative IOP-independent strategies aiming at halting or delaying RGC degeneration is the current therapeutic challenge for glaucoma management. Here, we review the literature on the neuroprotective activities, and the underlying mechanisms, of natural compounds and dietary supplements in experimental and clinical glaucoma.
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25
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Jabbehdari S, Chen JL, Vajaranant TS. Effect of dietary modification and antioxidant supplementation on intraocular pressure and open-angle glaucoma. Eur J Ophthalmol 2020; 31:1588-1605. [PMID: 33008269 DOI: 10.1177/1120672120960337] [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] [Indexed: 12/15/2022]
Abstract
Primary open-angle glaucoma (POAG) is an age-dependent, intraocular pressure (IOP)-related degeneration of the retinal ganglion cells (RGC). At present, IOP is the only modifiable factor that has been identified to prevent glaucomatous vision loss. Though the pathogenesis of glaucomatous optic neuropathy is still not well understood, increasing evidence suggests oxidative stress may contribute to the induction and progression of glaucoma. Furthermore, antioxidant use may be protective against glaucoma through various mechanisms, including reducing IOP, preserving vascular health, and preventing ganglion cell loss. This article provides a comprehensive review of the effect of oxidative stress, diet, and antioxidant therapy on IOP and open-angle glaucoma.
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Affiliation(s)
- Sayena Jabbehdari
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Judy L Chen
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
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Abstract
Glaucoma is the leading cause of irreversible blindness in the world. Intraocular pressure (IOP) is currently the only proven modifiable risk factor for POAG. IOP-independent mechanisms contributing to the development of glaucomatous neurodegeneration include oxidative stress, excitotoxicity, mitochondrial dysfunction, and impaired ocular blood flow. In this regard, there has recently been growing interest in the use of various antioxidant dietary supplements as neuroprotective therapy for glaucoma. The issue of the effectiveness and safety of these biologically active additives is an urgent scientific problem reflected in numerous studies. This article reviews current concepts of oxidative/nitrosative stress, the role of reactive oxygen species (ROS)/reactive nitrogen (Nr) and their participation in the development of POAG, as well as experimental models and clinical studies using essential fatty acids, natural compounds and a number of other antioxidant substances that can counteract oxidative stress in glaucoma.
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Affiliation(s)
| | - A D Poluianova
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
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27
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Liu Q, Liu D, Yan D, Huang W, Ji X, Hui J, Tang Z. Gender-Specific Association Between Serum Uric Acid and Incident High Intraocular Pressure in Chinese Population: A Cross-Sectional Study. Invest Ophthalmol Vis Sci 2020; 61:10. [PMID: 32897376 PMCID: PMC7488210 DOI: 10.1167/iovs.61.11.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose The purpose of this study was to investigate the relationship between high intraocular pressure (IOP) and uric acid. Methods In a retrospective cross-sectional study, 19,147 participants were included in 2018. Serum uric acid (SUA) was cut to four groups as Q1 to Q4, according to the quartiles. The odds ratio (OR) and 95% confidence interval (CI) of different SUA levels were estimated by a binomial logistic regression model in men and women. A restrictive cubic spline method was used to estimate the dose-response relationship between uric acid and high IOP. Subgroup analysis was performed to find the gender-specific association between uric acid and high IOP. Results In women, after adjusting for confounding factors, the Q3 and Q4 of SUA levels were significantly associated with the risk of high IOP. The OR with 95% CI for Q3 and Q4 were 1.77 (1.22, 2.57) and 1.51 (1.01, 2.26), respectively, Q1 as a reference. For men, SUA levels were not associated with the incidence of high IOP. Moreover, the spline analysis found an inverted U‐shaped relationship between uric acid and high IOP in women (P = 0.0171). Conclusions Elevated levels of SUAwere independently associated with an increased risk of high IOP in women, but not in men. In addition, uric acid had an inverse U-shaped nonlinear dose-response relationship with high IOP in women.
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Affiliation(s)
- Qianqian Liu
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Dan Liu
- Health Management Center, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Derui Yan
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Weicun Huang
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Xiaodong Ji
- Health Management Center, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Hui
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zaixiang Tang
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
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28
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Serra R, Coscas F, Pinna A, Peri M, Zucca I, Sellam A, Giancipoli E, Boscia F. Detection of serum uric acid in primary open angle glaucoma: A pilot study. Eur J Ophthalmol 2020; 31:1857-1861. [PMID: 32698611 DOI: 10.1177/1120672120944012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess the association between the serum levels of uric acid (UA) and primary open-angle glaucoma (POAG). METHODS In this pilot study, 46 eyes of 23 patients with a clinical history of POAG and 30 eyes of 15 healthy subjects were included. All patients underwent a complete ophthalmological examination, including best corrected visual acuity (BCVA), intraocular pressure (IOP), and gonioscopy. Visual field parameters, such as mean deviation (MD) and pattern standard deviation (PSD), and optical coherence tomography (OCT) values of the optic nerve head, including retinal nerve fiber layer (RNFL) thickness and vertical cup/disc ratio (VCDR), were noted. A blood sample was collected from each subject for serum UA measurement. RESULTS IOP, MD, PSD, RNFL thickness, and VCDR resulted significantly different in POAG patients, when compared with controls (p < 0.05). POAG patients showed significantly lower levels of mean serum UA than healthy controls (4.00 ± 0.66 mg/dL vs 4.95 ± 0.86 mg/dL, respectively, p < 0.0001). Furthermore, severe POAG patients showed mean serum levels of UA lower than mild POAG patients (3.36 ± 0.70 mg/dL vs 4.22 ± 0.51 mg/dL, respectively, p = 0.01). Visual field and OCT parameters were statistically correlated with the mean serum levels of UA in POAG eyes (p < 0.05). CONCLUSION Results suggest that in POAG patients, serum UA levels may be decreased and correlated with visual field and OCT parameters worsening. Further larger multi-center prospective studies are necessary to confirm our findings and establish the role of UA in glaucoma.
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Affiliation(s)
- Rita Serra
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,Istituto di Ricerca Genetica e Biomedica, CNR, Cittadella Universitaria di Cagliari, Monserrato (CA), Italy
| | - Florence Coscas
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, University Paris Est Creteil, Creteil, France
| | - Antonio Pinna
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Marcella Peri
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Ignazio Zucca
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | | | - Ermete Giancipoli
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Francesco Boscia
- Department of Medical, Surgical, and Experimental Sciences, Ophthalmology Unit, University of Sassari, Sassari, Italy
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Lee JY, Kim JM, Lee KY, Kim B, Lee MY, Park KH. Relationships between Obesity, Nutrient Supply and Primary Open Angle Glaucoma in Koreans. Nutrients 2020; 12:nu12030878. [PMID: 32214001 PMCID: PMC7146578 DOI: 10.3390/nu12030878] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/19/2020] [Accepted: 03/23/2020] [Indexed: 11/25/2022] Open
Abstract
To investigate the association between nutrient intake and primary open angle glaucoma (POAG) in Koreans, a population-based, cross-sectional survey, the Korean National Health and Nutrition Examination Survey, was analyzed. Glaucoma diagnosis was based on criteria established by the International Society of Geographic and Epidemiologic Ophthalmology. Multivariate regression analysis was used to assess the correlation between dietary intake and the prevalence of POAG in all enrolled subjects. In the low Body mass index(BMI) group (BMI <18.5), females with POAG had significantly lower intakes of energy, protein, fat, carbohydrate, ash, calcium, phosphorus, sodium, potassium, vitamin A, B-carotene, thiamin, riboflavin, and vitamin C than their non-glaucoma counterparts, based on a multivariate logistic regression analysis (all p < 0.05). In females with a medium BMI (18.5 ≤ BMI < 23), POAG showed a significant association with lower food intake, energy, protein, calcium, phosphorus, potassium, thiamin and niacin. (all p < 0.05). Lower protein thiamine intake in medium BMI males was related to POAG. Low dietary intake of several nutrients showed an association with glaucoma in low BMI female subjects. An insufficient intake of certain nutrients may be associated with an increased risk of glaucoma in Koreans. Further large-scale cohort studies are needed to determine how specific nutrients alter the risk of glaucoma.
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Affiliation(s)
- Jae Yeun Lee
- Department of Ophthalmology, Sahmyook Medical Center, Seoul 02500, Korea; (J.Y.L.); (K.Y.L.)
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea;
- Correspondence: ; Tel.: +82-2-2001-2257; Fax: +82-2-2001-2262
| | - Kyoung Yong Lee
- Department of Ophthalmology, Sahmyook Medical Center, Seoul 02500, Korea; (J.Y.L.); (K.Y.L.)
| | - Bokyung Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea;
| | - Mi Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea;
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea;
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Chen M, Yu X, Xu J, Ma J, Chen X, Chen B, Gu Y, Wang K. Association of Gene Polymorphisms With Primary Open Angle Glaucoma: A Systematic Review and Meta-Analysis. ACTA ACUST UNITED AC 2019; 60:1105-1121. [PMID: 30901387 DOI: 10.1167/iovs.18-25922] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Min Chen
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Xiaoning Yu
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Jia Xu
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Jian Ma
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Xinyi Chen
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Binbin Chen
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Yuxiang Gu
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Kaijun Wang
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
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Association between Pretreatment Serum Uric Acid Levels and Progression of Newly Diagnosed Primary Angle-Closure Glaucoma: A Prospective Cohort Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:7919836. [PMID: 30881597 PMCID: PMC6383391 DOI: 10.1155/2019/7919836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/03/2018] [Accepted: 12/16/2018] [Indexed: 12/17/2022]
Abstract
Purpose Increased evidence reveals that uric acid (UA) may have an important neuroprotective effect through its antioxidant properties. The aim of the present study was to investigate the relationship between pretreatment serum UA levels and the progression of newly diagnosed primary angle-closure glaucoma (PACG). Methods This prospective observational cohort study included 64 patients with newly diagnosed PACG who were followed up for a mean period of 12.77 months (range: 3–28 months). All subjects underwent a complete ophthalmological examination during the baseline and final follow-up visits, together with the acquisition of blood samples for UA measurements. During the follow-up period, the progression of PACG was defined as a clinical diagnosis of medically uncontrolled intraocular pressure and a loss of visual field with a mean deviation of >1 dB/year. Univariable and multivariable Cox regression models were used to investigate the association between baseline serum UA levels and the progression of PACG. The cumulative probability of progression of glaucoma was analyzed using the Kaplan-Meier method. Results During follow-up, 32 subjects were defined as progressive PACG, among whom baseline UA values were significantly higher in nonprogressing subjects than in progressing subjects (0.314 ± 0.069 mmol/l versus [vs.] 0.258 ± 0.069 mmol/l, respectively; P = 0.002). Similar results were also observed in male and female subgroups (P < 0.05). In a multivariable model, a decreased baseline serum UA level was associated with an increased risk for progressing PACG: both in male (hazard ratio [HR] 6.088 [95% confidence interval (CI) 1.163–31.8638]; P = 0.032) and female subjects (HR 3.565 [95% CI 1.131–11.236]; P = 0.030). Subjects with high UA levels demonstrated higher cumulative probabilities of nonprogressing PACG than those with low UA levels (male [16.67% vs. 80.00%; P = 0.0084] and female [29.41% vs. 68.00%; P = 0.0182]). Conclusion An association between high baseline serum UA levels and a decreased risk for progressing PACG was found. This primary finding suggests that high serum UA levels may have a protective role against PACG and could slow disease progression.
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Adeghate J, Rahmatnejad K, Waisbourd M, Katz LJ. Intraocular pressure-independent management of normal tension glaucoma. Surv Ophthalmol 2018; 64:101-110. [PMID: 30300625 DOI: 10.1016/j.survophthal.2018.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 08/15/2018] [Accepted: 08/20/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Jennifer Adeghate
- Wills Eye Hospital, Glaucoma Research Department, Philadelphia, Pennsylvania, USA; Weill Cornell Medical College, Department of Ophthalmology, New York, New York, USA
| | - Kamran Rahmatnejad
- Wills Eye Hospital, Glaucoma Research Department, Philadelphia, Pennsylvania, USA
| | - Michael Waisbourd
- Wills Eye Hospital, Glaucoma Research Department, Philadelphia, Pennsylvania, USA; Thomas Jefferson University, Department of Ophthalmology, Philadelphia, Pennsylvania, USA; Tel-Aviv University Medical Center, Glaucoma Research Center, Tel-Aviv, Israel
| | - L Jay Katz
- Wills Eye Hospital, Glaucoma Research Department, Philadelphia, Pennsylvania, USA; Thomas Jefferson University, Department of Ophthalmology, Philadelphia, Pennsylvania, USA.
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Gao Y, Tang L, Tang B, Cao W, Sun X. Effect of Repeated Freeze-Thaw on Serum Biomarkers Associated with Eye Disease. Med Sci Monit 2018; 24:4481-4488. [PMID: 29958264 PMCID: PMC6054774 DOI: 10.12659/msm.908567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Serum biomarkers are associated with eye diseases, which results in the need for cryopreservation of serum samples. However, the effect on serum biomarker levels of repeatedly freezing and thawing remains poorly understood. The aim of this study was to evaluate the effects of repeated freeze-thaw on the serum levels of the protein, complement C3c (C3c), the micromolecule, uric acid (UA), and the enzyme, angiotensin-converting enzyme (ACE). Material/Methods Serum samples were obtained from 50 patients who attended an ophthalmic outpatient department. Following baseline measurements, the serum samples from each subject were divided into aliquots and stored at −80°C for further analysis, following between one to six freeze-thaw cycles. The serum levels of C3c, UA, and ACE were measured immediately after the stored serum samples were thawed. Results The serum level of C3c was significantly changed after the first freeze-thaw cycle (p<0.05), and a significant alteration in serum ACE levels occurred after the third freeze-thaw cycle (p<0.05). The serum UA level remained unchanged after all freeze-thaw cycles. Repeated freeze-thaw cycles significantly increased the serum levels of C3c and decreased the serum levels of ACE. The serum levels of C3c, UA, and ACE, respectively were significantly correlated (p<0.001), while the correlation coefficient for C3c and UA were improved when compared with ACE. Conclusions Repeated freeze-thaw can have variable effects on the serum levels of biomarkers, C3c, UA and ACE, which supports the need for quality control of cryopreserved serum for biomarker evaluation.
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Affiliation(s)
- Yanting Gao
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China (mainland)
| | - Li Tang
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China (mainland)
| | - Binghua Tang
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China (mainland)
| | - Wenjun Cao
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China (mainland).,Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China (mainland)
| | - Xinghuai Sun
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China (mainland).,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China (mainland).,Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China (mainland).,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China (mainland)
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Dietary Niacin and Open-Angle Glaucoma: The Korean National Health and Nutrition Examination Survey. Nutrients 2018; 10:nu10040387. [PMID: 29565276 PMCID: PMC5946172 DOI: 10.3390/nu10040387] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/17/2018] [Accepted: 03/17/2018] [Indexed: 02/05/2023] Open
Abstract
Glaucoma is a leading cause of loss of sight. High intraocular pressure (IOP) is the most critical risk factor. However, glaucoma develops even within a normal IOP range. Normal tension glaucoma (NTG) is more common in Asia, whereas high tension glaucoma is more common in Western countries. The pathogenesis of glaucoma, especially NTG, is poorly understood. We evaluated the correlation between dietary nutrient intake and glaucoma using data from subjects ≥40 years old from the ongoing, nationwide, population-based study, the Korean National Health and Nutrition Examination Survey V (2008-2012). Dietary intake was determined using the 24 h recall method. Fiber (g/day), ash (g/day), calcium (mg/day), phosphorus (mg/day), iron (mg/day), sodium (mg/day), potassium (mg/day), β-Carotene (μg/day), retinol (μg/day), vitamin A (μg Retinol Equivalents/day), thiamine (mg/day), riboflavin (mg/day), niacin (mg/day), and vitamin C (mg/day) were included in nutrient intake data. All nutrient intake was divided into quartiles. The mean IOP did not differ according to quartiles from any nutrients (all p > 0.05). After adjusting for age, gender, income status, education level, smoking, alcohol consumption, physical activity, diabetes, hypertension, IOP, and total energy, the intake of niacin was associated with glaucoma (p = 0.013). Among subjects with IOP ≤ 21 mmHg, only niacin was related to glaucoma in a multivariate analysis (p = 0.022). Dietary nutrient intake was associated with open-angle glaucoma independent of IOP. Individuals with NTG showed lower intake of niacin among nutrients. This finding suggests the possibility that proper diet counseling may be another modifiable factor, aside from IOP, particularly among patients with NTG.
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35
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Ramdas WD, Schouten JSAG, Webers CAB. The Effect of Vitamins on Glaucoma: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:nu10030359. [PMID: 29547516 PMCID: PMC5872777 DOI: 10.3390/nu10030359] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 03/06/2018] [Accepted: 03/14/2018] [Indexed: 12/14/2022] Open
Abstract
Background: The aim of is to determine the association of vitamins with glaucoma by performing a systematic review and meta-analyses. Methods: Studies on the relation of vitamins and glaucoma published up to December 2017 were identified in the PubMed and Embase database. Data on vitamins (method of assessment), glaucoma (type and method of assessment), study characteristics and quality were recorded. In case of multiple studies for one nutrient a meta-analysis was performed. Results: A total of 629 articles were identified of which 36 were included in the systematic review. The meta-analysis included five of them (940 open-angle glaucoma (OAG) cases and 123,697 controls in total) and resulted in an odds ratio [95% confidence interval] (OR [95% CI]) of 0.58 [0.37–0.91] for dietary vitamin A, though heterogeneity was high (I2 = 51%). After omitting studies that contributed significantly to the heterogeneity, the pooled OR [95% CI] was 0.45 [0.30–0.68] for dietary vitamin A on OAG (I2 = 0%). For vitamin B1, C and E no significant association with OAG was found (OR [95% CI]: 0.84 [0.47–1.51]; 0.68 [0.38–1.22]; 0.95 [0.75–1.19]; respectively). However, after addressing heterogeneity, vitamin C showed a protective effect as well. Especially, foods high in these vitamins (e.g., dark green vegetables) were protective for OAG. Conclusions: Dietary intake of vitamin A and C showed a beneficial association with OAG; however, findings on blood levels of vitamins do not show a clear relation with OAG.
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Affiliation(s)
- Wishal D Ramdas
- Department of Ophthalmology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands.
- Department of Ophthalmology, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands.
| | - Jan S A G Schouten
- Department of Ophthalmology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands.
| | - Carroll A B Webers
- Department of Ophthalmology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands.
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Li S, Shao M, Tang B, Zhang A, Cao W, Sun X. The association between serum uric acid and glaucoma severity in primary angle closure glaucoma: a retrospective case-control study. Oncotarget 2018; 8:2816-2824. [PMID: 27926530 PMCID: PMC5356844 DOI: 10.18632/oncotarget.13745] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 11/23/2016] [Indexed: 12/13/2022] Open
Abstract
Uric acid (UA) is a major antioxidant molecule and has been hypothesized to have a protective effect on the central nervous system against oxidative damage. We prospectively investigated the serum concentration of UA in primary angle closure glaucoma (PACG), and explored the association between serum concentration of UA and the severity of PACG. Using a retrospective case-control study design, 886 PACG subjects and 994 control subjects who attended the Eye & ENT Hospital of Fudan University, were eligible for this study. Glaucoma severity was classified as mild (MD ≤ 6.00 dB), moderate (12 dB ≥ MD > 6 dB) and severe (MD > 12 dB) based on the MD (mean deviation). The levels of UA were significantly lower (p = 0.025) in PACG (0.286 ± 0.082 mmol/l) compared with control (0.295 ± 0.085 mmol/l). The mean serum UA levels were lowest in the severe group (0.281 ± 0.074 mmol/l) followed by moderate (0.282 ± 0.080 mmol/l) and mild (0.297 ± 0.090 mmol/l) with significant differences among the three groups (p = 0.032). In multivariate regression analysis, there was a significant negative correlation between UA level and vertical cup-disc ratio (B = −0.165, p = 0.035). Significantly lower serum UA concentration in PACG and its negative association with disease severity presented it as an important candidate in reaction to oxidative stress in glaucoma pathogenesis.
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Affiliation(s)
- Shengjie Li
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shangai, China
| | - Mingxi Shao
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shangai, China
| | - Binghua Tang
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shangai, China
| | - Aiping Zhang
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shangai, China
| | - Wenjun Cao
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shangai, China.,Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shangai, China
| | - Xinghuai Sun
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shangai, China.,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health (Fudan University), Shangai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shangai, China
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Antonio ML, Laura R, Annagrazia A, Tiziana CM, Rossella R. Rational Basis for Nutraceuticals in the Treatment of Glaucoma. Curr Neuropharmacol 2018; 16:1004-1017. [PMID: 29119928 PMCID: PMC6120110 DOI: 10.2174/1570159x15666171109124520] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Glaucoma, the second leading cause of blindness worldwide, is a chronic optic neuropathy characterized by progressive retinal ganglion cell (RGC) axons degeneration and death. Primary open-angle glaucoma (OAG), the most common type, is often associated with increased intraocular pressure (IOP), however other factors have been recognized to partecipate to the patogenesis of the optic neuropathy. IOP-independent mechanisms that contribute to the glaucoma-related neurodegeneration include oxidative stress, excitotoxicity, neuroinflammation, and impaired ocular blood flow. The involvement of several and diverse factors is one of the reasons for the progression of glaucoma observed even under efficient IOP control with the currently available drugs. METHODS Current research and online content related to the potential of nutritional supplements for limiting retinal damage and improving RGC survival is reviewed. RESULTS Recent studies have suggested a link between dietary factors and glaucoma risk. Particularly, some nutrients have proven capable of lowering IOP, increase circulation to the optic nerve, modulate excitotoxicity and promote RGC survival. However, the lack of clinical trials limit their current therapeutic use. The appropriate use of nutraceuticals that may be able to modify the risk of glaucoma may provide insight into glaucoma pathogenesis and decrease the need for, and therefore the side effects from, conventional therapies. CONCLUSION The effects of nutrients with anti-oxidant and neuroprotective properties are of great interest and nutraceuticals may offer some therapeutic potential although a further rigorous evaluation of nutraceuticals in the treatment of glaucoma is needed to determine their safety and efficacy.
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Affiliation(s)
- Morrone Luigi Antonio
- Address correspondence to this author at the Department of Pharmacy, Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, via P. Bucci, 87036 Rende (CS) Italy; E-mail:
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Asano Y, Himori N, Kunikata H, Yamazaki M, Shiga Y, Omodaka K, Takahashi H, Nakazawa T. Age- and sex-dependency of the association between systemic antioxidant potential and glaucomatous damage. Sci Rep 2017; 7:8032. [PMID: 28808277 PMCID: PMC5556047 DOI: 10.1038/s41598-017-08624-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/17/2017] [Indexed: 01/09/2023] Open
Abstract
Systemic oxidative stress is thought to be an important factor in the pathogenesis of glaucoma. In particular, low systemic antioxidative capacity, which normally counters oxidative stress, may contribute to glaucoma. Thus, we investigated the association between biological antioxidant potential (BAP), a biomarker of systemic antioxidative capacity, and glaucoma severity in patients with open-angle glaucoma (OAG). This study included 480 eyes of 240 patients with OAG and 66 healthy control eyes. We measured the BAP serum level with a free radical analyzer and compared it with a weighted estimate of the number of retinal ganglion cells (wrgc), derived from circumpapillary retinal nerve fiber layer thickness and visual field mean deviation. We found that wrgc was uncorrelated with BAP in the overall, male, and female OAG patients, but was correlated in young (aged ≤ 65 years) male OAG patients (better eye: r = 0.33, P = 0.02; worse eye: r = 0.27, P = 0.047). Furthermore, a mixed-effects regression analysis revealed that BAP was an independent contributing factor to wrgc in young male OAG patients (P = 0.02). Thus, systemic antioxidant capacity was associated with glaucomatous damage in relatively young male patients, suggesting that anti-oxidant therapy might be more effective in these patients.
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Affiliation(s)
- Yoshimi Asano
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriko Himori
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroshi Kunikata
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mai Yamazaki
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yukihiro Shiga
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuko Omodaka
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hidetoshi Takahashi
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Division of Ophthalmology Tohoku Medical and Pharmaceutical University Department of Medicine, Sendai, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan. .,Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan. .,Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan. .,Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Serum uric acid concentration is associated with hypertensive retinopathy in hypertensive chinese adults. BMC Ophthalmol 2017; 17:83. [PMID: 28577362 PMCID: PMC5457596 DOI: 10.1186/s12886-017-0470-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/15/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND This cross sectional investigation included 12,966 subjects with hypertension, a cohort of the China Stroke Primary Prevention Trial (CSPPT), a randomized, multicenter clinical trial. This study aimed to explore the correlation between serum uric acid (SUA) concentration and hypertensive retinopathy in hypertensive adults. METHODS Diagnosis of hypertensive retinopathy was determined by non-mydriatic fundus photography and classified with Keith-Wagener-Barker (KWB) system. The correlation of SUA levels with hypertensive retinopathy prevalence and severity was assessed by statistical analysis. RESULTS 9848 (75.95%) subjects were diagnosed with hypertensive retinopathy with the following retinopathy grade distribution: grade 1: 58.80%, grade 2: 14.81%, and grade 3-4: 2.34%. SUA levels were significantly associated with hypertensive retinopathy prevalence. Patients with hypertensive retinopathy had higher SUA levels than those without hypertensive retinopathy. Patients in the highest uric acid quartile had an odds ratio for hypertensive retinopathy of 1.21 compared to patients in the lowest uric acid quartile (OR = 1.21, 95% CI: 1.05-1.40, P = 0.008). When compared to the non-hyperuricemia group, those in the hyperuricemia group had an odds ratio for hypertensive retinopathy of 1.18(OR = 1.18, 95% CI: 1.05-1.33, P = 0.004). Every 1 mg/dl increase in uric acid concentration was significantly associated with a 6% higher odds of hypertensive retinopathy (OR = 1.06, 95% CI: 1.02-1.10, P = 0.002). CONCLUSIONS The prevalence of hypertensive retinopathy was high (75.95%) among hypertensives in our patients cohort. In addition, SUA concentration was significantly associated with hypertensive retinopathy.
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The Association between Dietary Intake of Antioxidants and Ocular Disease. Diseases 2017; 5:diseases5010003. [PMID: 28933356 PMCID: PMC5456332 DOI: 10.3390/diseases5010003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/20/2017] [Indexed: 12/15/2022] Open
Abstract
To assess the association between dietary antioxidant intake and the incidence of the three major oxidative stress-related eye diseases, cataracts, glaucoma, and age-related macular degeneration, 78 cases from the University of Auckland Optometry and Vision Science clinic and 149 controls were recruited. Participants completed an antioxidant food-frequency questionnaire, analysed through multiple logistic regression. Protective associations were identified with higher consumption of fruit and vegetables (OR = 0.99; 95% CI: 0.98, 1.00; p = 0.004), vitamin C (OR = 0.63; 95% CI: 0.23, 1.03; p = 0.022), and β-carotene (OR = 0.56; 95% CI: 0.15, 0.98; p = 0.007). Meanwhile, harmful associations were observed with greater consumption of meat/nuts (OR = 1.03; 95% CI: 1.01, 1.05; p = 0.006) and cholesterol (OR = 1.09; 95% CI: 1.50, 2.46; p = 0.005). Diets rich in fruit and vegetables appear to be protective against cataracts, glaucoma, and age-related macular degeneration, while diets higher in meat and nuts may increase the risk of oxidative stress-related eye diseases. In addition, higher intakes of vitamin C and β-carotene from food, with reduction of dietary cholesterol intake, may be beneficial towards the outcome of oxidative stress-related eye diseases.
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Shaghaghi MA, Kloss O, Eck P. Genetic Variation in Human Vitamin C Transporter Genes in Common Complex Diseases. Adv Nutr 2016; 7:287-98. [PMID: 26980812 PMCID: PMC4785466 DOI: 10.3945/an.115.009225] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Adequate plasma, cellular, and tissue vitamin C concentrations are required for maintaining optimal health through suppression of oxidative stress and optimizing functions of certain enzymes that require vitamin C as a cofactor. Polymorphisms in the vitamin C transporter genes, compromising genes encoding sodium-dependent ascorbate transport proteins, and also genes encoding facilitative transporters of dehydroascorbic acid, are associated with plasma and tissue cellular ascorbate status and hence cellular redox balance. This review summarizes our current knowledge of the links between variations in vitamin C transporter genes and common chronic diseases. We conclude that emerging genetic knowledge has a good likelihood of defining future personalized dietary recommendations and interventions; however, further validations through biological studies as well as controlled dietary trials are required to identify predictive and actionable genetic biomarkers. We further advocate the need to consider genetic variation of vitamin C transporters in future clinical and epidemiologic studies on common complex diseases.
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Affiliation(s)
| | | | - Peter Eck
- Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada
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42
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Mastropasqua R, Fasanella V, Agnifili L, Fresina M, Di Staso S, Di Gregorio A, Marchini G, Ciancaglini M. Advance in the pathogenesis and treatment of normal-tension glaucoma. PROGRESS IN BRAIN RESEARCH 2015; 221:213-32. [PMID: 26518080 DOI: 10.1016/bs.pbr.2015.05.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Normal-tension glaucoma (NTG) is a multifactorial disease where mechanical stresses and vascular alterations to the optic nerve head probably represent the key pathogenic moments. Although intraocular pressure (IOP) plays a crucial role in the retinal ganglion cell loss, the IOP reduction does not necessarily reduces the disease progression. Therefore, several IOP-independent factors such as glutamate toxicity, oxidative stress, autoimmunity, and vascular dysregulation have been considered in the pathogenesis of NTG. Numerous evidences documented an impairment of the ocular blood flow, involved both in the onset and progression of the disease. The IOP reduction remains the main strategy to reduce the damage progression in NTG. Recently, new treatment strategies have been proposed to improve the control of the disease. Neuroprotection is a rapidly expanding area of research, which represents a promising tool. In the present review, we summarize the recent scientific advancements in the pathogenesis and treatment of NTG.
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Affiliation(s)
- Rodolfo Mastropasqua
- Ophthalmology Unit Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy
| | - Vincenzo Fasanella
- Department of Medicine and Aging Science, Ophthalmology Clinic, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Luca Agnifili
- Department of Medicine and Aging Science, Ophthalmology Clinic, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Michela Fresina
- Department of Specialist, Diagnostics and Experimental Medicine (DIMES), Ophthalmology Service, University of Bologna, Bologna, Italy
| | - Silvio Di Staso
- Ophthalmic Clinic Department of Surgical Science, Eye Clinic, University of L'Aquila, L'Aquila, Italy
| | - Angela Di Gregorio
- Ophthalmic Clinic Department of Surgical Science, Eye Clinic, University of L'Aquila, L'Aquila, Italy
| | - Giorgio Marchini
- Ophthalmology Unit Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy
| | - Marco Ciancaglini
- Ophthalmic Clinic Department of Surgical Science, Eye Clinic, University of L'Aquila, L'Aquila, Italy.
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Pinazo-Durán MD, Zanón-Moreno V, Gallego-Pinazo R, García-Medina JJ. Oxidative stress and mitochondrial failure in the pathogenesis of glaucoma neurodegeneration. PROGRESS IN BRAIN RESEARCH 2015; 220:127-53. [PMID: 26497788 DOI: 10.1016/bs.pbr.2015.06.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This review focuses on oxidative stress and mitochondrial failure for understanding mechanisms of optic nerve damage in primary open-angle glaucoma. The chapter shows scientific evidence for the role of mitochondrial disbalance and reactive oxygen species in glaucoma neurodegeneration. Mitochondria regulate important cellular functions including reactive oxygen species generation and apoptosis. Mitochondrial alterations result from a wide variety of damaging sources. Reactive oxygen species formed by the mitochondria can act as signaling molecules, inducing lipid peroxidation and/or excitotoxicity with the result of cell lesion and death. Antioxidants may help to counteract oxidative stress and to promote neuroprotection. We provide information that may lead to a new way for diagnosing and treating glaucoma patients.
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Affiliation(s)
- Maria D Pinazo-Durán
- Ophthalmic Research Unit "Santiago Grisolía", University Hospital Dr. Peset, Valencia, Spain; Department of Surgery/Ophthalmology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain.
| | - Vicente Zanón-Moreno
- Ophthalmic Research Unit "Santiago Grisolía", University Hospital Dr. Peset, Valencia, Spain; Department of Surgery/Ophthalmology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
| | - Roberto Gallego-Pinazo
- Ophthalmic Research Unit "Santiago Grisolía", University Hospital Dr. Peset, Valencia, Spain; Department of Ophthalmology, University and Polytechnic Hospital la Fe, Valencia, Spain
| | - José J García-Medina
- Ophthalmic Research Unit "Santiago Grisolía", University Hospital Dr. Peset, Valencia, Spain; Department of Ophthalmology, University Hospital Reina Sofia, Murcia, Spain; Department of Ophthalmology and Optometry, University of Murcia, Murcia, Spain
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Serum Uric Acid, Alanine Aminotransferase, Hemoglobin and Red Blood Cell Count Levels in Pseudoexfoliation Syndrome. J Ophthalmol 2015; 2015:914098. [PMID: 26075087 PMCID: PMC4444578 DOI: 10.1155/2015/914098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 04/15/2015] [Accepted: 04/15/2015] [Indexed: 11/23/2022] Open
Abstract
Purpose. The pathogenesis of pseudoexfoliation (PEX), the most common cause of secondary glaucoma, has not been clearly identified, but there is increasing evidence that points out the role of oxidative stress. The aim of this study is to evaluate some of the most commonly used blood parameters, hemoglobin (Hb), red blood cell count (RBC), alanine aminotransferase (ALT), and uric acid (UA) levels, in subjects with PEX. Materials and Methods. This study is performed in a state hospital between November 2011 and December 2012. Retrospective chart review of subjects who underwent cataract surgery was performed. Thirty-one healthy subjects with PEX and 34 healthy subjects without PEX were evaluated. Hb, RBC, ALT, and UA levels were recorded. Student's t-test was used to compare the two groups. Results. The mean age was 73.6 ± 14.1 years in PEX group and 70.1 ± 12.7 in control group (p = 0.293). Hb, RBC, ALT, and UA levels did not show a statistically significant difference among PEX and control groups (p > 0.05 for all). Conclusion. Serum levels of Hb, RBC, ALT, and UA levels were similar in subjects with and without PEX. Further studies are needed to clarify the precise role of Hb, RBC, ALT, and UA in the pathogenesis of PEX.
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Abstract
Glaucoma is an optic neuropathy characterized by a progressive typical pattern of optic neurodegeneration and visual field loss. A relatively high proportion of glauctomatous individuals admit to interest in dietary modification in an attempt to manage their disease. Heavy caffeine consumption appears to have a transient effect on increasing intraocular pressure (IOP). This effect may be clinically insignificant for nonglaucomatous individuals, but the association warrants clinical consideration in those with the disease. Studies investigating the relationship between self-reported antioxidant intake and risk of glaucomatous disease have reported conflicting results. Preliminary studies investigating the relationship between self-reported glaucoma diagnosis and consumption of the oxidants calcium and iron suggest a possible relationship indicating increased risk of the disease with increased consumption of these dietary factors. Initial reports in the literature suggest a potential role for dietary modification in the treatment of glaucomatous optic neuropathy. Further study, with randomized controlled trials, may be necessary to further characterize these relationships.
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Affiliation(s)
- Igor I Bussel
- Chicago Medical School at Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Ahmad A Aref
- Illinois Eye & Ear Infirmary, 1855 W. Taylor St., Suite 3.171, Chicago, IL 60612, USA
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Xu P, Lin Y, Porter K, Liton PB. Ascorbic acid modulation of iron homeostasis and lysosomal function in trabecular meshwork cells. J Ocul Pharmacol Ther 2014; 30:246-53. [PMID: 24552277 DOI: 10.1089/jop.2013.0183] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To investigate the antioxidant properties and biological functions of ascorbic acid (AA) on trabecular meshwork (TM) cells. METHODS Primary cultures of porcine TM cells were supplemented for 10 days with increasing concentrations of AA. Antioxidant properties against cytotoxic effect of H2O2 were evaluated by monitoring cell viability. Redox-active iron was quantified using calcein-AM. Intracellular reactive oxygen species (iROS) production was quantified using H2DCFDA. Ferritin and cathepsin protein levels were analyzed by Western blot. Autophagy was evaluated by monitoring lipidation of LC3-I to LC3-II. Lysosomal proteolysis and cathepsins activities were quantified using specific fluorogenic substrates. RESULTS AA exerts a dual effect against oxidative stress in TM cells, acting as an anti-oxidant or a pro-oxidant, depending on the concentration used. The pro-oxidant effect of AA was mediated by free intracellular iron and correlated with increased protein levels of ferritin and elevated iROS. In contrast, antioxidant properties correlated with lower ferritin and basal iROS content. Ascorbic acid supplementation also caused induction of autophagy, as well as increased lysosomal proteolysis, with the latter resulting from higher proteolytic activation of lysosomal cathepsins in treated cultures. CONCLUSIONS Our results suggest that the reported decrease of AA levels in plasma and aqueous humor can compromise lysosomal degradation in the outflow pathway cells with aging and contribute to the pathogenesis of glaucoma. Restoration of physiological levels of vitamin C inside the cells might improve their ability to degrade proteins within the lysosomal compartment and recover tissue function.
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Affiliation(s)
- Ping Xu
- Department of Ophthalmology, Duke University , Durham, North Carolina
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Izzotti A, Centofanti M, Saccà SC. Molecular diagnostics of ocular diseases: the application of antibody microarray. Expert Rev Mol Diagn 2014; 12:629-43. [DOI: 10.1586/erm.12.57] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Grover AK, Samson SE. Antioxidants and vision health: facts and fiction. Mol Cell Biochem 2013; 388:173-83. [PMID: 24311110 DOI: 10.1007/s11010-013-1908-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 11/15/2013] [Indexed: 12/12/2022]
Abstract
A number of nutritional supplements containing antioxidants are advertised for better vision health. Do they benefit the average consumer? The literature was examined for the effectiveness of antioxidants for human eye health, and for the intricacies in collection of such evidence. The following diseases were considered: cataract, glaucoma, age-related macular degeneration (AMD), retinopathy, retinitis pigmentosa, eye infections, and uveitis. The literature indicates that antioxidant supplements plus lutein have a reasonable probability of retarding AMD. For glaucoma, such supplements were ineffectual in some studies but useful in others. In some studies, antioxidant rich fruits and vegetables were also useful for protection against glaucoma. For diabetic retinopathy, antioxidant supplements may have a small benefit, if any, but only as an adjunct to glycemic control. In very high-risk premature retinopathy and retinitis pigmentosa, antioxidant supplements may be beneficial but those with excess Vitamin E should be avoided. For cataract, there is no evidence for an advantage of such nutritional supplements. However, lubricant drops containing N-acetylcarnosine may be helpful in initial stages of the disease. For eye infections and other causes of uveitis, antioxidants have not been found useful. We recommend that a diet high in antioxidant rich foods should be developed as a habit from an early age. However, when initial signs of vision health deterioration are observed, the appropriate nutritional supplement products may be recommended but only to augment the primary medical treatments.
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Affiliation(s)
- Ashok K Grover
- Department of Medicine, McMaster University, Hamilton, ON, L8N3Z5, Canada,
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Janssen SF, Gorgels TG, Ramdas WD, Klaver CC, van Duijn CM, Jansonius NM, Bergen AA. The vast complexity of primary open angle glaucoma: Disease genes, risks, molecular mechanisms and pathobiology. Prog Retin Eye Res 2013; 37:31-67. [DOI: 10.1016/j.preteyeres.2013.09.001] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 07/26/2013] [Accepted: 09/03/2013] [Indexed: 12/21/2022]
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Yuki K, Tsubota K. Increased urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG)/creatinine level is associated with the progression of normal-tension glaucoma. Curr Eye Res 2013; 38:983-8. [PMID: 23767426 DOI: 10.3109/02713683.2013.800889] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE The objective of this study was to investigate the association between systemic oxidative stress and visual field defect progression in normal-tension glaucoma (NTG). PATIENTS AND METHODS The subjects were 40 consecutive patients with NTG who were admitted to Keio University Hospital for 24-h intraocular pressure (IOP) evaluation; all subjects underwent six or more visual field tests in either eye and were followed up for >5 years. Spot samples of morning urine were collected during admission from all participants to determine the levels of urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) by ELISA kit. A linear regression line was calculated with the least squares method. Those subjects whose regression lines were negative and the p value <0.05 were classified as progressive, while all others were defined as non-progressive. Urinary 8-OHdG/creatinine level was compared between the two groups. Adjusted odds ratio and 95% confidence intervals for the progression were estimated with logistic regression models. RESULTS Seventeen subjects showed visual field defect progression (age: 59.9 ± 9.5 years, untreated IOP in the right eye: 15.8 ± 2.1 mmHg), and 23 subjects showed no progression (age: 57.4 ± 10.4 years, untreated IOP in the right eye: 16.0 ± 2.6 mmHg). Urinary 8-OHdG/creatinine level was significantly higher in the progressive group than in the non-progressive group (progressive group: 9.0 ± 2.4 ng/mg creatinine, non-progressive group: 7.3 ± 1.8 ng/mg creatinine, p = 0.02). Multivariable analysis revealed that higher urinary 8-OHdG/creatinine level was a significant risk factor for the progression (odds ratio 1.54, 95% confidence interval 1.03-2.29). CONCLUSIONS Increased urinary 8-OHdG/creatinine was associated with glaucomatous visual field progression in subjects with NTG.
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Affiliation(s)
- Kenya Yuki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
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