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Qiao GL, Mikelberg FS, Etminan M. Use of Diuretics and Risk of Acute Angle Closure: A Case-Control Study. Ophthalmic Epidemiol 2024; 31:321-324. [PMID: 37786355 DOI: 10.1080/09286586.2023.2264387] [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: 04/12/2022] [Accepted: 09/15/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE To examine the possible link between acute angle closure (AAC) with use of diuretics. METHODS A nested case-control study (NCC) was conducted among a cohort of diuretic users using the PharMetrics Plus database from 2006 to 2020. Cases were identified as the first international classification of diseases 9th and 10th editions (ICD-9/10) code for ACC. For each case, 4 controls were selected and matched to the cases by age and sex using density-based sampling. A conditional logistic regression model was used to compute rate ratios (RRs) adjusted for the drugs topiramate, bupropion, sulphonamide antibiotics, acetazolamide, and sulfasalazine. The RRs for a negative control drug, amlodipine, was also assessed. RESULTS From the initial cohort of 713 574 diuretics users, 1 553 cases and 6 212 controls were identified. No increase in the risk of AAC with current users of diuretics was found (RR = 1.06, (95% CI: 0.81-1.37) for all diuretics; RR = 0.97, (95% CI: 0.71-1.32) for thiazides; RR = 1.24, (95% CI: 0.90-1.73) for loop diuretics; RR = 0.99, (95% CI: 0.73-1.36) for potassium sparing). CONCLUSION We found no increase in the risk of acute angle closure with use of diuretics. Future studies are needed to confirm these findings.
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Affiliation(s)
- Grace L Qiao
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Frederick S Mikelberg
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Mahyar Etminan
- Departments of Ophthalmology and Visual Sciences, Medicine and Pharmacology, University of British Columbia, Vancouver, Canada
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2
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Harvey DH, Sugali CK, Mao W. Glucocorticoid-Induced Ocular Hypertension and Glaucoma. Clin Ophthalmol 2024; 18:481-505. [PMID: 38379915 PMCID: PMC10878139 DOI: 10.2147/opth.s442749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 01/22/2024] [Indexed: 02/22/2024] Open
Abstract
Glucocorticoid (GC) therapy is indicated in many diseases, including ocular diseases. An important side-effect of GC therapy is GC-induced ocular hypertension (GIOHT), which may cause irreversible blindness known as GC-induced glaucoma (GIG). Here, we reviewed the pathological changes that contribute to GIOHT including in the trabecular meshwork and Schlemm's canal at cellular and molecular levels. We also discussed the clinical aspects of GIOHT/GIG including disease prevalence, risk factors, the type of GCs, the route of GC administration, and management strategies.
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Affiliation(s)
- Devon Hori Harvey
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
- Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Chenna Kesavulu Sugali
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
- Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Weiming Mao
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
- Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Biochemistry & Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, USA
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
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3
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Zhang H, Houadj L, Wu KY, Tran SD. Diagnosing and Managing Uveitis Associated with Immune Checkpoint Inhibitors: A Review. Diagnostics (Basel) 2024; 14:336. [PMID: 38337852 PMCID: PMC10855398 DOI: 10.3390/diagnostics14030336] [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: 01/02/2024] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
This review aims to provide an understanding of the diagnostic and therapeutic challenges of uveitis associated with immune checkpoint inhibitors (ICI). In the wake of these molecules being increasingly employed as a treatment against different cancers, cases of uveitis post-ICI therapy have also been increasingly reported in the literature, warranting an extensive exploration of the clinical presentations, risk factors, and pathophysiological mechanisms of ICI-induced uveitis. This review further provides an understanding of the association between ICIs and uveitis, and assesses the efficacy of current diagnostic tools, underscoring the need for advanced techniques to enable early detection and accurate assessment. Further, it investigates the therapeutic strategies for ICI-related uveitis, weighing the benefits and limitations of existing treatment regimens, and discussing current challenges and emerging therapies in the context of their potential efficacy and side effects. Through an overview of the short-term and long-term outcomes, this article suggests recommendations and emphasizes the importance of multidisciplinary collaboration between ophthalmologists and oncologists. Finally, the review highlights promising avenues for future research and development in the field, potentially informing transformative approaches in the ocular assessment of patients under immunotherapy and the management of uveitis following ICI therapy.
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Affiliation(s)
- Huixin Zhang
- Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada;
| | - Lysa Houadj
- Faculty of Medicine, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada;
| | - Kevin Y. Wu
- Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada
| | - Simon D. Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC H3A 1G1, Canada
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4
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Shih HL, Chang R, Yeh WB, Chou MC. Risk of new-onset glaucoma in patients with systemic lupus erythematosus: A nationwide, population-based cohort study. Int J Rheum Dis 2024; 27:e14838. [PMID: 37608688 DOI: 10.1111/1756-185x.14838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 08/24/2023]
Affiliation(s)
- Han-Lin Shih
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Renin Chang
- Department of Emergency Medicine, Veterans General Hospital, Kaohsiung, Taiwan
| | - Wen-Bin Yeh
- Department of Emergency Medicine, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan
| | - Mei-Chia Chou
- Department of Physical Medicine and Rehabilitation, Pingtung Veterans General Hospital, Pingtung, Taiwan
- Department of Physical Medicine and Rehabilitation, Pingtung Veterans General Hospital, Longquan Branch, Pingtung, Taiwan
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5
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Kozaru M, Iida T, Hosohata K. A Pharmacovigilance Study of Drug-Induced Glaucoma Utilizing the Japanese Adverse Event Reporting System. Clin Ophthalmol 2023; 17:3645-3653. [PMID: 38050555 PMCID: PMC10693769 DOI: 10.2147/opth.s439255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023] Open
Abstract
Purpose Clinically, glaucoma is a serious problem because it is asymptomatic until a relatively late stage in most cases, which can lead to delays in the diagnosis and treatment of the disease. The purpose of this study was to clarify the rank-order of the association of glaucoma with the causative drugs using a spontaneous reporting system database. Methods Data were extracted from the Japanese Adverse Drug Event Report database of the Pharmaceuticals and Medical Devices Agency (Japan). Based on reports of glaucoma caused by all drugs, we calculated the reporting odds ratio (ROR) and 95% confidence interval (CI) for glaucoma. Results Among 609 reports of adverse events corresponding to glaucoma (46%, women), the most frequently implicated drug were steroids (prednisolone, betamethasone sodium phosphate, triamcinolone acetonide, and fluorometholone), pregabalin, ranibizumab, crizotinib, tacrolimus hydrate, darbepoetin alfa, and foscarnet sodium hydrate. Among 207 reports involved in angle-closure glaucoma (86%, women), anticholinergic drug and antidepressants ranked high and showed signals. Signals were also detected in bromazepam (ROR, 69.7; 95% CI, 30.9-157.5), oral brotizolam (ROR, 16.6; 95% CI, 6.18-44.8), and oral milnacipran hydrochloride (ROR, 22.8; 95% CI, 8.46-61.4) for angle-closure glaucoma. Conclusion A national pharmacovigilance database enabled us to identify the drugs that frequently induce glaucoma. The likelihood of the reporting of glaucoma varied among the drugs, which should be used carefully in clinical practice to avoid it.
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Affiliation(s)
- Mariko Kozaru
- Education and Research Center for Clinical Pharmacy, Faculty of Pharmacy, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-1094, Japan
| | - Tatsuya Iida
- Education and Research Center for Clinical Pharmacy, Faculty of Pharmacy, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-1094, Japan
| | - Keiko Hosohata
- Education and Research Center for Clinical Pharmacy, Faculty of Pharmacy, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-1094, Japan
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6
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Agarwal P, Rupenthal ID. Non-aqueous formulations in topical ocular drug delivery - a paradigm shift? Adv Drug Deliv Rev 2023; 198:114867. [PMID: 37178927 DOI: 10.1016/j.addr.2023.114867] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/03/2023] [Accepted: 05/07/2023] [Indexed: 05/15/2023]
Abstract
Topical eyedrop application is the preferred route for drug delivery to anterior segment tissues; however, the challenge of overcoming the eye's anatomical and physiological barriers while minimising tissue toxicity has restricted developments in this field. Aqueous vehicles have traditionally been used, which typically require several additives and preservatives to achieve physiologically compatible and sterile eyedrops, elevating their toxicity potential. Non-aqueous vehicles have been suggested as efficient alternatives for topical drug delivery as they can address many of the limitations associated with conventional aqueous eyedrops. However, despite their obvious advantages, non-aqueous eyedrops remain poorly researched and few non-aqueous formulations are currently available in the market. This review challenges the conventional hypothesis that aqueous solubility is a prerequisite to ocular drug absorption and establishes a rationale for using non-aqueous vehicles for ocular drug delivery. Recent advances in the field have been detailed and future research prospects have been explored, pointing towards a paradigm shift in eyedrop formulation in the near future.
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Affiliation(s)
- Priyanka Agarwal
- Buchanan Ocular Therapeutics Unit, Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland 1142, New Zealand.
| | - Ilva D Rupenthal
- Buchanan Ocular Therapeutics Unit, Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland 1142, New Zealand
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7
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Balas M, Mathew DJ. Secondary open-angle glaucoma in a young male related to dimethylamylamine supplementation. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023:S0008-4182(23)00066-2. [PMID: 36965509 DOI: 10.1016/j.jcjo.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/26/2023] [Indexed: 03/27/2023]
Affiliation(s)
| | - David J Mathew
- University of Toronto, Toronto, Ont.; Donald K. Johnson Eye Institute, Krembil Research Institute, University Health Network, Toronto, Ont..
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8
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Deleu L, Bremer F. Two cases of acute intraocular pressure elevation with dabigatran use in glaucoma patients. J Fr Ophtalmol 2023; 46:e114-e116. [PMID: 36792469 DOI: 10.1016/j.jfo.2022.09.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/18/2022] [Accepted: 09/26/2022] [Indexed: 02/17/2023]
Affiliation(s)
- L Deleu
- Department of Ophthalmology, Cliniques universitaires de Bruxelles, Hôpital Erasme, Université libre de Bruxelles (ULB), 808, route de Lennik, 1070 Brussels, Belgium.
| | - F Bremer
- Department of Ophthalmology, Cliniques universitaires de Bruxelles, Hôpital Erasme, Université libre de Bruxelles (ULB), 808, route de Lennik, 1070 Brussels, Belgium
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9
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Nadeau Nguyen M, Chambers W, Dores GM, Nayernama A, Jones SC. Association of Daratumumab Use With Ocular Events in a Case Series of US Adults. JAMA Oncol 2022; 8:1209-1210. [PMID: 35653128 DOI: 10.1001/jamaoncol.2022.1634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Michelle Nadeau Nguyen
- Division of Pharmacovigilance, Office of Surveillance and Epidemiology, US Food and Drug Administration, Silver Spring, Maryland
| | - Wiley Chambers
- Division of Ophthalmology, Office of Specialty Medicine, US Food and Drug Administration, Silver Spring, Maryland
| | - Graça M Dores
- Division of Pharmacovigilance, Office of Surveillance and Epidemiology, US Food and Drug Administration, Silver Spring, Maryland
| | - Afrouz Nayernama
- Division of Pharmacovigilance, Office of Surveillance and Epidemiology, US Food and Drug Administration, Silver Spring, Maryland
| | - S Christopher Jones
- Division of Pharmacovigilance, Office of Surveillance and Epidemiology, US Food and Drug Administration, Silver Spring, Maryland
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10
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Rad LM, Yumashev AV, Hussen BM, Jamad HH, Ghafouri-Fard S, Taheri M, Rostami S, Niazi V, Hajiesmaeili M. Therapeutic Potential of Microvesicles in Cell Therapy and Regenerative Medicine of Ocular Diseases With an Especial Focus on Mesenchymal Stem Cells-Derived Microvesicles. Front Genet 2022; 13:847679. [PMID: 35422841 PMCID: PMC9001951 DOI: 10.3389/fgene.2022.847679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/28/2022] [Indexed: 12/13/2022] Open
Abstract
These days, mesenchymal stem cells (MSCs), because of immunomodulatory and pro-angiogenic abilities, are known as inevitable factors in regenerative medicine and cell therapy in different diseases such as ocular disorder. Moreover, researchers have indicated that exosome possess an essential potential in the therapeutic application of ocular disease. MSC-derived exosome (MSC-DE) have been identified as efficient as MSCs for treatment of eye injuries due to their small size and rapid diffusion all over the eye. MSC-DEs easily transfer their ingredients such as miRNAs, proteins, and cytokines to the inner layer in the eye and increase the reconstruction of the injured area. Furthermore, MSC-DEs deliver their immunomodulatory cargos in inflamed sites and inhibit immune cell migration, resulting in improvement of autoimmune uveitis. Interestingly, therapeutic effects were shown only in animal models that received MSC-DE. In this review, we summarized the therapeutic potential of MSCs and MSC-DE in cell therapy and regenerative medicine of ocular diseases.
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Affiliation(s)
- Lina Moallemi Rad
- Department of Molecular and Cell Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran
| | - Alexey V Yumashev
- Department of Prosthetic Dentistry, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Bashdar Mahmud Hussen
- Department of Pharmacognosy, College of Pharmacy, Hawler Medical University, Kurdistan Region, Erbil, Iraq.,Center of Research and Strategic Studies, Lebanese French University, Kurdistan Region, Erbil, Iraq
| | - Hazha Hadayat Jamad
- Department of Biology, College of Education, Salahaddin University-Erbil, Kurdistan Region, Erbil, Iraq
| | - Soudeh Ghafouri-Fard
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Taheri
- Institute of Human Genetics, Jena University Hospital, Jena, Germany
| | - Samaneh Rostami
- Department of Immunology, School of Medicine, Zanjan University of Medical Sciecnes, Zanjan, Iran
| | - Vahid Niazi
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Hajiesmaeili
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Critical Care Quality Improvement Research Center, Loghman Hakin Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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11
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Mullick R, Annavajjhala S, Thakur P, Mohapatra A, Shetty R, D'Souza S. Efficacy of topical cyclosporine 0.05% and osmoprotective lubricating eye drops in treating dry eye disease and inflammation. Indian J Ophthalmol 2021; 69:3473-3477. [PMID: 34826977 PMCID: PMC8837309 DOI: 10.4103/ijo.ijo_3822_20] [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] [Indexed: 11/04/2022] Open
Abstract
Purpose To evaluate the effect of topical cyclosporine 0.05% and osmoprotective lubricating eye drops on patients with dry eye disease (DED) with inflammation as measured by raised tear matrix metalloproteinases (MMP-9). Methods This prospective study included 106 eyes of 53 patients diagnosed with DED based on any of the following DED criteria (Ocular Surface Disease Index [OSDI] score >12, tear film breakup time [TBUT] <10 s, Schirmer's I test result <10 mm/5 min, ocular surface staining). Ocular surface inflammation was assessed by assessing MMP-9 positivity from tears of the patients in the study (Inflammadry kit Quidel corporation). Patients were prescribed osmoprotective lubricating eye drops (Osmodrops, Cipla Ltd) four times a day and cyclosporine A 0.05% eye drops (Imudrops, Cipla Ltd) twice a day for 6 months. Efficacy of the formulations was evaluated by OSDI scores, Schirmer's test, TBUT change, reduction in ocular surface staining, and reduction in MMP-9 levels after 6 months of usage. Check P value and add from results. Results After 6 months of topical therapy, improvement was observed in OSDI scores (mean pretreatment: 25.7 ± 12.8, and mean posttreatment: 15.2 ± 8.4), P < 0.001. There was also reduction number of patients who were MMP-9 positive. Out of 75 eyes that tested MMP-9 positive, 70.66% showed reduction in MMP-9 levels P < 0.0001). Ocular surface staining also improved. Conclusion Topical osmoprotective lubricating eye drops and cyclosporine A 0.05% reduce inflammation in cases of DED, which correlates with improvement in OSDI scores, ocular surface staining, and reduction in inflammation as measured by levels of tear MMP-9.
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Affiliation(s)
- Ritika Mullick
- Department of Cornea and Refractive Surgery, Narayana Nethralaya Eye Hospital, Bengaluru, Karnataka, India
| | - Sriram Annavajjhala
- Department of Cornea and Refractive Surgery, Narayana Nethralaya Eye Hospital, Bengaluru, Karnataka, India
| | - Prashansa Thakur
- Department of Cornea and Refractive Surgery, Narayana Nethralaya Eye Hospital, Bengaluru, Karnataka, India
| | - Ayushi Mohapatra
- Department of Cornea and Refractive Surgery, Narayana Nethralaya Eye Hospital, Bengaluru, Karnataka, India
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya Eye Hospital, Bengaluru, Karnataka, India
| | - Sharon D'Souza
- Department of Cornea and Refractive Surgery, Narayana Nethralaya Eye Hospital, Bengaluru, Karnataka, India
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12
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Filippelli M, dell'Omo R, Gelso A, Rinaldi M, Bartollino S, Napolitano P, Russo A, Campagna G, Costagliola C. Effects of topical low-dose preservative-free hydrocortisone on intraocular pressure in patients affected by ocular surface disease with and without glaucoma. Graefes Arch Clin Exp Ophthalmol 2021; 260:247-253. [PMID: 34406502 DOI: 10.1007/s00417-021-05345-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 07/05/2021] [Accepted: 07/26/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This study aims to investigate the safety and efficacy of short-term treatment for ocular surface disease (OSD) with topical low-dose (1,005 mg) preservative-free hydrocortisone in one hundred patients with and without glaucoma. METHODS This was an open label non-randomized clinical trial. Patients with OSD with and without primary open-angle glaucoma (POAG) received topical low-dose (1,005 mg) preservative-free hydrocortisone twice daily in each eye for 2 weeks. All patients underwent a complete ophthalmological examination at baseline (T0) and at 1 (T1) and 2 (T2) weeks post-treatment. At each visit, the intraocular pressure (IOP) and the ocular surface disease index (OSDI) questionnaire scores were recorded; the Schirmer test was performed only at T0 and T2. RESULTS The OSDI score significantly decreased in both the POAG and no-POAG groups (both p < 0.0001) after hydrocortisone treatment, with no difference between the two groups (p = 0.72). There were no significant differences in IOP and Schirmer test results between T0 and T2 in both treatment groups (p = 0.68 and p = 0.83, respectively). CONCLUSIONS Topical low-dose (1,005 mg) preservative-free hydrocortisone is safe and effective for improving OSD symptoms both in patients with and without POAG. TRIAL REGISTRATION The trial was registered at clinicaltrials.gov under NCT04536129 on 01/09/2020 ("retrospectively registered").
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Affiliation(s)
- M Filippelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
| | - R dell'Omo
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - A Gelso
- "Villa Dei Fiori" Hospital, Acerra, Naples, Italy
| | - M Rinaldi
- Department of Ophthalmology, University Della Campania Luigi Vanvitelli, Naples, Italy
| | - S Bartollino
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - P Napolitano
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - A Russo
- "Villa Dei Fiori" Hospital, Acerra, Naples, Italy
| | - G Campagna
- Department of Medical-Surgical Sciences and Translational Medicine, University of Rome "La Sapienza", Rome, Italy
| | - C Costagliola
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
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13
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Sgambellone S, Lucarini L, Lanzi C, Masini E. Novel Insight of Histamine and Its Receptor Ligands in Glaucoma and Retina Neuroprotection. Biomolecules 2021; 11:1186. [PMID: 34439851 PMCID: PMC8392511 DOI: 10.3390/biom11081186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 01/01/2023] Open
Abstract
Glaucoma is a multifactorial neuropathy characterized by increased intraocular pressure (IOP), and it is the second leading cause of blindness worldwide after cataracts. Glaucoma combines a group of optic neuropathies characterized by the progressive degeneration of retinal ganglionic cells (RGCs). Increased IOP and short-term IOP fluctuation are two of the most critical risk factors in glaucoma progression. Histamine is a well-characterized neuromodulator that follows a circadian rhythm, regulates IOP and modulates retinal circuits and vision. This review summarizes findings from animal models on the role of histamine and its receptors in the eye, focusing on the effects of histamine H3 receptor antagonists for the future treatment of glaucomatous patients.
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Affiliation(s)
- Silvia Sgambellone
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Pharmacology and Toxicology Section, University of Florence, 50139 Florence, Italy; (S.S.); (E.M.)
| | - Laura Lucarini
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Pharmacology and Toxicology Section, University of Florence, 50139 Florence, Italy; (S.S.); (E.M.)
| | - Cecilia Lanzi
- Toxicology Unit, Emergency Department, Careggi University Hospital, 50139 Florence, Italy;
| | - Emanuela Masini
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Pharmacology and Toxicology Section, University of Florence, 50139 Florence, Italy; (S.S.); (E.M.)
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14
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Kim WJ, Li J, Oh IS, Song I, Lee E, Namkoong K, Shin JY. Benzodiazepine Use and Risk of Acute Angle-Closure Glaucoma: A Population-Based Case-Crossover Study. Drug Saf 2021; 43:539-547. [PMID: 32034700 DOI: 10.1007/s40264-020-00914-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Theoretically, benzodiazepines (BZDs) can narrow the iridocorneal angle and induce acute angle-closure glaucoma (AACG). However, little evidence exists regarding this association. OBJECTIVE The objective of this study was to assess whether the use of BZDs is associated with the risk of AACG. METHODS We conducted a population-based case-crossover study using the nationwide claims database of the National Health Insurance Service in Korea. Patients with newly diagnosed AACG-between 1 January 2013 and 31 December 2016-who had received at least one BZD prescription prior to AACG diagnosis were enrolled. The date of AACG diagnosis was set as the index date. We assessed BZD use by each patient during a 30-day case period prior to the index date and three consecutive control periods that preceded this date. We used conditional logistic regression that adjusted for concomitant medications to determine the odds ratio for the use of BZDs in the case period compared with that in the control period in patients with incident AACG. RESULTS Of the 11,093 patients with incident AACG, 6709 received a prescription for BZD prior to diagnosis. BZD use was associated with an increased risk of AACG [adjusted odds ratio (aOR) = 1.40; 95% confidence interval (CI) 1.27-1.54]. AACG risk was similar for short-acting (aOR = 1.40, 95% CI 1.24-1.57) and long-acting BZDs (aOR = 1.33, 95% CI 1.18-1.50). CONCLUSION We found that BZD use was associated with AACG risk in the Korean population. Clinicians should carefully monitor the occurrence of visual disturbance in BZD-treated patients.
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Affiliation(s)
- Woo Jung Kim
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Junqing Li
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, Republic of Korea
| | - In-Sun Oh
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Inmyung Song
- Department of Health Administration, Kongju National University College of Nursing and Health, Gongju-si, Chungcheongnam-do, Republic of Korea
| | - Eun Lee
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kee Namkoong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, Republic of Korea.
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15
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Ciobanu AM, Dionisie V, Neagu C, Bolog OM, Riga S, Popa-Velea O. Psychopharmacological Treatment, Intraocular Pressure and the Risk of Glaucoma: A Review of Literature. J Clin Med 2021; 10:jcm10132947. [PMID: 34209089 PMCID: PMC8269427 DOI: 10.3390/jcm10132947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/25/2021] [Accepted: 06/29/2021] [Indexed: 12/19/2022] Open
Abstract
Through the years, the available psychopharmacological treatments have expanded with numerous new drugs. Besides weight gain, gastro-intestinal problems or Parkinson-like symptoms, ocular adverse effects of psychiatric drugs have been reported. These adverse effects are not common, but can be dangerous for the patient. This review summarises the current knowledge on the risk of raised intraocular pressure and glaucoma entailed by psychopharmacological treatment. Also, it provides updated data for clinicians involved in the treatment of patients with glaucoma or glaucoma risk factors. For this purpose, we performed an extensive literature search in the PubMed database using specific terms. Selective serotonin and noradrenaline reuptake inhibitors are the best evidenced as having no association with glaucoma. Antipsychotics, and especially first generation, seem to have no correlation with an increased intraocular pressure and therefore possibly with a risk of glaucoma, although a special attention should be paid when using ziprasidone. Tricyclic antidepressants, benzodiazepines and topiramate should be avoided in patients diagnosed with glaucoma or at risk. Clinicians should be aware of the possible psychotropic drug induced glaucoma and monitor at risk patients closely in order to prevent this condition. Irrespective of the psychopharmacological regimen taken into consideration, the glaucoma patient should be under the strict supervision of the ophthalmologist.
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Affiliation(s)
- Adela Magdalena Ciobanu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
- Correspondence: (A.M.C.); (V.D.)
| | - Vlad Dionisie
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
- Department of Psychiatry and Psychology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Correspondence: (A.M.C.); (V.D.)
| | - Cristina Neagu
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
| | - Otilia Maria Bolog
- Service d’Ophtalmologie, Centre Hospitalier ‘Rene Dubos’, 95300 Pontoise, France;
| | - Sorin Riga
- Department of Stress Research and Prophylaxis, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
- Romanian Academy of Medical Sciences, 927180 Bucharest, Romania
| | - Ovidiu Popa-Velea
- Department of Medical Psychology, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
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16
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Tanaka F, Shibatani N, Fujita K, Ikesue H, Yoshimizu S, Muroi N, Kurimoto Y, Hashida T. Polypharmacy-associated potential contraindications of drug prescriptions in patients with primary angle closure disease in a real-world setting. J Pharm Health Care Sci 2021; 7:17. [PMID: 33934721 PMCID: PMC8091551 DOI: 10.1186/s40780-021-00196-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 02/24/2021] [Indexed: 11/21/2022] Open
Abstract
Background Primary angle closure disease (PACD) is a type of glaucoma in which the intraocular pressure (IOP) is increased because of the blockage of the anterior chamber angle. Medications contraindicated for patients with PACD, such as anticholinergics, cause mydriasis, and can elevate IOP. However, anticholinergics are currently contraindicated only for primary angle closure glaucoma (PACG) in Japanese package inserts. In this study, we investigated the prescription status of medications contraindicated for PACD, such as anticholinergics, in patients with PACD scheduled for eye surgeries. Methods Forty-three Japanese patients diagnosed with PACD at Kobe City Eye Hospital, Japan, and scheduled hospitalization for eye surgeries between December 2017 and July 2018, were included. Data, including sex, age, diagnosis, IOP, anterior chamber depth, and patients’ regular medications prior to hospitalization, were collected for each patient from the electronic medical records. Results The number of patients with chronic primary angle closure (CPAC) and acute primary angle closure (APAC) was 35 (81.4%) and 8 (18.6%), respectively. Among all the 43 patients with PACD, 8 (18.6%) received 15 medications that are potentially contraindicated for PACD by non-ophthalmologist. According to medication categories, benzodiazepine hypnotics were the most commonly prescribed. Among the 8 patients with APAC, 2 (25.0%) had routinely received medications contraindicated for PACD. The median number of all kinds of prescriptions on the day of hospitalization was significantly higher for patients who received medications contraindicated for PACD than for those who did not receive them (p = 0.010). Conclusions About 20% of patients with PACD received medications potentially contraindicated for PACD, such as anticholinergics. Attention should be paid to patients prescribed multiple drugs for adverse events, such as increase in intraocular pressure.
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Affiliation(s)
- Fumiaki Tanaka
- Department of Pharmacy, Kobe City Eye Hospital, 2-1-8 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan.,Present Address: Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Naoki Shibatani
- Department of Pharmacy, Kobe City Eye Hospital, 2-1-8 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan.,Present Address: Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Kazumi Fujita
- Department of Pharmacy, Kobe City Eye Hospital, 2-1-8 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan.,Present Address: Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Hiroaki Ikesue
- Present Address: Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Satoru Yoshimizu
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan
| | - Nobuyuki Muroi
- Department of Pharmacy, Kobe City Eye Hospital, 2-1-8 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan. .,Present Address: Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan.
| | - Yasuo Kurimoto
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan
| | - Tohru Hashida
- Present Address: Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
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17
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Ding RF, Yu Q, Liu K, Du J, Yin HJ, Ji ZL. Gene network analyses unveil possible molecular basis underlying drug-induced glaucoma. BMC Med Genomics 2021; 14:109. [PMID: 33874942 PMCID: PMC8056654 DOI: 10.1186/s12920-021-00960-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/07/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Drug-induced glaucoma (DIG) is a kind of serious adverse drug reaction that can cause irreversible blindness. Up-to-date, the molecular mechanism of DIG largely remains unclear yet due to the medical complexity of glaucoma onset. METHODS In this study, we conducted data mining of tremendous historical adverse drug events and genome-wide drug-regulated gene signatures to identify glaucoma-associated drugs. Upon these drugs, we carried out serial network analyses, including the weighted gene co-expression network analysis (WGCNA), to illustrate the gene interaction network underlying DIG. Furthermore, we applied pathogenic risk assessment to discover potential biomarker genes for DIG. RESULTS As the results, we discovered 13 highly glaucoma-associated drugs, a glaucoma-related gene network, and 55 glaucoma-susceptible genes. These genes likely played central roles in triggering DIGs via an integrative mechanism of phototransduction dysfunction, intracellular calcium homeostasis disruption, and retinal ganglion cell death. Further pathogenic risk analysis manifested that a panel of nine genes, particularly OTOF gene, could serve as potential biomarkers for early-onset DIG prognosis. CONCLUSIONS This study elucidates the possible molecular basis underlying DIGs systematically for the first time. It also provides prognosis clues for early-onset glaucoma and thus assists in designing better therapeutic regimens.
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Affiliation(s)
- Ruo-Fan Ding
- State Key Laboratory of Stress Cell Biology, School of Life Sciences, Xiamen University, Xiamen, 361102, Fujian, People's Republic of China
| | - Qian Yu
- State Key Laboratory of Stress Cell Biology, School of Life Sciences, Xiamen University, Xiamen, 361102, Fujian, People's Republic of China
| | - Ke Liu
- State Key Laboratory of Stress Cell Biology, School of Life Sciences, Xiamen University, Xiamen, 361102, Fujian, People's Republic of China
| | - Juan Du
- State Key Laboratory of Stress Cell Biology, School of Life Sciences, Xiamen University, Xiamen, 361102, Fujian, People's Republic of China
| | - Hua-Jun Yin
- State Key Laboratory of Stress Cell Biology, School of Life Sciences, Xiamen University, Xiamen, 361102, Fujian, People's Republic of China
| | - Zhi-Liang Ji
- State Key Laboratory of Stress Cell Biology, School of Life Sciences, Xiamen University, Xiamen, 361102, Fujian, People's Republic of China.
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18
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Abstract
This article provides a practical review of the diagnosis and management of angle closure induced by psychotropic agents, including tricyclic antidepressants, antipsychotics and anticonvulsants. Selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, monoamine oxidase inhibitors and antipsychotics may trigger angle closure by influencing pupil configuration through adrenergic, anticholinergic, serotonergic or dopaminergic mechanisms. Patients with narrow iridocorneal angles are at risk, and these are more common in people with hypermetropia (near-sightedness), older people and individuals with an Asian background. These patients may benefit from a laser peripheral iridotomy, either prophylactically or to relieve an acute angle-closure episode. An idiosyncratic reaction to medications such as topiramate may lead to angle closure through an alternate mechanism, leading to a uveal effusion. Ophthalmological review may be considered prior to commencing medications in high-risk patients.
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19
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Ishii M, Horita N, Takeuchi M, Matsumoto H, Ebina-Shibuya R, Hara Y, Kobayashi N, Mizuki N, Kaneko T. Inhaled Corticosteroid and Secondary Glaucoma: A Meta-analysis of 18 Studies. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2021; 13:435-449. [PMID: 33733638 PMCID: PMC7984945 DOI: 10.4168/aair.2021.13.3.435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/23/2020] [Accepted: 10/30/2020] [Indexed: 01/11/2023]
Abstract
Purpose Guidelines and systematic reviews frequently warn of inhaled corticosteroid (ICS)-induced glaucoma. However, most of the published studies deny it. Methods We performed a systematic review of randomized, cohort, nested-case control, cross-sectional studies by using Meta-analyses of Observational Studies in Epidemiology statement. Four major databases, PubMed, EMBASE, Cochrane Search Manager, and the Web of Science Core Collection as well as meta-analysis were used. Studies comparing incidence, prevalence and intraocular pressure (IOP) between patients who were treated with and without ICSs were included. A random-model meta-analysis was performed using the inverse variance method. Results Out of 623 studies screened, 18 with 31,665 subjects were finally included. No significant difference between the 2 groups was observed for crude glaucoma incidence (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.86–1.04; P = 0.26; I2 = 0%; P for heterogeneity = 0.57) as a primary endpoint, adjusted glaucoma incidence (OR, 0.90; 95% CI, 0.65–1.24; P = 0.64), crude prevalence (OR, 1.82; 95% CI, 0.23–14.19; P = 0.57), adjusted prevalence (OR, 1.22; 95% CI, 0.50–2.96; P = 0.66), IOP change during ICS treatment (mean difference [MD] +0.01 mmHg; 95% CI, −0.19–0.20; P = 0.95), and single measurement IOP (MD +0.37 mmHg; 95% CI, −0.24–0.97; P = 0.23). Time-to-event analysis for glaucoma development as one of the secondary endpoints (adjusted hazard ratio, 0.52; 95% CI, 0.28–0.96) suggested a reverse association between ICS and glaucoma. Conclusions The ophthalmological side effects of ICSs, such as glaucoma and intraocular hypertension, should not be exaggerated. Trial Registration University Hospital Medical Information Network Center Clinical Trial Registry Identifier: UMIN000040351
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Affiliation(s)
- Mai Ishii
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Nobuyuki Horita
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Masaki Takeuchi
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiromi Matsumoto
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Risa Ebina-Shibuya
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Yu Hara
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Nobuaki Kobayashi
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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20
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Liu J, Jiang F, Jiang Y, Wang Y, Li Z, Shi X, Zhu Y, Wang H, Zhang Z. Roles of Exosomes in Ocular Diseases. Int J Nanomedicine 2020; 15:10519-10538. [PMID: 33402823 PMCID: PMC7778680 DOI: 10.2147/ijn.s277190] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022] Open
Abstract
Exosomes, nanoscale vesicles with a diameter of 30 to 150 nm, are composed of a lipid bilayer, protein, and genetic material. Exosomes are secreted by virtually all types of cells in the human body. They have key functions in cell-to-cell communication, immune regulation, inflammatory response, and neovascularization. Mounting evidence indicates that exosomes play an important role in various diseases, such as cancer, cardiovascular diseases, and brain diseases; however, the role that exosomes play in eye diseases has not yet been rigorously studied. This review covers current exosome research as it relates to ocular diseases including diabetic retinopathy, age-related macular degeneration, autoimmune uveitis, glaucoma, traumatic optic neuropathies, corneal diseases, retinopathy of prematurity, and uveal melanoma. In addition, we discuss recent advances in the biological functions of exosomes, focusing on the toxicity of exosomes and the use of exosomes as biomarkers and drug delivery vesicles. Finally, we summarize the primary considerations and challenges to be taken into account for the effective applications of exosomes.
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Affiliation(s)
- Jia Liu
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, People's Republic of China
| | - Feng Jiang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin 300052, People's Republic of China
| | - Yu Jiang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, People's Republic of China
| | - Yicheng Wang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, People's Republic of China
| | - Zelin Li
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, People's Republic of China
| | - Xuefeng Shi
- Department of Pediatric Ophthalmology and Strabismus, Tianjin Eye Hospital, Tianjin, 300020, People's Republic of China.,School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China.,Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, People's Republic of China.,Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin 300020, People's Republic of China
| | - Yanping Zhu
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, People's Republic of China
| | - Hongbo Wang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, People's Republic of China
| | - Zhuhong Zhang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, People's Republic of China
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21
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Hynnekleiv L, Thrane AS, Krohn J. Simultaneous bilateral aqueous misdirection following certolizumab therapy for rheumatoid arthritis. BMJ Case Rep 2020; 13:13/10/e235194. [PMID: 33012711 PMCID: PMC7536770 DOI: 10.1136/bcr-2020-235194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aqueous misdirection syndrome is a rare, incompletely understood, sight-threatening eye condition that is difficult to diagnose and treat. We present a case of simultaneous bilateral aqueous misdirection following the administration of certolizumab in a 41-year-old women with rheumatoid arthritis and no known risk factors. To our knowledge, aqueous misdirection has not previously been associated with the use of tumour necrosis factor-alpha inhibitors.
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Affiliation(s)
- Leif Hynnekleiv
- Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway
| | | | - Jørgen Krohn
- Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Section of Ophthalmology, University of Bergen, Bergen, Norway
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22
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Abstract
PURPOSE To describe a case of zonisamide-induced bilateral choroidal effusion. CASE REPORT A 72-year-old woman presented with a 4-day history of bilateral blurred vision 9 days after initiating oral zonisamide for essential tremor. Clinical examination revealed an asymmetric choroidal detachment with open anterior chamber angle and intraocular pressure within the normal range. Posterior segment ultrasonography and ultrasound biomicroscopy both confirmed the presence of bilateral ciliochoroidal effusion. Zonisamide treatment was discontinued. One month after treatment discontinuation, the ophthalmological examination was normal and no further treatment was needed. CONCLUSION Zonisamide can cause an idiosyncratic reaction leading to choroidal effusion with or without acute angle closure. Early withdrawal of the causative agent is the key to reversing this condition. These findings indicate that zonisamide and other sulfa-derived drugs must be ruled out in the differential diagnosis of choroidal effusion of unknown cause.
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23
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Foutch BK, Sandberg KA, Bennett ES, Naeger LL. Effects of Oral Antihistamines on Tear Volume, Tear Stability, and Intraocular Pressure. Vision (Basel) 2020; 4:vision4020032. [PMID: 32575705 PMCID: PMC7355746 DOI: 10.3390/vision4020032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 11/21/2022] Open
Abstract
The goal of this study was to investigate the effects of two commonly used oral antihistamines—diphenhydramine and loratadine—on tear volume, tear breakup time, and intraocular pressure. Placebo, diphenhydramine, and loratadine were administered for one week to 33 subjects experimentally blind to the treatment given. All the subjects received all three treatments over a period of six weeks. The outcome measures were the change in phenol red thread test (PRT), the tear breakup time (TBUT), and the intraocular pressure (IOP) of both eyes evaluated by experimentally masked observers. Neither of the mean changes in TBUT or IOP depended on the treatment given, but there was a significant monocular decrease in tear volume from diphenhydramine use. While we used an adequate treatment washout period of seven days, our investigation was limited by the short treatment times and inclusion of only young healthy patients. Overall, however, these results suggest that systemic diphenhydramine use should be limited to increase the effectiveness of conventional therapies. Clinicians should have fewer reservations about recommending the use of loratadine concurrent with dry eye treatments.
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Affiliation(s)
- Brian K. Foutch
- Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, TX 78229, USA;
- Correspondence: ; Tel.: +1-210-930-8162
| | - Kyle A. Sandberg
- Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, TX 78229, USA;
| | - Edward S. Bennett
- College of Optometry, University of Missouri-St Louis, St. Louis, MO 63121, USA; (E.S.B.); (L.L.N.)
| | - Leonard L. Naeger
- College of Optometry, University of Missouri-St Louis, St. Louis, MO 63121, USA; (E.S.B.); (L.L.N.)
- St. Louis College of Pharmacy, St. Louis, MO 63110, USA
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24
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Chen YH, Gepstein R, Sharief L, Tseng HJ, Wei R, Zhang X, Lightman S, Tomkins-Netzer O. Outcome and risk of ocular complications of managing children with chronic anterior uveitis with topical rimexolone 1. Int Ophthalmol 2020; 40:1061-1068. [PMID: 32318939 DOI: 10.1007/s10792-020-01358-9] [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: 01/08/2019] [Accepted: 11/08/2019] [Indexed: 10/24/2022]
Abstract
PURPOSE To investigate the efficacy and safety of 1% rimexolone ophthalmic suspension in children with chronic anterior uveitis under real-life conditions in a tertiary center. METHODS This is a retrospective longitudinal study. Medical records were analyzed at baseline, 1, 3, 6 and 12 months before and after switching to rimexolone for best-corrected visual acuity (BCVA), oral steroid use, number of flares, IOP and anti-glaucoma management. RESULTS Twenty-four patients (41 eyes) diagnosed with either anterior uveitis (n = 25, 60.0%) or panuveitis (n = 16, 40%) were enrolled. The mean age was 10.5 years (4-16 years). The number of patients requiring oral prednisolone reduced from 8 patients (32.0%) at baseline to 3 patients (20.0%) at 12 months (P < 0.001). Following baseline, the median number of uveitis flares reduced from 2.0 (inter-quartile range (IQR) 1.0-2.75) to 1.0 (IQR 0.0-1.0) compared to the 12 months before baseline (P < 0.001). The mean IOP reduced from baseline (22.0 ± 7.3 mmHg) to 1 month (18.8 ± 8.7 mmHg, P = 0.01) and remained stable up to 12 months (15.9 ± 5.0 mmHg, P < 0.001). Average BCVA, dose of oral prednisolone and anti-glaucoma treatments did not change compared to the baseline. The development for IOP ≥ 30 mmHg was associated with a known corticosteroid response [odds ratio (OR) 6.8, P = 0.003] and a dose > 7.5 mg/day oral prednisolone (OR 4.4, P = 0.033). CONCLUSIONS Rimexolone 1% ophthalmic suspension is an effective and safe topical steroid for pediatric anterior uveitis.
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Affiliation(s)
- Yi-Hsing Chen
- Institute of Ophthalmology, University College of London, London, UK.,Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Moorfields Eye Hospital, London, UK
| | | | - Lazha Sharief
- Institute of Ophthalmology, University College of London, London, UK.,Moorfields Eye Hospital, London, UK
| | - Hsiao-Jung Tseng
- Biostatistical Center for Clinical Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | | | - Xiaozhe Zhang
- Institute of Ophthalmology, University College of London, London, UK
| | - Sue Lightman
- Institute of Ophthalmology, University College of London, London, UK.,Moorfields Eye Hospital, London, UK
| | - Oren Tomkins-Netzer
- Institute of Ophthalmology, University College of London, London, UK. .,Moorfields Eye Hospital, London, UK. .,Ophthalmology Department, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology, Haifa, Israel.
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25
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Corneal neovascularization is inhibited with nucleolin-binding aptamer, AS1411. Exp Eye Res 2020; 193:107977. [PMID: 32081668 DOI: 10.1016/j.exer.2020.107977] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 01/21/2020] [Accepted: 02/14/2020] [Indexed: 12/18/2022]
Abstract
Corneal neovascularization (CNV) is a common sight-threatening pathology that can be induced by a variety of inflammatory and angiogenic stimuli. Current CNV treatments include anti-inflammatory drugs and antibody-based inhibitors of vascular endothelial growth factor (VEGF). However, these are not always effective and novel therapeutic approaches are needed. Previous work has indicated a role for nucleolin (NCL) in VEGF-mediated neoangiogenesis in a suture-induced CNV model. The major goal for this current study is to test the effect of AS1411, a NCL-binding DNA aptamer that has reached human clinical trials, on neovascularization in a murine model of VEGF-mediated CNV. Our results show that topical administration of AS1411 can significantly inhibit corneal neovascularization in this model. Mechanistic studies indicate that AS1411 reduces the VEGF-stimulated proliferation, migration, and tube formation of primary cells obtained from human limbus stroma (HLSC). AS1411 treatment also significantly reduced VEGF-stimulated induction of miR-21 and miR-221 in HLSC, suggesting a role for these pro-angiogenic miRNAs in mediating the effects of AS1411 in this system. In sum, this new research further supports a role for NCL in the molecular etiology of CNV and identifies AS1411 as a potential anti-angiogenic CNV treatment that works by a novel mechanism of action.
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26
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Steroid-induced glaucoma: Epidemiology, pathophysiology, and clinical management. Surv Ophthalmol 2020; 65:458-472. [PMID: 32057761 DOI: 10.1016/j.survophthal.2020.01.002] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 12/31/2019] [Accepted: 01/02/2020] [Indexed: 12/17/2022]
Abstract
Glucocorticoids are a class of anti-inflammatory drugs commonly used to treat various ocular and systemic conditions. Although the role of glucocorticoids in the treatment of numerous serious inflammatory diseases is pivotal, their prolonged use may increase intraocular pressure resulting in steroid-induced glaucoma. We provide a detailed update on steroid-induced glaucoma as a preventable cause of blindness in the adult and pediatric population and describe its epidemiology, social impact, and risk factors. Furthermore, we explore the propensity of different steroids to increase the intraocular pressure, the role of different routes of steroid administration, dosage and duration of treatment, as well as the clinical features, genetics, and management of steroid-induced glaucoma.
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Potentially inappropriate prescriptions of anticholinergic medications in patients with closed-angle glaucoma. Int Ophthalmol 2019; 40:803-809. [PMID: 31792854 DOI: 10.1007/s10792-019-01241-2] [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: 06/20/2019] [Accepted: 11/21/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Glaucoma is the leading cause for blindness after cataracts worldwide. The aim was to identify anticholinergic drugs prescribed to patients diagnosed with closed-angle glaucoma in Colombia. METHODS This cross-sectional study identified the prescribing patterns of cholinergic antagonists related to the increased intraocular pressure in patients diagnosed with closed-angle glaucoma from a Colombian database. The Anticholinergic Drug Scale was used to quantify the anticholinergic burden. RESULTS We identified 1958 patients with closed-angle glaucoma, with a mean age of 70.5 ± 10.3 years, 72.9% of whom were women. Cholinergic antagonists were prescribed in at least 32.4% of cases. An age range between 75 and 84 years (odds ratio (OR) 2.35, 95% confidence interval (CI) 1.366-4.059) and being aged 85 years or older (OR 3.40, 95% CI 1.809-6.425) were associated with a greater probability of receiving an anticholinergic burden between 1 and 2 points. Females (OR 1.54, 95% CI 1.096-2.181) had a higher probability of receiving an anticholinergic burden ≥ 3 points. Interactions between antiglaucoma medications and anticholinergic treatments were identified in 32.1% of the patients. CONCLUSIONS Most patients were prescribed multiple antiglaucoma medications, reflecting a large number of potentially inappropriate prescriptions, with anticholinergic drugs, related to the increased intraocular pressure.
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Acute Angle-closure Glaucoma Associated With Aripiprazole in the Setting of Plateau Iris Configuration. J Glaucoma 2019; 27:e40-e43. [PMID: 29189543 DOI: 10.1097/ijg.0000000000000836] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF THE STUDY The purpose of this study was to report a novel case of drug-induced angle-closure from aripiprazole (Abilify), an atypical antipsychotic, and propose a mechanism for this association. METHODS/RESULTS We report a case of a 45-year-old white woman who presented in subacute angle closure 2 months after initiating aripiprazole 5 mg daily for depression. This patient reported no prior ocular history and had been on longstanding duloxetine (Cymbalta) 60 mg daily for over 10 years before starting aripiprazole. Examination at initial presentation revealed an intraocular pressure (IOP) of 16 mm Hg in the right eye and an elevated IOP of 44 mm Hg in the left eye. Gonioscopy demonstrated a plateau iris configuration in the right eye and angle closure with a plateau iris configuration in the left eye. She was started on IOP-lowering therapy and underwent a laser peripheral iridotomy. Despite recommendation to discontinue aripiprazole, duloxetine was discontinued; aripiprazole was maintained and later increased to 10 mg daily for worsening depression. Three months after the dosage increase, the patient was found to have an elevated IOP of 32 mm Hg and angle-closure with a plateau iris configuration in the left eye. Iridoplasty was performed in the left eye with subsequent opening of the angle and improvement in IOP. The second attack of angle-closure led to the discontinuation of aripiprazole and a corresponding widening of the angles in both eyes 1 week after cessation. CONCLUSIONS This is the first report to describe drug-induced angle-closure glaucoma associated with aripiprazole use. The mechanism of angle closure, we hypothesize, is from mydriasis and/or supraciliary effusion mediated by the serotoninergic effect on the iris and ciliary body complex. Treatment is preferably cessation of the medication. However, in cases where the medication is necessary for management of major depression, iridoplasty should be performed to reduce the risk of angle closure.
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de Oliveira RC, Wilson SE. Practical guidance for the use of cyclosporine ophthalmic solutions in the management of dry eye disease. Clin Ophthalmol 2019; 13:1115-1122. [PMID: 31308620 PMCID: PMC6612764 DOI: 10.2147/opth.s184412] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/07/2019] [Indexed: 01/02/2023] Open
Abstract
Dry eye disease (DED) is a multifactorial disease of ocular surface and tear film, and is a common disorder treated by eye care providers. It is well established that ocular surface inflammation has an important role in the pathophysiology of DED and that anti-inflammatory cyclosporine A (CsA) improves the treatment outcomes of most patients with DED. The purpose of this review is to provide guidance for practitioners in the use of topical CsA for the management of DED to improve patient satisfaction and the quality of life.
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Park MY, Kim WJ, Lee E, Kim C, Son SJ, Yoon JS, Kim W, Namkoong K. Association between use of benzodiazepines and occurrence of acute angle-closure glaucoma in the elderly: A population-based study. J Psychosom Res 2019; 122:1-5. [PMID: 31126405 DOI: 10.1016/j.jpsychores.2019.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 04/22/2019] [Accepted: 04/25/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Because benzodiazepines (BZDs) can affect pupillae muscles, their use could be a risk factor for acute angle-closure glaucoma (AACG), which is an ophthalmic emergency. However, there is no research evidence for the association between BZDs and AACG, except two case reports. We aimed to investigate whether BZDs increase the risk of AACG in a geriatric population. METHODS We performed a case-control study using a geriatric cohort from the National Health Insurance database (2002-2013) in Korea. Case subjects (n = 1117) were patients diagnosed with AACG. Controls, people who have not been diagnosed with AACG, were randomly matched with the case according to age, sex, and index year (n = 4468). To examine the risk of BZD use for AACG, we performed conditional logistic regression analyses with potential confounders including comorbidities and concomitant medication. RESULTS The use of BZD within 30 days was not significantly associated with AACG risk (adjusted odds ratio [aOR] = 1.14, 95% confidence interval [CI] = 0.94-1.37). Further analyses showed that, compared with non-use of BZD, new BZD use had a significantly increased risk for the development of AACG (aOR = 1.62, 95% CI = 1.09-2.37). The risk was higher in the new BZD users exposed within 7 days (aOR = 3.09, 95% CI = 1.58-5.88). CONCLUSION We found that BZDs increase the risk of AACG at the beginning of its use among the Korean elderly. Clinicians should monitor visual disturbance in the elderly during the early period after prescription of BZD.
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Affiliation(s)
- Man Young Park
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Woo Jung Kim
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Eun Lee
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jin Sook Yoon
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woojae Kim
- Department of Public Health and Medical Administration, Dongyang University, Yeongju, Republic of Korea
| | - Kee Namkoong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
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Brill D, Albert D, Fields T, Mikkilineni S, Crandall D, Gao H. Ciliochoroidal effusion syndrome with central serous-like chorioretinopathy and secondary angle closure following exogenous testosterone use. Am J Ophthalmol Case Rep 2019; 15:100482. [PMID: 31198887 PMCID: PMC6557563 DOI: 10.1016/j.ajoc.2019.100482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 05/30/2019] [Accepted: 05/30/2019] [Indexed: 11/16/2022] Open
Abstract
Purpose To report a unique presentation of ciliochoroidal effusion syndrome with central serous-like chorioretinopathy and secondary angle closure following exogenous testosterone use. Observations A 37 year-old man presented with a two week history of blurred vision, elevated intraocular pressure, and myopic shift in his right eye. Gonioscopy showed angle closure. After YAG iridotomy, ultrasound biomicroscopy (UBM) showed ciliochoroidal effusion and anterior rotation of the ciliary processes. Subsequent color fundus photography, enhanced depth imaging optical coherence tomography (EDI-OCT) and near-infrared reduced-illuminance autofluorescence imaging (NIR-RAFI) showed macular striae, choroidal folds, and increased choroidal thickness without presence of subretinal fluid (SRF) or pigment epithelial detachment (PED). Further questioning revealed the patient was using dermal testosterone gel for six months for treatment of hypogonadism. The patient stopped using the testosterone gel, and his visual acuity and intraocular pressure significantly improved six weeks later. Follow-up UBM showed significant improvement of the ciliochoroidal effusion, and repeat multimodal images demonstrated resolution of the macular striae and choroidal folds, and slightly improved choroidal thickness. Conclusions and importance Our patient demonstrates a rare case of ciliochoroidal effusion, central serous-like chorioretinopathy, and secondary angle closure that dramatically improved with cessation of testosterone. We believe that this unique clinical constellation is the first to be reported associated with exogenous testosterone use.
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Affiliation(s)
- Daniel Brill
- Henry Ford Health System, Department of Ophthalmology, Detroit, MI, USA
| | - Desiree Albert
- Henry Ford Health System, Department of Ophthalmology, Detroit, MI, USA
| | - Taylor Fields
- Henry Ford Health System, Department of Ophthalmology, Detroit, MI, USA
| | | | - David Crandall
- Henry Ford Health System, Department of Ophthalmology, Detroit, MI, USA
| | - Hua Gao
- Henry Ford Health System, Department of Ophthalmology, Detroit, MI, USA
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Hamada N, Azizova TV, Little MP. Glaucomagenesis following ionizing radiation exposure. MUTATION RESEARCH. REVIEWS IN MUTATION RESEARCH 2019; 779:36-44. [PMID: 31097150 PMCID: PMC10654893 DOI: 10.1016/j.mrrev.2019.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 01/02/2019] [Accepted: 01/07/2019] [Indexed: 12/31/2022]
Abstract
Glaucoma is a group of optic neuropathies causing optic nerve damage and visual field defects, and is one of the leading causes of blindness. Nearly a century has passed since the first report of glaucoma manifested following ionizing radiation therapy of cancers. Nevertheless, associations between glaucoma and radiation exposures, a dose response relationship, and the mechanistic underpinnings remain incompletely understood. Here we review the current knowledge on manifestations and mechanisms of radiogenic glaucoma. There is some evidence that neovascular glaucoma is manifest relatively quickly, within a few years after high-dose and high dose-rate radiotherapeutic exposure, but little evidence of excess risks of glaucoma after exposure to much lower doses or dose rates. As such, glaucoma appears to have some of the characteristics of a tissue reaction effect, with a threshold of at least 5 Gy but possibly much higher.
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Affiliation(s)
- Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo, 201-8511, Japan.
| | - Tamara V Azizova
- Clinical Department, Southern Urals Biophysics Institute, Ozyorskoe Shosse 19, Ozyorsk Chelyabinsk Region, 456780, Russia.
| | - Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, MSC 9778, Bethesda, MD, 20892-9778, USA.
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Abstract
Aim Our goal is to review current literature regarding drug-induced acute angle-closure glaucoma (AACG) and provide ophthalmologists and general practitioners with a thorough understanding of inciting medications and treatment pitfalls to be avoided. Background Drug-induced AACG is an ophthalmological emergency that ophthalmologists and general practitioners should be familiar with, given its potentially blinding consequences. Common anatomical risk factors for AACG include a shallow anterior chamber depth, short axial length, plateau iris configuration, thick lens, anteriorly positioned lens, and rarely, intraocular tumor. Demographic risk factors include female sex, Asian ethnicity, family history, and advanced age. In patients with predisposing factors, acute angle closure can be triggered by various classes of medications including adrenergic agonists, anticholinergics, cholinergics, sulfonamides, supplements, and serotonergic medications. Physicians prescribing such inciting medications should be aware of their potentially sight-threatening adverse effects and to inform patients of the warning symptoms. Patients typically present with elevated intraocular pressure (IOP), headache, nausea, blurry vision, and halos around lights. Review results There are two main mechanisms of drug-induced AACG, both with different treatment strategies. The first mechanism of drug-induced AACG is pupillary block and iridocorneal angle closure secondary to thickening of iris base with mydriasis. The second mechanism of drug-induced AACG is anterior displacement of the lens-iris diaphragm due to mass effect (e.g., blood, misdirected aqueous humor, and tumors), uveal effusion, or weakened zonules. Conclusion This paper reviews drug-induced AACG, high-risk anatomical features, underlying mechanisms, inciting medications, and options for treatment and prevention. Clinical significance With proper understanding of the underlying mechanism of drug-induced AACG, physicians can respond promptly to save their patients' vision by employing the correct treatment strategy. How to cite this article Yang MC, Lin KY. Drug-induced Acute Angle-closure Glaucoma: A Review. J Curr Glaucoma Pract 2019;13(3):104-109.
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Affiliation(s)
- Michael C Yang
- Department of Ophthalmology, UCI Health Gavin Herbert Eye Institute, University of California, Irvine, California, USA
| | - Ken Y Lin
- Department of Ophthalmology, UCI Health Gavin Herbert Eye Institute, University of California, Irvine, California, USA
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Haddad A, Arwani M, Sabbagh O. A Novel Association between Oxybutynin Use and Bilateral Acute Angle Closure Glaucoma: A Case Report and Literature Review. Cureus 2018; 10:e2732. [PMID: 30087808 PMCID: PMC6075637 DOI: 10.7759/cureus.2732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We are reporting a case of a 62-year-old male presenting with headache and blurry vision. His condition resolved with cessation of the presumed offending medication and urgent bilateral laser peripheral iridotomies since he failed medical therapy. This case presents a novel association between oxybutynin and bilateral acute angle-closure glaucoma (AACG).
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Affiliation(s)
| | - Mais Arwani
- Internal Medicine, Allegheny General Hospital - Western Pennsylvania Hospital Medical Education Consortium, Pittsburgh , USA
| | - Osama Sabbagh
- Department of Ophthalmology, George Washington University, Washington , USA
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Systemic medication usage in glaucoma patients. Can J Ophthalmol 2018; 53:242-245. [DOI: 10.1016/j.jcjo.2017.10.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/12/2017] [Indexed: 11/23/2022]
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Ben Salem C, Fathallah N, Zayani H. Glaucoma. Lancet 2018; 391:739-740. [PMID: 29486942 DOI: 10.1016/s0140-6736(18)30306-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 01/05/2018] [Indexed: 11/28/2022]
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Overview of the Diagnosis, Evaluation, and Novel Treatment Strategies for Ophthalmic Emergencies in the Hospitalized Geriatric Patient. Am J Ther 2018. [DOI: 10.1097/mjt.0000000000000664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ryu SJ, Shin YU, Kang MH, Cho HY, Seong M. Bilateral acute myopia and angle closure glaucoma induced by Ma-huang (Ephedra): A case report. Medicine (Baltimore) 2017; 96:e9257. [PMID: 29390365 PMCID: PMC5815777 DOI: 10.1097/md.0000000000009257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Cases of bilateral acute angle closure have been reported after use of various drugs. PATIENT CONCERNS A 52-year-old woman visited the emergency room and complained of acute bilateral ocular pain and decreased vision accompanied by headache, nausea, and vomiting. One day before, she had started a herbal medicine containing Ma-huang for weight loss. On examinations, myopic shift, edematous cornea, increased intraocular pressure, shallow anterior chamber, and thickened choroid on both eyes were observed. DIAGNOSES Angle closure glaucoma induced by drug (Ma-huang). INTERVENTIONS To promptly quit the offending drug and apply ocular hypotensives and cycloplegics. OUTCOMES Her symptoms and signs were relieved after antiglaucoma medications and no significant recurrence has been occurred. LESSONS Physicians prescribing weight loss medications containing Ma-huang must be aware of the potentially sight-threatening adverse effect of bilateral acute angle closure.
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Affiliation(s)
- So Jung Ryu
- Department of Ophthalmology, Hanyang University College of Medicine, Seongdong-gu, Seoul, Republic of Korea
| | - Yong Un Shin
- Department of Ophthalmology, Hanyang University College of Medicine, Seongdong-gu, Seoul, Republic of Korea
| | - Min Ho Kang
- Department of Ophthalmology, Hanyang University College of Medicine, Seongdong-gu, Seoul, Republic of Korea
| | - Hee Yoon Cho
- Department of Ophthalmology, Hanyang University College of Medicine, Seongdong-gu, Seoul, Republic of Korea
| | - Mincheol Seong
- Department of Ophthalmology, Hanyang University College of Medicine, Seongdong-gu, Seoul, Republic of Korea
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Chen VCH, Ng MH, Chiu WC, McIntyre RS, Lee Y, Lin TY, Weng JC, Chen PC, Hsu CY. Effects of selective serotonin reuptake inhibitors on glaucoma: A nationwide population-based study. PLoS One 2017; 12:e0173005. [PMID: 28257449 PMCID: PMC5336262 DOI: 10.1371/journal.pone.0173005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/12/2017] [Indexed: 11/17/2022] Open
Abstract
Background Selective serotonin reuptake inhibitors (SSRIs) are one of the most commonly prescribed classes of antidepressants. Glaucoma is the second leading cause of blindness globally and iatrogenic glaucoma has been implicated across disparate medication classes. Available studies that have sought to determine the association between SSRI exposure and glaucoma have provided mixed results. The aim of the study herein was to investigate whether an association exists between SSRI exposure and glaucoma incidence. Methods Glaucoma cases were identified from Taiwan’s National Health Insurance Research Database with a new primary diagnosis of glaucoma between 1997 and 2009. The date wherein the cases were diagnosed with glaucoma was operationalized as the index date. The control group was comprised of individuals within the database who were not diagnosed with glaucoma. 15,865 glaucoma cases were compared to 77,014 sex-, age-, residence- and insurance premium-matched controls on measures of prescribed duration and dosage of SSRIs up to 365 days before index date to proxy SSRIs exposure. Results Individuals receiving SSRIs were at greater risk of glaucoma incidence (OR = 1.39; 95% CI = 1.29–1.50); the foregoing increased likelihood was reduced after adjusting for confounding variables (aOR = 1.09; 95% CI = 1.00,1.18). SSRI treatment of longer duration (i.e. >365 days) and higher doses (≥1 defined daily dose) were associated with greater risk of glaucoma incidence (aOR = 1.36; 95% CI = 1.08–1.71). Subgroup analysis showed that the effect of SSRIs on glaucoma was limited to individuals younger than 65 years of age (aOR = 1.37; 95% CI = 1.25–1.50), without diabetes (aOR = 1.39; 95% CI = 1.27–1.52), without hypertension (aOR = 1.46; 95% CI = 1.31–1.63) or hypercholesterolemia (aOR = 1.35; 95% CI = 1.23–1.48). Conclusion Treatment with SSRIs was associated with greater risk of having a diagnosis of glaucoma, particularly in individuals with longer duration and/or higher average dose of SSRI. Our findings suggest that individuals receiving SSRIs treatment for extended periods of time and/or at relatively higher therapeutic doses should be monitored for symptoms associated with glaucoma.
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Affiliation(s)
- Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Psychiatry, School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Mei-Hing Ng
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou County, Taiwan
- PhD Student of Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- * E-mail:
| | - Wei-Che Chiu
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan
- College of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada
- Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada
| | - Tsang-Yaw Lin
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou County, Taiwan
| | - Jun-Cheng Weng
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Chung-Yao Hsu
- Department of Neurology, Kaoshiung Medical University Hospital, Kaoshiung, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Kirkham J, Seitz D. Evidence of ocular side effects of SSRIs and new warnings. EVIDENCE-BASED MENTAL HEALTH 2017; 20:27. [PMID: 27993931 PMCID: PMC10688421 DOI: 10.1136/eb-2016-102528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 11/04/2022]
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AlQuorain S, Alfaraj S, Alshahrani M. Bilateral acute closed angle glaucoma associated with the discontinuation of escitalopram: a case report. Open Access Emerg Med 2016; 8:61-5. [PMID: 27660499 PMCID: PMC5019444 DOI: 10.2147/oaem.s107551] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A 45-year-old woman presented to the Emergency Department complaining of severe headache for 3 hours duration associated with bilateral blurred vision, photophobia, and one attack of vomiting. Her clinical examination revealed normal vital signs and decrease in visual acuity with hazy cornea bilaterally. There were no signs of increased intracranial pressure and no neck rigidity or meningeal signs. The patient was diagnosed with bilateral acute closed angle glaucoma (AACG) with intraocular pressure of 60 mmHg in both eyes. She was using escitalopram for the treatment of depression, which was the only known risk factor for her condition. Standard treatment for AACG was provided. It included topical β-blocker, α agonists, and acetazolamide. This was followed by bilateral peripheral iridotomy. Follow-up intraocular pressure measurement revealed a value of 5 mmHg after 24 hours, indicating complete recovery. To the best of our knowledge, this is the first case to describe AACG after stopping the medication. It is highly important that clinicians be aware of this risk factor for AACG and have high index of suspicion in such patients with vision-threatening condition even after discontinuing the medication, because the risk persists for some time.
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Affiliation(s)
| | - Sukayna Alfaraj
- Department of Emergency Medicine, King Fahad Hospital of the University, University of Dammam, Dammam, Saudi Arabia
| | - Mohammed Alshahrani
- Department of Emergency Medicine, King Fahad Hospital of the University, University of Dammam, Dammam, Saudi Arabia
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Quiroz-Mercado J, Ramírez-Velázquez N, Partido G, Zenteno E, Chávez R, Agundis-Mata C, Jiménez-Martínez MC, Garfias Y. Tissue and cellular characterisation of nucleolin in a murine model of corneal angiogenesis. Graefes Arch Clin Exp Ophthalmol 2016; 254:1753-63. [PMID: 27313162 DOI: 10.1007/s00417-016-3409-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 05/08/2016] [Accepted: 06/07/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Corneal neovascularisation (CNV), with consequent loss of transparency, is due to an imbalance of proangiogenic factors. Cell-surface nucleolin (NCL) has been associated with neo-angiogenesis. There are studies identifying NCL translocation from nucleus to the cell surface, which is essential for endothelial cell proliferation. To find the possible role of NCL in the generation of corneal neovessels, the aim of this study is to characterise the NCL presence and cell-localisation in non-injured corneas, as well as to describe the changes in NCL cell and tissue localisation in CNV, and to analyse the effect of bevacizumab on NCL cellular and tissular distribution. METHODS Suture-induced CNV was performed in mice. The corneal tissues were obtained and the histological and co-immunofluorescence assays were performed using different proteins, such as CD31, cadherin and isolectin B4. To determine the possible role of VEGF in NCL presence and localisation in our CNV model, bevacizumab was concomitantly used. RESULTS Nucleolin was principally observed in the nucleus of the basal epithelial cells of normal corneas. Interestingly, angiogenesis-induced changes were observed in the localisation of NCL, not only in tissue but also at the cellular level where NCL was extranuclear in epithelial cells, stromal cells and neovessels. In contrast, these changes were reverted when bevacizumab was used. Besides, NCL was able to stain only aberrant corneal neovessels in comparison with retinal vessels. CONCLUSIONS NCL mobilisation outside the nucleus during angiogenesis could have a possible role as a proangiogenic molecule in the corneal tissue.
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Affiliation(s)
- Joaquín Quiroz-Mercado
- Research Unit, Institute of Ophthalmology Conde de Valenciana Foundation, Chimalpopoca 14, 06800, Mexico City, Mexico
- Faculty of Veterinary Medicine and Animal Husbandry, Universidad Nacional Autónoma de México, Avenida Universidad 3000, 04510, Mexico City, Mexico
| | - Norma Ramírez-Velázquez
- Research Unit, Institute of Ophthalmology Conde de Valenciana Foundation, Chimalpopoca 14, 06800, Mexico City, Mexico
| | - Graciela Partido
- Research Unit, Institute of Ophthalmology Conde de Valenciana Foundation, Chimalpopoca 14, 06800, Mexico City, Mexico
| | - Edgar Zenteno
- Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, Avenida Universidad 3000, 04510, Mexico City, Mexico
| | - Raúl Chávez
- Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, Avenida Universidad 3000, 04510, Mexico City, Mexico
| | - Concepción Agundis-Mata
- Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, Avenida Universidad 3000, 04510, Mexico City, Mexico
| | - Maria Carmen Jiménez-Martínez
- Research Unit, Institute of Ophthalmology Conde de Valenciana Foundation, Chimalpopoca 14, 06800, Mexico City, Mexico
- Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, Avenida Universidad 3000, 04510, Mexico City, Mexico
| | - Yonathan Garfias
- Research Unit, Institute of Ophthalmology Conde de Valenciana Foundation, Chimalpopoca 14, 06800, Mexico City, Mexico.
- Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, Avenida Universidad 3000, 04510, Mexico City, Mexico.
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Abstract
BACKGROUND An ocular injury can lead to secondary glaucoma in the traumatized eye in 3% to 20% of cases. Literature on the risk of developing elevated intraocular pressure in the nontraumatized fellow eye is scant. Clinicians treating ocular traumas should also bear in mind sympathetic ophthalmia, a rare bilateral granulomatous panuveitis following accidental or surgical trauma to 1 eye. CASE REPORT We report a case of high-pressure glaucoma of the fellow eye without any signs of uveitis. The left eye of a 24-year-old man was injured in an inadvertent movement during a free-time table-tennis match. The eye was severely crushed, leading to blindness. His right eye developed medically uncontrolled high-pressure glaucoma only 1 month after the injury. CONCLUSION To the best of our knowledge, there are no previous reports of post-traumatic glaucoma in the nontraumatized eye after open-globe injury.
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Affiliation(s)
- Anu Vaajanen
- Tays Eye Centre, Tampere University Hospital
- Department of Ophthalmology, School of Medicine, University of Tampere, Tampere, Finland
- Correspondence: Anu Vaajanen, Tampere, Finland (e-mail: )
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Impact of the Topical Ophthalmic Corticosteroid Loteprednol Etabonate on Intraocular Pressure. Adv Ther 2016; 33:532-52. [PMID: 26984315 PMCID: PMC4846687 DOI: 10.1007/s12325-016-0315-8] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Indexed: 12/18/2022]
Abstract
Corticosteroids are a mainstay therapeutic option for the treatment of ocular inflammation. However, safety remains a concern for clinicians, particularly with long-term use. Though highly effective at suppressing inflammatory and allergic responses, topical ophthalmic corticosteroids carry an inherent risk of side effects, including elevated intraocular pressure (IOP), a risk factor for the development of glaucoma. The corticosteroid loteprednol etabonate (LE) contains an ester rather than a ketone at the C-20 position, minimizing the potential for side effects, including IOP elevation. In early pivotal clinical trials of LE ophthalmic suspension for conjunctivitis (allergic, giant papillary), anterior uveitis, and post-operative inflammation, LE had minimal impact on IOP over short-term (<28 days) and long-term (≥28 days) use. Since then, new LE formulations—including a gel, an ointment, and a suspension of LE in combination with tobramycin—have become commercially available. Multiple studies evaluating the safety and efficacy of LE for inflammatory conditions have been reported, including those requiring longer-term treatment such as photorefractive keratectomy, corneal transplantation, and dry eye disease. We review the available published data on the effect of LE on IOP and report on the cumulative incidence of clinically significant IOP elevations (≥10 mm Hg from baseline) with short-term and long-term LE use. In all studies, LE consistently demonstrated a low propensity to elevate IOP, regardless of formulation, dosage regimen, or treatment duration, including in known steroid responders. The cumulative proportion of patients exhibiting clinically significant IOP increases was 0.8% (14/1725 subjects) in studies evaluating short-term LE treatment and 1.5% (21/1386 subjects) in long-term studies. Furthermore, use of LE was associated with significantly lower rates of IOP elevation ≥10 mm Hg as compared to prednisolone acetate or dexamethasone (when used in combination with tobramycin). The cumulative data to date substantiates a favorable IOP-safety profile for LE with both short-term and long-term use.
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45
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Hong EH, Lee MJ, Song IS. A Case of Bilateral Acute Angle Closure Attack Induced by Common Cold Medication. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.2.334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Eun Hee Hong
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - Min Jee Lee
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - In Seok Song
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
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46
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Ah-Kee EY, Egong E, Shafi A, Lim LT, Yim JL. A review of drug-induced acute angle closure glaucoma for non-ophthalmologists. Qatar Med J 2015; 2015:6. [PMID: 26535174 PMCID: PMC4614311 DOI: 10.5339/qmj.2015.6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/15/2015] [Indexed: 11/05/2022] Open
Abstract
Acute angle closure glaucoma is an ophthalmic emergency and can lead to blindness if left untreated. Several types of drugs have the potential to precipitate acute angle closure glaucoma. These include adrenergic, cholinergic and anticholinergic, antidepressants, anticoagulants and sulfa-based agents. This article provides a basic overview of the risk factors and pathophysiologic mechanisms involved in angle closure glaucoma and focuses on drug-induced angle closure glaucoma for the non-ophthalmologist. A PubMed search limited to the English language was conducted to find relevant literature for the purpose of this article. Most attacks occur in subjects unaware that they are at risk due to innately narrow iridocorneal angles. Clinicians should always review medications in patients presenting with symptoms of acute angle closure glaucoma. The aim of this article is to bring this ophthalmic condition to the attention of clinicians, particularly those outside the field of ophthalmology who commonly prescribe these medications or see these patients prior to referring to ophthalmologists.
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Affiliation(s)
- Elliott Yann Ah-Kee
- Monklands Hospital, Monkscourt Ave, Airdrie, North Lanarkshire, United Kingdom
| | - Eric Egong
- Monklands Hospital, Monkscourt Ave, Airdrie, North Lanarkshire, United Kingdom
| | - Ahad Shafi
- Monklands Hospital, Monkscourt Ave, Airdrie, North Lanarkshire, United Kingdom
| | - Lik Thai Lim
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, United Kingdom
| | - James Li Yim
- Department of Ophthalmology, University Hospital Ayr, Ayr, Glasgow, United Kingdom
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47
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Rieger-Reyes C, Rubio-Galán FJ. [Glaucoma: pharmacological implications]. Semergen 2013; 39:26-33. [PMID: 23517894 DOI: 10.1016/j.semerg.2012.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 04/27/2012] [Accepted: 05/06/2012] [Indexed: 11/29/2022]
Abstract
Glaucoma is the first cause of irreversible blindness worldwide. Its prevalence in our country is 2%; half of patients remain undiagnosed. Certain drugs can trigger and/or exacerbate glaucoma; hence the importance of having knowledge of these drugs by Primary Care physician. In addition, the drugs used in the treatment of glaucoma, even topically, can have systemic side effects that should be also know to the Primary Care physician. An adequate knowledge of all the drug groups and the prescribing of the appropriate drug in patients with risk factors and underlying pathology, will enable the Primary Care physician to optimise the risk/benefit ratio in the therapeutic management of these patients. An update is presented on this ophthalmological disease, with special attention to its implications for pharmacological treatments.
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Affiliation(s)
- C Rieger-Reyes
- Unidad Docente Medicina de Familia y Comunitaria Sector II, Zaragoza, España.
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48
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Kowsarnia S, Aflaky E, Banifatemi M, Razeghinejad MR. Correlation between Peak Intraocular Pressure of the Water Drinking Test and Peak Intraocular Pressure Induced by Intravenous Methylprednisolone Pulse Therapy. Ophthalmic Res 2013; 50:187-91. [DOI: 10.1159/000351640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 04/11/2013] [Indexed: 11/19/2022]
Abstract
<b><i>Purpose:</i></b> It was the aim of this study to determine any possible correlation between the peaks and changes in intraocular pressure (IOP) of a water drinking test and intravenous methylprednisolone pulse therapy (IVMPT) IOP response. <b><i>Methods:</i></b> Patients with rheumatic disorders scheduled for IVMPT with normal ocular examination received a WDT before and after 3 days of IVMPT. The maximum value of IOPs detected during the WDT or IVMPT was regarded as peak IOP, and IOP change was defined as the difference between peak IOP and baseline IOP. <b><i>Results:</i></b> The mean ± standard deviation (SD) IOPs on the first (21.9 ± 4.6 mm Hg; p = 0.04), second (21.9 ± 4.1 mm Hg; p = 0.03) and third (21.3 ± 4.2 mm Hg; p = 0.01) days of 20 enrolled patients were greater than that at baseline (19.3 ± 2.8 mm Hg). The mean ± SD of peak IVMPT IOP response was 23.9 ± 3.7 mm Hg, and IVMPT IOP change was 4.6 ± 3.7 mm Hg. These values for the first and second WDTs were 22.9 ± 4.9 and 3.9 ± 4.07 as well as 24.1 ± 4.6 and 3.00 ± 2.9 mm Hg, respectively. A significant correlation was observed between the first WDT and IVMPT IOP changes (r = 0.5, p = 0.007) and peak IOPs (r = 0.6, p = 0.001). <b><i>Conclusion:</i></b> WDT, a low-cost and feasible test in clinical practice, may be a useful tool in determining the IOP peak and change following IVMPT.
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49
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Khurana AK, Khurana B, Khurana AK. Drug-induced Angle-Closure Glaucoma. J Curr Glaucoma Pract 2012; 6:6-8. [PMID: 27990064 PMCID: PMC5159452 DOI: 10.5005/jp-journals-10008-1100] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Accepted: 11/02/2011] [Indexed: 11/23/2022] Open
Abstract
Drug-induced angle-closure glaucoma is an important entity for the ophthalmologist as well as the general physician as it represents a preventable cause of potential blindness. This brief review highlights the fact that a high index of suspicion, in a susceptible individual followed by confirmation on appropriate imaging modality (UBM, ultrasound or anterior segment OCT) can alleviate the threat to sight and also help to institute appropriate therapy.
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Affiliation(s)
- Aruj K Khurana
- Senior Professor, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Bhawna Khurana
- Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Ashok K Khurana
- Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
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50
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Karimi S, Dharia SP, Flora DS, Slattum PW. Anticholinergic Burden: Clinical Implications for Seniors and Strategies for Clinicians. ACTA ACUST UNITED AC 2012; 27:564-82. [DOI: 10.4140/tcp.n.2012.564] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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