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Taufik SA, Ramli N, Tan AH, Lim SY, Ghani MTA, Shahrizaila N. Longitudinal Changes in the Retinal Nerve Fiber Layer Thickness in Amyotrophic Lateral Sclerosis and Parkinson's Disease. J Clin Neurol 2024; 20:285-292. [PMID: 38627230 PMCID: PMC11076187 DOI: 10.3988/jcn.2023.0353] [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: 09/05/2023] [Revised: 11/05/2023] [Accepted: 11/22/2023] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND AND PURPOSE There is increasing evidence that the anterior visual pathways are involved in neurodegenerative diseases including amyotrophic lateral sclerosis (ALS) and Parkinson's disease (PD). This study investigated longitudinal changes in retinal nerve fiber layer (RNFL) thickness in patients with ALS and PD with the aim of better understanding their roles as biomarkers of disease progression. METHODS This study recruited 21 ALS patients, 19 age-matched PD patients, and 21 agematched healthy controls. Patient demographics and clinical scores relating to the respective diseases were documented. The RNFL thickness was measured using optical coherence tomography at baseline and after 6 months. RESULTS At baseline, the RNFL in the superior quadrant was significantly thinner in the patients with ALS than in healthy controls (109.90±22.41 µm vs. 127.81±17.05 µm [mean±standard deviation], p=0.008). The RNFL thickness did not differ significantly between the ALS and PD patients or between the PD patients and healthy controls. At 6 months, there was further significant RNFL thinning in patients with ALS, for both the overall thickness (baseline: median=94.5 µm, range=83.0-106.0 µm; follow-up: median=93.5 µm, range=82.5-104.5 µm, p=0.043) and the thickness in the inferior quadrant (median=126 µm, range=109.5-142.5 µm; and median=117.5 µm, range=98.5-136.5 µm; respectively, p=0.032). However, these changes were not correlated with the ALS functional scores. In contrast, the patients with PD did not demonstrate a significant change in RNFL thickness between the two time points. CONCLUSIONS The RNFL thickness is a promising biomarker of disease progression in patients with ALS but not in those with PD, which has a slower disease progression.
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Affiliation(s)
- Sharifah Azira Taufik
- UM Eye Research Centre, Department of Ophthalmology, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
| | - Norlina Ramli
- UM Eye Research Centre, Department of Ophthalmology, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia.
| | - Ai Huey Tan
- Division of Neurology, Department of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
| | - Shen-Yang Lim
- Division of Neurology, Department of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
| | - Mohd Taufiq Abdul Ghani
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
| | - Nortina Shahrizaila
- Division of Neurology, Department of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia.
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Vautier A, Lebreton AL, Codron P, Awada Z, Gohier P, Cassereau J. Retinal vessels as a window on amyotrophic lateral sclerosis pathophysiology: A systematic review. Rev Neurol (Paris) 2023; 179:548-562. [PMID: 36842953 DOI: 10.1016/j.neurol.2022.11.010] [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: 07/30/2022] [Revised: 10/13/2022] [Accepted: 11/04/2022] [Indexed: 02/28/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a rare fatal motor neuron disease. Although many potential mechanisms have been proposed, the pathophysiology of the disease remains unknown. Currently available treatments can only delay the progression of the disease and prolong life expectancy by a few months. There is still no definitive cure for ALS, and the development of new treatments is limited by a lack of understanding of the underlying biological processes that trigger and promote neurodegeneration. Several scientific results suggest a neurovascular impairment in ALS providing perspectives for the development of new biomarkers and treatments. In this article, we performed a systematic review using PRISMA guidelines including PubMed, EmBase, GoogleScholar, and Web of Science Core Collection to analyze the scientific literature published between 2000 and 2021 discussing the neurocardiovascular involvement and ophthalmologic abnormalities in ALS. In total, 122 articles were included to establish this systematic review. Indeed, microvascular pathology seems to be involved in ALS, affecting all the neurovascular unit components. Retinal changes have also been recently highlighted without significant alteration of the visual pathways. Despite the peripheral location of the retina, it is considered as an extension of the central nervous system (CNS) as it displays similarities to the brain, the inner blood-retinal barrier, and the blood-brain barrier. This suggests that the eye could be considered as a 'window' into the brain in many CNS disorders. Thus, studying ocular manifestations of brain pathologies seems very promising in understanding neurodegenerative disorders, mainly ALS. Optical coherence tomography angiography (OCT-A) could therefore be a powerful approach for exploration of retinal microvascularization allowing to obtain new diagnostic and prognostic biomarkers of ALS.
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Affiliation(s)
- A Vautier
- Department of Ophthalmology, University Hospital, Angers, France.
| | - A L Lebreton
- Department of Ophthalmology, University Hospital, Angers, France
| | - P Codron
- Amyotrophic Lateral Sclerosis (ALS) Center, Department of Neurology, University Hospital, Angers, France; Department of Neurobiology and Neuropathology, University Hospital, Angers, France; University of Angers, Inserm, CNRS, MITOVASC, SFR ICAT, Angers, France
| | - Z Awada
- Department of neuroscience, LHH-SIUH, New York, USA
| | - P Gohier
- Department of Ophthalmology, University Hospital, Angers, France
| | - J Cassereau
- Amyotrophic Lateral Sclerosis (ALS) Center, Department of Neurology, University Hospital, Angers, France; University of Angers, Inserm, CNRS, MITOVASC, SFR ICAT, Angers, France.
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3
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Sensory Involvement in Amyotrophic Lateral Sclerosis. Int J Mol Sci 2022; 23:ijms232415521. [PMID: 36555161 PMCID: PMC9779879 DOI: 10.3390/ijms232415521] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/19/2022] [Accepted: 12/03/2022] [Indexed: 12/13/2022] Open
Abstract
Although amyotrophic lateral sclerosis (ALS) is pre-eminently a motor disease, the existence of non-motor manifestations, including sensory involvement, has been described in the last few years. Although from a clinical perspective, sensory symptoms are overshadowed by their motor manifestations, this does not mean that their pathological significance is not relevant. In this review, we have made an extensive description of the involvement of sensory and autonomic systems described to date in ALS, from clinical, neurophysiological, neuroimaging, neuropathological, functional, and molecular perspectives.
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Nepal G, Kharel S, Coghlan MA, Yadav JK, Parajuli P, Pandit K, Shing YK, Ojha R. Amyotrophic lateral sclerosis and retinal changes in optical coherence tomography: A systematic review and meta-analysis. Brain Behav 2022; 12:e2741. [PMID: 35996223 PMCID: PMC9480919 DOI: 10.1002/brb3.2741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/20/2022] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Increasing evidence suggests Amyotrophic Lateral Sclerosis (ALS) as a widespread pathological process comprising nonmotor features like fatigue, mild sensory symptoms, cognitive decline, and visual impairment. Measurements of retinal nerve fiber layer (RNFL) thickness using Optical Coherence Tomography (OCT) may correlate with the neurodegeneration associated with ALS. In addition to RNFL thickness, other OCT parameters have been explored in the context of diagnosing ALS and predicting disease severity. In this study, we explore the possibility that OCT parameters of patients with ALS may differ significantly from those of healthy controls and thus serve as biomarkers for the disease and its progression. MATERIALS AND METHODS Between 2010 and 2021, the PubMed and EMBASE databases were examined for English language literature. ALS severity was assessed using the revised ALS functional rating scale (ALSFRS-R). The pooled mean differences in RNFL thickness between ALS patients and controls were calculated using the Standard Mean Difference (Hedges's g) with a 95% confidence interval (CI) in STATA software version 16. RESULTS Eleven studies were reviewed for data collection. RNFL thickness was not statistically significantly different between ALS patients (n = 412) and controls (n = 376) (Hedges's g = -0.22; 95% CI: -0.51 to 0.07, I2 = 73.04%, p = .14). However, the thickness of inner nuclear layer was significantly different between ALS patients and controls (Hedges's g = -0.38; 95% CI: -0.61 to 0.14, I2 = 14.85%, p = .00). CONCLUSION Our meta-analysis found that RNFL thickness as a whole or by individual quadrants was not significantly different between ALS patients and controls while the inner nuclear layer (INL) was substantially thinner.
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Affiliation(s)
- Gaurav Nepal
- Department of Internal Medicine, Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Maharajgunj, Kathmandu, Nepal
| | - Sanjeev Kharel
- Department of Internal Medicine, Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Maharajgunj, Kathmandu, Nepal
| | - Megan Ariel Coghlan
- Department of Neurology, University of Louisville School of Medicine, Louisville, Kentucky, US
| | - Jayant Kumar Yadav
- Department of Internal Medicine, Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Maharajgunj, Kathmandu, Nepal
| | - Pawan Parajuli
- Department of Internal Medicine, Koshi Hospital, Biratnagar, Nepal
| | - Kamal Pandit
- Department of Ophthalmology, Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Maharajgunj, Kathmandu, Nepal
| | - Yow Ka Shing
- Department of Internal Medicine, National University Hospital, Singapore, Singapore
| | - Rajeev Ojha
- Department of Internal Medicine, Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Maharajgunj, Kathmandu, Nepal
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Zhang Y, Liu X, Fu J, Zhang Y, Yang X, Zhang S, Fan D. Selective and Inverse U-Shaped Curve Alteration of the Retinal Nerve in Amyotrophic Lateral Sclerosis: A Potential Mirror of the Disease. Front Aging Neurosci 2022; 13:783431. [PMID: 35069179 PMCID: PMC8770270 DOI: 10.3389/fnagi.2021.783431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/14/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Alterations in the visual pathway involving the retina have been reported in amyotrophic lateral sclerosis (ALS) but they lack consistency and subgroup analysis. We aimed to assess the retinal nerve fiber layer (RNFL) and retinal ganglion cells (RGCs) alterations in different stages of ALS patients and their association with ALS progression parameters. Methods: The study population consisted of 70 clinically diagnosed ALS patients and 55 age, sex matched controls. All of them underwent ophthalmic assessments and optical coherence tomography imaging. Four quadrants of the peripapillary RNFL and ganglion cell/inner plexiform complex (GCIP) were observed and automatically measured. Early-stage distal motor neuron axon dysfunction in ALS was detected by compound muscle action potential (CMAP) of the distal limbs within 12 months. The ALS disease parameters included the ALSFRS-R score and the disease progression rate (ΔFS). Results: Generally compared with controls, the nasal (p = 0.016) quadrant of the RNFL was thicker in ALS patients. When controlling for age and ΔFS, the RNFL(r = 0.37, p = 0.034) and GCIP(r = 0.40, p = 0.021) were significantly thickened as disease progressed within 12 months, while the RNFL declined with time after one year (r = −0.41, p = 0.037). ALS patients was subclassified into thickened RNFL (T-RNFL, >95th percentile of normal), impaired RNFL (I-RNFL, <5th percentile of normal) and normal RNFL. There were significant differences in the GCIP among the three groups (p < 0.001). In the T-RNFL group (n = 18), the RNFL was negatively correlated with the abductor pollicis brevis-CMAP amplitude within 12 months (r = −0.56, p = 0.01). Patients within 12 months in this group progressed faster than others (p = 0.039). In the normal RNFL group (n = 22), 13 patients were diagnosed beyond 12 months, whose ΔFS was remarkably lower (p = 0.007). In I-RNFL group (n = 30), the early stage patients (<12 months) had significant higher ΔFS (p = 0.006). One patient was with SOD1 pathogenic variant (p.A5V). Conclusion: Alterations of retinal nerve were not consistent in ALS patients with diverse phenotypes and progression rates. Generally speaking, the RNFL thickened during the first year and then gradually declined, which is related to but preceding the thickness change of the RGCs. Patients with a significant RNFL thinning in the early stage may have a faster progression rate. The inverse U-shaped curve transformation might be in accordance with early-stage motor neuron axonopathy.
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Affiliation(s)
- Yixuan Zhang
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Xiangyi Liu
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Jiayu Fu
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Yuanjin Zhang
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Xue Yang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Shuo Zhang
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Dongsheng Fan
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
- *Correspondence: Dongsheng Fan
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Jing D, Liu Z, Chou Y, Wang H, Gao S, Fan X, Wang W. Discrepancy between NTG and POAG with corneal nerves in CCM. Eye (Lond) 2021; 36:1662-1668. [PMID: 34341486 PMCID: PMC9307790 DOI: 10.1038/s41433-021-01705-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 07/05/2021] [Accepted: 07/16/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To investigate the morphological features of corneal subbasal nerve plexus (CSNP) in normal-tension glaucoma (NTG) and primary open-angle glaucoma (POAG). METHODS Thirty-four eyes with NTG (16 untreated), 23 eyes with POAG (11 untreated) and 31 eyes of healthy subjects were recruited. CSNP were assessed by corneal confocal microscopy (CCM) and peripapillary retinal nerve fibre layer (RNFL) was measured with optical coherence tomography (OCT). CCM parameters including corneal subbasal nerve fibre length (FL), corneal subbasal nerve branch number (BN), corneal subbasal nerve width (NW), corneal subbasal nerve reflectivity (NR), total and local corneal subbasal nerve tortuosity (NT) was compared across all groups, as well as between the topical medication treated and the nontreated patients. RESULTS The newly diagnosed NTG patients had the longest FL (3619.15 ± 501.55), most BN (21.02 ± 5.90), thinnest corneal subbasal nerve width (3.04 ± 0.82), corneal subbasal nerve lowest reflectivity (140.43 ± 10.24) and the corneal subbasal nerves were most bending (1.09 ± 0.06) and tortuous (123.36 ± 7.82) compared with untreated POAG patients and controls. Untreated POAG had similar CSNP to controls. The treated glaucoma patients had longer FL and more BN than the nontreated but with no significant difference. FL and BN had correlations with RNFL thickness in untreated NTG patients, and NR and NW had correlations with RNFL thickness in untreated POAG patients. NT had no correlations with RNFL thickness. CONCLUSIONS The NTG group had different CSNP characteristics from the POAG group and controls, while the latter two shared more morphological features. The CCM parameters except NT had associations with the RNFL thickness in glaucoma patients.
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Affiliation(s)
- Dl Jing
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, China
| | - Zy Liu
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, China
| | - Yl Chou
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, China
| | - Hk Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, China
| | - S Gao
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, China
| | - X Fan
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, China.
| | - W Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, China.
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Rojas P, Ramírez AI, Fernández-Albarral JA, López-Cuenca I, Salobrar-García E, Cadena M, Elvira-Hurtado L, Salazar JJ, de Hoz R, Ramírez JM. Amyotrophic Lateral Sclerosis: A Neurodegenerative Motor Neuron Disease With Ocular Involvement. Front Neurosci 2020; 14:566858. [PMID: 33071739 PMCID: PMC7544921 DOI: 10.3389/fnins.2020.566858] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/24/2020] [Indexed: 12/11/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that causes degeneration of the lower and upper motor neurons and is the most prevalent motor neuron disease. This disease is characterized by muscle weakness, stiffness, and hyperreflexia. Patients survive for a short period from the onset of the disease. Most cases are sporadic, with only 10% of the cases being genetic. Many genes are now known to be involved in familial ALS cases, including some of the sporadic cases. It has also been observed that, in addition to genetic factors, there are numerous molecular mechanisms involved in these pathologies, such as excitotoxicity, mitochondrial disorders, alterations in axonal transport, oxidative stress, accumulation of misfolded proteins, and neuroinflammation. This pathology affects the motor neurons, the spinal cord, the cerebellum, and the brain, but recently, it has been shown that it also affects the visual system. This impact occurs not only at the level of the oculomotor system but also at the retinal level, which is why the retina is being proposed as a possible biomarker of this pathology. The current review discusses the main aspects mentioned above related to ALS, such as the main genes involved, the most important molecular mechanisms that affect this pathology, its ocular involvement, and the possible usefulness of the retina as a biomarker.
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Affiliation(s)
- Pilar Rojas
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense de Madrid, Madrid, Spain.,Hospital General Universitario Gregorio Marañón, Instituto Oftálmico de Madrid, Madrid, Spain
| | - Ana I Ramírez
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense de Madrid, Madrid, Spain.,OFTARED, ISCIII, Madrid, Spain.,Departamento de Inmunología Oftalmología y ORL, Facultad de Óptica y Optometría, Universidad Complutense de Madrid, Madrid, Spain
| | - José A Fernández-Albarral
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense de Madrid, Madrid, Spain
| | - Inés López-Cuenca
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense de Madrid, Madrid, Spain
| | - Elena Salobrar-García
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense de Madrid, Madrid, Spain.,OFTARED, ISCIII, Madrid, Spain.,Departamento de Inmunología Oftalmología y ORL, Facultad de Óptica y Optometría, Universidad Complutense de Madrid, Madrid, Spain
| | - Manuel Cadena
- Hospital General Universitario Gregorio Marañón, Instituto Oftálmico de Madrid, Madrid, Spain
| | - Lorena Elvira-Hurtado
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan J Salazar
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense de Madrid, Madrid, Spain.,OFTARED, ISCIII, Madrid, Spain.,Departamento de Inmunología Oftalmología y ORL, Facultad de Óptica y Optometría, Universidad Complutense de Madrid, Madrid, Spain
| | - Rosa de Hoz
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense de Madrid, Madrid, Spain.,OFTARED, ISCIII, Madrid, Spain.,Departamento de Inmunología Oftalmología y ORL, Facultad de Óptica y Optometría, Universidad Complutense de Madrid, Madrid, Spain
| | - José M Ramírez
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense de Madrid, Madrid, Spain.,OFTARED, ISCIII, Madrid, Spain.,Departamento de Inmunología Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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8
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Artero-Castro A, Rodriguez-Jimenez FJ, Jendelova P, VanderWall KB, Meyer JS, Erceg S. Glaucoma as a Neurodegenerative Disease Caused by Intrinsic Vulnerability Factors. Prog Neurobiol 2020; 193:101817. [PMID: 32360241 DOI: 10.1016/j.pneurobio.2020.101817] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/30/2020] [Accepted: 04/23/2020] [Indexed: 01/08/2023]
Abstract
Glaucoma, one of the most common causes of blindness in developing countries today, involves a progressive loss of neural cells in the optic nerve that leads to progressive, irreversible vision loss. Increased intraocular pressure (IOP) presents as a major risk factor for glaucoma, although there exist cases of glaucoma patients with normal IOP that exhibit damage to retinal ganglion cells (RGCs) and the optic nerve. However, treatment approaches have maintained their focus on modifying IOP due to a lack of other modifiable risks factors. Traditional concepts in glaucoma involve the neuronal environment and external effects as a source of causative factors; however, studies have yet to investigate whether the molecular profile of RGCs in glaucoma patients makes them more vulnerable and/or susceptible to external damage. Our hypothesis states that molecular changes at the whole cell, gene expression, and electrophysiological level of the neurons can contribute to their degeneration. Herein, we briefly describe different types of glaucoma and any similarities to different molecular and cellular features of neurodegeneration. To test our hypothesis, we describe human induced pluripotent stem cells (hiPSCs) as a reliable cellular tool to model neurodegenerative aspects of glaucoma to reveal the multiple pathological molecular mechanisms underlying disease development.
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Affiliation(s)
- Ana Artero-Castro
- Stem Cells Therapies in Neurodegenerative Diseases Lab, Research Center "Principe Felipe", Valencia, Spain.
| | | | - Pavla Jendelova
- Institute of Experimental Medicine, Czech Academy of Sciences, Department of Neuroregeneration, Prague, Czech Republic.
| | - Kirstin B VanderWall
- Department of Biology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA.
| | - Jason S Meyer
- Department of Biology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA; Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA; Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Slaven Erceg
- Stem Cells Therapies in Neurodegenerative Diseases Lab, Research Center "Principe Felipe", Valencia, Spain; National Stem Cell Bank-Valencia Node, Platform for Proteomics, Genotyping and Cell Lines, PRB3,ISCIII, Research Center "Principe Felipe", Valencia, Spain; Institute of Experimental Medicine, Czech Academy of Sciences, Department of Neuroregeneration, Prague, Czech Republic.
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9
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Cerveró A, Casado A, Riancho J. Retinal changes in amyotrophic lateral sclerosis: looking at the disease through a new window. J Neurol 2019; 268:2083-2089. [PMID: 31792674 DOI: 10.1007/s00415-019-09654-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 12/12/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is the most frequent degenerative disease affecting motor neurons (MN). ALS has been traditionally considered as a pure motor system disease; however, there are currently sufficient evidences supporting the involvement of other non-motor systems. Recently, the development and the implementation of the optical coherence tomography (OCT) have provided new data regarding the ocular involvement in the disease. In this sense, alterations in retinal nerve fiber layer thickness (RNFL), other retinal layers thicknesses such as outer nuclear layer (ONL) and inner nuclear layer (INL) and changes in the retinal blood vessels have been described in ALS patients. Interestingly, the study of ocular alterations in ALS appears not only as new biomarker tool, but also as a new opportunity to deep into the pathogenesis of the disease. In this article we will review and standardize published studies regarding OCT and ALS, emphasizing both their strengths and weaknesses.
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Affiliation(s)
- Andrea Cerveró
- Department of Ophthalmology, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain
| | - Alfonso Casado
- Department of Ophthalmology, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain
| | - Javier Riancho
- Service of Neurology, Hospital Sierrallana-IDIVAL, Barrio Ganzo, s/n, 39300, Torrelavega, Cantabria, Spain. .,CIBERNED, Madrid, Spain.
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