Acute changes in the retina and central retinal artery with methamphetamine

Attention-Deficit/Hyperactivity Disorder Animal Model Presents Retinal Alterations and Methylphenidate Has a Differential Effect in ADHD versus Control Conditions

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders. Interestingly, children with ADHD seem to experience more ophthalmologic abnormalities, and the impact of methylphenidate (MPH) use on retinal physiology remains unclear. Thus, we aimed to unravel the retina's structural, functional, and cellular alterations and the impact of MPH in ADHD versus the control conditions. For that, spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY) were used as animal models of ADHD and the controls, respectively. Animals were divided into four experimental groups as follows: WKY vehicle (Veh; tap water), WKY MPH (1.5 mg/kg/day), SHR Veh, SHR MPH. Individual administration was performed by gavage between P28-P55. Retinal physiology and structure were evaluated at P56 followed by tissue collection and analysis. The ADHD animal model presents the retinal structural, functional, and neuronal deficits, as well as the microglial reactivity, astrogliosis, blood-retinal barrier (BRB) hyperpermeability and a pro-inflammatory status. In this model, MPH had a beneficial effect on reducing microgliosis, BRB dysfunction, and inflammatory response, but did not correct the neuronal and functional alterations in the retina. Curiously, in the control animals, MPH showed an opposite effect since it impaired the retinal function, neuronal cells, and BRB integrity, and also promoted both microglia reactivity and upregulation of pro-inflammatory mediators. This study unveils the retinal alterations in ADHD and the opposite effects induced by MPH in the retina of ADHD and the control animal models.

Vision health perspectives on Breaking Bad: Ophthalmic sequelae of methamphetamine use disorder

Methamphetamine use has become a rampant public health issue that not only causes devastating consequences to the user but also poses a burden to surrounding communities. A spectrum of ophthalmic sequelae is associated with methamphetamine use and includes episcleritis, scleritis, corneal ulceration, panophthalmitis, endophthalmitis, retinal vasculitis, and retinopathy. In many instances, prompt recognition of the condition and associated infectious process and early initiation of antimicrobial therapy are crucial steps to preventing vision loss. In this review, we summarize the reported ocular complications that may result from methamphetamine use in addition to several postulated mechanisms regarding the ocular toxicity of methamphetamine. The increasing prevalence of methamphetamine use as a public health threat highlights the need for continued investigation of this ophthalmologic issue.

Long-term effects of methamphetamine abuse on visual evoked potentials

PURPOSE

To compare visual evoked potential (VEP) components in normal individuals and those with long-term methamphetamine and crystal methamphetamine use.

METHODS

In this study, monocular pattern-reversal VEPs were recorded in 40 methamphetamine and crystal methamphetamine users and 38 normal individuals. Visual stimuli were high-contrast (99%) checkerboard patterns at 15 and 60 min of arc with a reversal rate of 1.53 reversals per second.

RESULTS

A significant difference was seen between the two groups for the P100 peak time for the 60 min of arc checks (p = 0.002, d = 0.75, 4.61% higher peak time in the addicted group) and the 15 min of arc checks (p = 0.004, d = 0.73, 4.78% higher peak time in the addicted group). However, other VEP components were not significantly different between the two groups.

CONCLUSIONS

The higher P100 peak time at both 15 and 60 min of arc in methamphetamine-dependent users reveals that VEPs are highly sensitive for the diagnosis of retinal and visual pathway lesions.

Macula and optic disk features in methamphetamine and crystal methamphetamine addicts using optical coherence tomography

PURPOSE

Methamphetamine and crystal methamphetamine abusers were compared with healthy subjects using optical coherence tomography to assess their retinal nerve fiber layer, macula, and optic disk characteristics.

METHODS

Forty-one methamphetamine and crystal methamphetamine abusers and 42 healthy subjects (mean ± SD of age: 35.82 ± 8.6 and 37.76 ± 9.1 years, respectively) were incorporated in this cross-sectional study. The drug abusers had a history of at least five years of substance use through smoking. Fourier-domain optical coherence tomography was used to image and assess the characteristics of retinal nerve fiber layer, macular thickness, and optic disk in the study groups.

RESULTS

The retinal nerve fiber layer thickness was significantly lower in the superior and temporal retinal quadrants of drug abusers than healthy subjects (P = 0.008 and P = 0.028, respectively). This study did not find a significant difference between drug abusers and healthy controls regarding optic to disk ratio, rim area, and disk area (P > 0.05). The comparison between the study groups showed that the reductions in perifovea and the superior quadrant of parafoveal thickness were statistically significant (P < 0.001 and P = 0.029, respectively).

CONCLUSION

Fourier-domain optical coherence tomography measurements showed that the retinal nerve fiber layer and macular thickness were different between methamphetamine and crystal methamphetamine abusers and healthy subjects, which should be considered in clinical practice. It seems that these drug abuses can cause alterations in retinal morphology.

Changes in corneal and anterior chamber indices due to methamphetamine abuse

CLINICAL RELEVANCE

Considering the significant relationship between methamphetamine abuse and some anterior segment indices, methamphetamine abuse should be considered in differential diagnosis especially in the case of angle closure glaucoma.

BACKGROUND

To investigate the effect of inhaled methamphetamine (meth) and crystal methamphetamine (crystal meth) on the quantitative indices of the cornea and anterior chamber using pentacam and anterior segment optical coherence tomography.

METHODS

In this cross-sectional study, the participants were (crystal) meth addicts living in Zahedan. The participants were transported to the examination site to undergo imaging and optometric tests. Pentacam and anterior segment optical coherence tomography imaging were then conducted so as to evaluate corneal and anterior chamber quantitative indices.

RESULTS

A total of 42 (crystal) meth addicts and 42 healthy subjects with matching age and gender were examined. Out of 42 subjects in the case group, 6 were female and 36 were male (mean age: 35.7 ± 8.6 years). The mean dose of drug used was 0.0074 ± 0.0034 g, and the mean duration of drug use was 6.9 ± 2.6 years (5-12 years). Based on the images of both devices, corneal curvature was significantly steeper in both meridians of anterior and posterior surfaces compared to the control group (p = 0.01). Among the anterior chamber parameters, the anterior chamber depth and volume were lower in the cases than the controls (p < 0.01). However, the lens rise was higher in addicts than controls (p = 0.01).

CONCLUSION

Quantitative changes in corneal and anterior segment indices including dilated pupils, shallower anterior chamber depth and higher lens rise in addicted cases compared to the control group may precipitate the risk of closed-angle in these individuals.

Retinal hypoxia and angiogenesis with methamphetamine

Central retinal artery occlusion, retinopathy, and retinal neovascularization have been reported in methamphetamine (METH) abusers. In the current study, we investigated whether METH induces retinal neovascularization in a mouse model, and if so, whether the neovascularization is associated with increased hypoxia, hypoxia-inducible factor 1α (HIF-1α), and vascular endothelial growth factor (VEGF). Mice were administrated METH by intraperitoneal injection over a 26-day period, or injected with saline as a vehicle control. The number of retinal arterioles and venules were counted using in vivo live imaging following infusion with fluorescein isothiocyanate-dextran. Excised retinas were stained with griffonia simplicifolia lectin I and flat mounted for a measurement of vascularity (length of vessels per tissue area) with AngioTool. Retinal hypoxia was examined by formation of pimonidazole adducts with an anti-pimonidazole antibody, and HIF-1α and VEGFa protein levels in the retina were detected by immunoblot. METH administration increased vascularity (including the number of arterioles) measured on Day 26. Retinal VEGFa protein level was not changed in METH-treated mice on Day 5, but was increased on Day 12 and Day 26. Hypoxia (pimonidazole adduct formation) was increased in retinas of METH-treated mice on Day 12 and Day 26, as were HIF-1α protein expression levels. These results indicate that METH administration induces hypoxia, HIF-1α, VEGFa, and angiogenesis in the retina.