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García-Llorca A, Carta F, Supuran CT, Eysteinsson T. Carbonic anhydrase, its inhibitors and vascular function. Front Mol Biosci 2024; 11:1338528. [PMID: 38348465 PMCID: PMC10859760 DOI: 10.3389/fmolb.2024.1338528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/03/2024] [Indexed: 02/15/2024] Open
Abstract
It has been known for some time that Carbonic Anhydrase (CA, EC 4.2.1.1) plays a complex role in vascular function, and in the regulation of vascular tone. Clinically employed CA inhibitors (CAIs) are used primarily to lower intraocular pressure in glaucoma, and also to affect retinal blood flow and oxygen saturation. CAIs have been shown to dilate vessels and increase blood flow in both the cerebral and ocular vasculature. Similar effects of CAIs on vascular function have been observed in the liver, brain and kidney, while vessels in abdominal muscle and the stomach are unaffected. Most of the studies on the vascular effects of CAIs have been focused on the cerebral and ocular vasculatures, and in particular the retinal vasculature, where vasodilation of its vessels, after intravenous infusion of sulfonamide-based CAIs can be easily observed and measured from the fundus of the eye. The mechanism by which CAIs exert their effects on the vasculature is still unclear, but the classic sulfonamide-based inhibitors have been found to directly dilate isolated vessel segments when applied to the extracellular fluid. Modification of the structure of CAI compounds affects their efficacy and potency as vasodilators. CAIs of the coumarin type, which generally are less effective in inhibiting the catalytically dominant isoform hCA II and unable to accept NO, have comparable vasodilatory effects as the primary sulfonamides on pre-contracted retinal arteriolar vessel segments, providing insights into which CA isoforms are involved. Alterations of the lipophilicity of CAI compounds affect their potency as vasodilators, and CAIs that are membrane impermeant do not act as vasodilators of isolated vessel segments. Experiments with CAIs, that shed light on the role of CA in the regulation of vascular tone of vessels, will be discussed in this review. The role of CA in vascular function will be discussed, with specific emphasis on findings with the effects of CA inhibitors (CAI).
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Affiliation(s)
- Andrea García-Llorca
- Department of Physiology, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Fabrizio Carta
- NEUROFARBA Department, Section of Pharmaceutical and Nutraceutical Sciences, University of Florence, Florence, Italy
| | - Claudiu T. Supuran
- NEUROFARBA Department, Section of Pharmaceutical and Nutraceutical Sciences, University of Florence, Florence, Italy
| | - Thor Eysteinsson
- Department of Physiology, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Ophthalmology, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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Eysteinsson T, García-Llorca A, Hardarson AO, Vullo D, Carta F, Supuran CT. Membrane Permeability Is Required for the Vasodilatory Effect of Carbonic Anhydrase Inhibitors in Porcine Retinal Arteries. Int J Mol Sci 2023; 24:ijms24098140. [PMID: 37175846 PMCID: PMC10179589 DOI: 10.3390/ijms24098140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/20/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
It has been demonstrated previously that a variety of carbonic anhydrase inhibitors (CAIs) can induce vasodilation in pre-contracted retinal arteriolar segments although with different efficacy and potency. Since the CAIs tested so far are able to permeate cell membranes and inhibit both intracellular and extracellular isoforms of the enzyme, it is not clear whether extra- or intracellular isoforms or mechanisms are mediating their vasodilatory effects. By means of small wire myography, we have tested the effects of four new CAIs on wall tension in pre-contracted retinal arteriolar segments that demonstrably do not enter cell membranes but have high affinity to both cytosolic and membrane-bound isoforms of CA. At concentrations between 10-6 M to 10-3 M, none of the four membrane impermeant CAIs had any significant effect on arteriolar wall tension, while the membrane permeant CAI benzolamide (10-3 M) fully dilated all arteriolar segments tested. This suggests that CAI act as vasodilators through cellular mechanisms located in the cytoplasm of vascular cells.
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Affiliation(s)
- Thor Eysteinsson
- Department of Physiology, BioMedical Center, Faculty of Medicine, University of Iceland, IS101 Reykjavik, Iceland
| | - Andrea García-Llorca
- Department of Physiology, BioMedical Center, Faculty of Medicine, University of Iceland, IS101 Reykjavik, Iceland
| | - Arnar Oessur Hardarson
- Department of Physiology, BioMedical Center, Faculty of Medicine, University of Iceland, IS101 Reykjavik, Iceland
| | - Daniela Vullo
- Sezione di Scienze Farmaceutiche e Nutraceutiche, Neurofarba Department, University of Florence, Via Ugo Schiff 6, 50019 Florence, Italy
| | - Fabrizio Carta
- Sezione di Scienze Farmaceutiche e Nutraceutiche, Neurofarba Department, University of Florence, Via Ugo Schiff 6, 50019 Florence, Italy
| | - Claudiu T Supuran
- Sezione di Scienze Farmaceutiche e Nutraceutiche, Neurofarba Department, University of Florence, Via Ugo Schiff 6, 50019 Florence, Italy
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Eysteinsson T, García-Llorca A, Angeli A, Supuran CT, Carta F. Vasodilation of Pre-contracted Porcine Retinal Arteries by Carbonic Anhydrase Inhibitors with Enhanced Lipophilicity. Curr Eye Res 2022; 47:1615-1621. [PMID: 36221858 DOI: 10.1080/02713683.2022.2126861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE In this study, we investigated the vasodilation properties on pre-contracted retinal arteries of a restricted series of carbonic anhydrase inhibitors (CAIs) of the sulfonamide type with enhanced lipophilicity, to assess if it affects the potency of CAIs as vasodilators. METHODS Carbonic anhydrase (CA) inhibition and in vitro kinetics of the compounds designed and synthesized for testing in this study were assessed by extracting human CA isoform proteins (hCA) from human cells expressing the isoforms of interest, and then measure the affinity of the novel compound for the hCAs by stopped-flow CO2 hydrase spectroscopy. Lipophilicity of compounds was measured by obtaining their octanol-water partition coefficient, expressed as calculated logP. Porcine eyes were obtained from a local abattoir, and the wall tension of porcine retinal arteriole segments dissected from the eyes was measured with small wire vessel myography. The effects of the CA compounds on wall tension were assessed by adding them to the myography bath, after pre-contracting the vessel by prostaglandin analog U-46619. RESULTS All compounds induced vasodilation but at different concentrations. Among the tested compounds the most potent vasodilators were found to be the seleno-compound 4 and sulfur-ether compound 8 with EC50 values of 7.13 × 10-5 and 7.93 × 10-5 M, respectively, whereas the remaining ones induced complete vasodilation at EC50 comprised within the sub millimolar range. CONCLUSIONS All the data reported in this study (i.e. results from myography, in vitro kinetics and LogPs) confirm the important role played by several CA isoforms in vasodilation, although the precise mechanism of action still remains to be elucidated.
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Affiliation(s)
- Thor Eysteinsson
- Department of Physiology and Ophthalmology, Biomedical Center, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Andrea García-Llorca
- Department of Physiology and Ophthalmology, Biomedical Center, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Andrea Angeli
- NEUROFARBA Department, Sezione di Scienze Farmaceutiche e Nutraceutiche, Universitá degli Studi di Firenze, Florence, Italy.,Center of Advanced Research in Bionanoconjugates and Biopolymers - "Petru Poni," Institute of Macromolecular Chemistry, Iasi, Romania
| | - Claudiu T Supuran
- NEUROFARBA Department, Sezione di Scienze Farmaceutiche e Nutraceutiche, Universitá degli Studi di Firenze, Florence, Italy
| | - Fabrizio Carta
- NEUROFARBA Department, Sezione di Scienze Farmaceutiche e Nutraceutiche, Universitá degli Studi di Firenze, Florence, Italy
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Hua Y, Lu Y, Walker J, Lee PY, Tian Q, McDonald H, Pallares P, Ji F, Brazile BL, Yang B, Voorhees AP, Sigal IA. Eye-specific 3D modeling of factors influencing oxygen concentration in the lamina cribrosa. Exp Eye Res 2022; 220:109105. [PMID: 35568202 PMCID: PMC11007759 DOI: 10.1016/j.exer.2022.109105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/06/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022]
Abstract
Our goal was to identify the factors with the strongest influence on the minimum lamina cribrosa (LC) oxygen concentration as potentially indicative of conditions increasing hypoxia risk. Because direct measurement of LC hemodynamics and oxygenation is not yet possible, we developed 3D eye-specific LC vasculature models. The vasculature of a normal monkey eye was perfusion-labeled post-mortem. Serial cryosections through the optic nerve head were imaged using fluorescence and polarized light microscopy to visualize the vasculature and collagen, respectively. The vasculature within a 450 μm-thick region containing the LC - identified from the collagen, was segmented, skeletonized, and meshed for simulations. Using Monte Carlo sampling, 200 vascular network models were generated with varying vessel diameter, neural tissue oxygen consumption rate, inflow hematocrit, and blood pressures (arteriole, venule, anterior boundary, and posterior boundary). Factors were varied over ranges of baseline ±20% with uniform probability. For each model we first obtained the blood flow, and from this the neural tissue oxygen concentration. ANOVA was used to identify the factors with the strongest influence on the minimum (10th percentile) oxygen concentration in the LC. The three most influential factors were, in ranked order, vessel diameter, neural tissue oxygen consumption rate, and arteriole pressure. There was a strong interaction between vessel diameter and arteriole pressure whereby the impact of one factor was larger when the other factor was small. Our results show that, for the eye analyzed, conditions that reduce vessel diameter, such as vessel compression due to elevated intraocular pressure or gaze-induced tissue deformation, may particularly contribute to decreased LC oxygen concentration. More eyes must be analyzed before generalizing.
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Affiliation(s)
- Yi Hua
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yuankai Lu
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jason Walker
- Department of Biological Science, University of Pittsburgh, Pittsburgh, PA, United States
| | - Po-Yi Lee
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Qi Tian
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Haiden McDonald
- Department of Biological Science, University of Pittsburgh, Pittsburgh, PA, United States
| | - Pedro Pallares
- Department of Biological Science, University of Pittsburgh, Pittsburgh, PA, United States
| | - Fengting Ji
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bryn L Brazile
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bin Yang
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States; Department of Engineering, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Andrew P Voorhees
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ian A Sigal
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States.
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Tan Q, Zhu M, Du F, Jiang X, Huang X, Chen J, Peng H, Wang D. Changes in Retinal Vessel Flow after Small Incision Lenticule Extraction. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8437066. [PMID: 35309847 PMCID: PMC8926514 DOI: 10.1155/2022/8437066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/14/2022] [Accepted: 01/20/2022] [Indexed: 11/18/2022]
Abstract
Objective In order to analyze changes in retinal vessel flow after small incision lenticule extraction (SMILE). Methods A total of 32 patients (62 eyes) who underwent SMILE were enrolled in this prospective study. Optical parameters, including vessel density (VD), and perfusion density (PD) of foveal, parafoveal, and perifoveal regions, respectively, were measured before surgery and at 1 day, 1 week, 1 month, and 3 months postoperation. Preoperative parameters and surgical parameters were recorded. Results Significant decreases in VD and PD on postoperative day 1 were detected in all quadrants, both in 3 mm and in 6 mm regions (P < 0.001). One month after surgery, VD returned to preoperative levels. None of the preoperative and surgical parameters were significantly correlated with the VD and PD fluctuations (all P > 0.05). Conclusion. VD may decrease significantly with regional disparity 1 day after SMILE while recovering at 1 month. Elevation of intraocular pressure due to suction may account for such changes.
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Affiliation(s)
- Qian Tan
- Department of Ophthalmology, Shenzhen People's Hospital, Shenzhen 518000, China
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Minyi Zhu
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Fangfang Du
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Xianming Jiang
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Xiaoshan Huang
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Jingfang Chen
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Hongjun Peng
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Danyang Wang
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
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Samaha D, Diaconu V, Bouchard JF, Desalliers C, Dupont A. Effect of Latanoprostene Bunod on Optic Nerve Head Blood Flow. Optom Vis Sci 2022; 99:172-176. [PMID: 34889858 DOI: 10.1097/opx.0000000000001842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Topical latanoprostene bunod increases capillary oxygen saturation and blood volume at the optic nerve head in healthy individuals. PURPOSE This study aimed to evaluate the effect of topical latanoprostene bunod on optic nerve blood volume and oxygen saturation in a population of healthy participants. METHODS In this prospective double-blind crossover study, 23 healthy participants aged from 21 to 62 years were recruited. Optic nerve head capillary blood volume (ONHvol) and oxygen saturation (ONHSaO2) baselines were measured over a period of 2 hours using multichannel spectroscopic reflectometry and were remeasured after a 7-day once-daily instillation regimen of either latanoprost 0.005% or latanoprostene bunod 0.024%. After a 30-day washout period, participants were crossed over to the alternate product, and measurements were repeated. Participants were used as their own baselines to calculate variation in ONHvol and ONHSaO2 across time and pharmacological agents. The Friedman test was used to establish significant differences in optic nerve head parameters from baseline values, and Conover post hoc analysis was carried for multiple between-group comparisons. RESULTS Latanoprostene bunod 0.024% induced a significant increase of 4% in ONHSaO2 compared with latanoprost 0.005% (P < .001). Furthermore, latanoprostene bunod increased ONHvol levels by more than twofold at all time points (P < .001 at T60, T90, and T120). The increase in ONHvol was 66.2% higher than levels achieved with latanoprost at T60 (P = .001), 47% higher at T90 (P < .001), and 45% higher at T120 (P < .01). CONCLUSIONS Latanoprostene bunod 0.024% induces a significant increase in optic nerve head blood volume and oxygen saturation in healthy subjects, when compared with latanoprost 0.005%. Future studies are needed to evaluate whether similar responses are elicited in patients suffering from glaucomatous optic neuropathy.
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Affiliation(s)
| | - Vasile Diaconu
- Montreal University School of Optometry, Montreal, Quebec, Canada
| | | | | | - Ariane Dupont
- Montreal University School of Optometry, Montreal, Quebec, Canada
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Marino MJ, Gehlbach PL, Rege A, Jiramongkolchai K. Current and novel multi-imaging modalities to assess retinal oxygenation and blood flow. Eye (Lond) 2021; 35:2962-2972. [PMID: 34117399 PMCID: PMC8526664 DOI: 10.1038/s41433-021-01570-6] [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: 08/27/2020] [Revised: 01/28/2021] [Accepted: 04/20/2021] [Indexed: 02/05/2023] Open
Abstract
Retinal ischemia characterizes the underlying pathology in a multitude of retinal diseases that can ultimately lead to vision loss. A variety of novel imaging modalities have been developed to characterize retinal ischemia by measuring retinal oxygenation and blood flow in-vivo. These technologies offer valuable insight into the earliest pathophysiologic changes within the retina and provide physicians and researchers with new diagnostic and monitoring capabilities. Future retinal imaging technologies with the capability to provide affordable, noninvasive, and comprehensive data on oxygen saturation, vasculature, and blood flow mechanics are needed. This review will highlight current and future trends in multimodal imaging to assess retinal blood flow and oxygenation.
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Affiliation(s)
- Michael J. Marino
- grid.415233.20000 0004 0444 3298Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD USA
| | - Peter L. Gehlbach
- grid.21107.350000 0001 2171 9311Retina Division, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Abhishek Rege
- grid.505446.6Vasoptic Medical, Inc., Baltimore, MD USA
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Burgos-Blasco B, Güemes-Villahoz N, Vidal-Villegas B, Garcia-Feijoo J, Donate-Lopez J, Martin-Sanchez FJ, Gonzalez-Armengol JJ, Mendez-Hernandez CD. Optic Nerve Head Vessel Density Assessment in Recovered COVID-19 Patients: A Prospective Study Using Optical Coherence Tomography Angiography. J Glaucoma 2021; 30:711-717. [PMID: 33927148 PMCID: PMC8366516 DOI: 10.1097/ijg.0000000000001858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/06/2021] [Indexed: 01/08/2023]
Abstract
PRECIS Vascular diseases have been linked to alterations in optic nerve head perfusion. PURPOSE The main objective was to investigate the changes in peripapillary vessel density (VD) in post coronavirus disease (COVID-19) patients. METHODS In this prospective pilot exploratory study, patients with COVID-19 that were attended in the Emergency Department of Hospital Clinico San Carlos (Madrid) were included. All patients underwent optic nerve head optical coherence tomography angiography using the Cirrus HD-OCT 500 with AngioPlex OCTA (Zeiss, Dublin, CA) 4 and 12 weeks after diagnosis by positive reverse transcriptase-polymerase chain reaction test from nasopharyngeal swab at the Emergency Department. Sociodemographic data, medical history, disease severity, and laboratory work-up were collected. RESULTS One hundred and eighty eyes of 90 patients with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection were included. None of the patients reported visual changes. Severe patients were older, more frequently hispanic, dyslipidemic, and presented lower lymphocytes counts, as well as increased ferritin, D-dimer, fibrinogen, and international normalized ratio levels. No changes in optic nerve head vascularization were observed when both visits were compared. No correlation was found between VD and clinical parameters, disease severity and laboratory work-up. CONCLUSIONS Changes to peripapillary VD were not observed in patients with COVID-19 in the early months following diagnosis.
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Affiliation(s)
- Barbara Burgos-Blasco
- Department of Ophthalmology, Instituto de investigación sanitaria del Hospital Clínico San Carlos (IsISSC), Instituto de Investigaciones Oftalmológicas Ramón Castroviejo
- Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, ISCIII (OFTARED)
| | - Noemi Güemes-Villahoz
- Department of Ophthalmology, Instituto de investigación sanitaria del Hospital Clínico San Carlos (IsISSC), Instituto de Investigaciones Oftalmológicas Ramón Castroviejo
- Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, ISCIII (OFTARED)
| | - Beatriz Vidal-Villegas
- Department of Ophthalmology, Instituto de investigación sanitaria del Hospital Clínico San Carlos (IsISSC), Instituto de Investigaciones Oftalmológicas Ramón Castroviejo
- Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, ISCIII (OFTARED)
| | - Julian Garcia-Feijoo
- Department of Ophthalmology, Instituto de investigación sanitaria del Hospital Clínico San Carlos (IsISSC), Instituto de Investigaciones Oftalmológicas Ramón Castroviejo
- Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, ISCIII (OFTARED)
| | - Juan Donate-Lopez
- Department of Ophthalmology, Instituto de investigación sanitaria del Hospital Clínico San Carlos (IsISSC), Instituto de Investigaciones Oftalmológicas Ramón Castroviejo
- Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, ISCIII (OFTARED)
| | - Francisco J. Martin-Sanchez
- Emergency Department, Hospital Clínico San Carlos, Instituto de investigación sanitaria del Hospital Clínico San Carlos (IsISCC), Madrid, Spain
| | - Juan J. Gonzalez-Armengol
- Emergency Department, Hospital Clínico San Carlos, Instituto de investigación sanitaria del Hospital Clínico San Carlos (IsISCC), Madrid, Spain
| | - Carmen D. Mendez-Hernandez
- Department of Ophthalmology, Instituto de investigación sanitaria del Hospital Clínico San Carlos (IsISSC), Instituto de Investigaciones Oftalmológicas Ramón Castroviejo
- Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, ISCIII (OFTARED)
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Affiliation(s)
- Zheng He
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
| | - Algis J Vingrys
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
| | - James A Armitage
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia E‐mail:
| | - Bang V Bui
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
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Zhou J, Chen F, Yan A, Xia X. Role of mammalian target of rapamycin in regulating HIF-1α and vascular endothelial growth factor signals in glaucoma. Arch Physiol Biochem 2021; 127:44-50. [PMID: 31274018 DOI: 10.1080/13813455.2019.1609996] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hypoxia inducible factor subtype 1α (HIF-1α) in retinal tissues is involved in the development of glaucoma. This study examined the role played by mammalian target of rapamycin (mTOR) in regulating expression of HIF-1α and its downstream pathway, vascular endothelial growth factor (VEGF). Glaucoma was induced by chronic elevation of intraocular pressure using laser burns in rats. ELISA and western blot analysis were employed to determine the levels of HIF-1α, VEGF and mTOR in retinal tissues of eyes with high intraocular pressure. In results, HIF-1α, VEGF and VEGF receptor subtype 2 were increased in laser eyes. The p-mTOR, mTOR-mediated phosphorylation of 4E-binding protein 4, p70 ribosomal S6 protein kinase 1 were also amplified in retina of laser eyes. Blocking mTOR using rapamycin attenuated HIF-1α-VEGF pathways, accompanied with downregulation of apoptotic Caspase-3. Our data revealed potential signalling pathways engaged in the development of glaucoma, including the activation of mTOR and HIF-1α-VEGF mechanism.
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Affiliation(s)
- Jinzi Zhou
- Department of Ophthalmology, The First People's Hospital of Guiyang, Guiyang, China
| | - Fenghua Chen
- Department of Ophthalmology, The First People's Hospital of Guiyang, Guiyang, China
| | - Aimin Yan
- Department of Ophthalmology, The First People's Hospital of Guiyang, Guiyang, China
| | - Xiaobo Xia
- Department of Ophthalmology, Xiangya Hospital of Central South University, Changsha, China
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Hübnerová P, Mlčák P, Šínová I, Karhanová M, Šín M. Current use of the automatic retinal oximetry. Review. CESKÁ A SLOVENSKÁ OFTALMOLOGIE : CASOPIS CESKÉ OFTALMOLOGICKÉ SPOLECNOSTI A SLOVENSKÉ OFTALMOLOGICKÉ SPOLECNOSTI 2020; 76:3-11. [PMID: 32917089 DOI: 10.31348/2020/1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE To inform about possible use of the automatic retinal oximetry for the retinal oxygen saturation measurement in the eye and systemic diseases. METHODS We performed a literature review dealing with issues of retinal oxygen saturation monitoring by dual non-invasive retinal oximetry Oxymap T1 (Oxymap ehf. Reykjavík, Iceland). RESULTS We have found two main strains writing our paper on retinal oxygen saturation eye diseases. The first section concerns diseases created by having hypoxia as its main pathological factor - for example diabetes mellitus and retinal vein occlusion. The second group deals with atrophy as the main pathological mechanism which is typical for decreasing retinal oxygen consumption - for example glaucoma or retinitis pigmentosa (the second one named is not included in our work). Oximetry in systemic diseases creates a relatively new chapter of this branch with a very big potential of interdisciplinary cooperation for the future. It is possible the cooperation will not only include diabetologists but also neurologists (for example, in diseases like sclerosis multiplex or Devics, Alzheimers and Parkinsons disease) and haematologists (retinal oxygen saturation changes in patients with different rheological attributes of blood). CONCLUSION Retinal oxygen saturation measuring by automatic retinal oximetry is a relatively new method with scientifically confirmed high reproducibility of results. Currently it is the only experimental method with vast potentials not only in the realm of the possibility of observing eye diseases (diabetic retinopathy, retinal vein occlusion or glaucoma) but also in developing interdisciplinary cooperation with diabetologists, neurologists and haematologists.
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Shughoury A, Mathew S, Arciero J, Wurster P, Adjei S, Ciulla T, Siesky B, Harris A. Retinal oximetry in glaucoma: investigations and findings reviewed. Acta Ophthalmol 2020; 98:559-571. [PMID: 32248646 DOI: 10.1111/aos.14397] [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: 05/14/2019] [Accepted: 02/20/2020] [Indexed: 12/17/2022]
Abstract
Abnormalities of the retinal blood supply have been widely implicated in primary open-angle glaucoma (POAG). Impaired blood supply to the retina and optic nerve head (ONH) may be a primary pathophysiologic mechanism contributing to POAG ('vascular hypothesis'). However, the decreased metabolic activity of atrophic tissue is itself known to induce both vascular changes and decreased blood flow due to reduced oxygen demand. Therefore, primary nonvascular factors could potentially induce glaucomatous atrophy, with subsequent secondary vascular pathology ('mechanical hypothesis'). Retinal oximetry holds great promise in the investigation of glaucoma pathogenesis, as it can provide useful data on retinal metabolic oxygen demand, especially when combined with measurements of retinal blood flow. This review surveys the research on retinal metabolism in POAG using spectroscopic retinal oximetry. The use of mathematical models in combination with oximetric data to investigate the role of retinal metabolism and oxygen supply in POAG is also discussed.
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Affiliation(s)
- Aumer Shughoury
- Eugene and Marilyn Glick Eye Institute Department of Ophthalmology Indiana University School of Medicine Indianapolis IN USA
| | - Sunu Mathew
- Eugene and Marilyn Glick Eye Institute Department of Ophthalmology Indiana University School of Medicine Indianapolis IN USA
| | - Julia Arciero
- Department of Mathematical Sciences Indiana University Purdue University Indianapolis IN USA
| | - Patrick Wurster
- Eugene and Marilyn Glick Eye Institute Department of Ophthalmology Indiana University School of Medicine Indianapolis IN USA
| | - Susuana Adjei
- Eugene and Marilyn Glick Eye Institute Department of Ophthalmology Indiana University School of Medicine Indianapolis IN USA
| | | | - Brent Siesky
- Icahn School of Medicine at Mount Sinai New York NY USA
| | - Alon Harris
- Icahn School of Medicine at Mount Sinai New York NY USA
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Harris A, Guidoboni G, Siesky B, Mathew S, Verticchio Vercellin AC, Rowe L, Arciero J. Ocular blood flow as a clinical observation: Value, limitations and data analysis. Prog Retin Eye Res 2020; 78:100841. [PMID: 31987983 PMCID: PMC8908549 DOI: 10.1016/j.preteyeres.2020.100841] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 12/24/2022]
Abstract
Alterations in ocular blood flow have been identified as important risk factors for the onset and progression of numerous diseases of the eye. In particular, several population-based and longitudinal-based studies have provided compelling evidence of hemodynamic biomarkers as independent risk factors for ocular disease throughout several different geographic regions. Despite this evidence, the relative contribution of blood flow to ocular physiology and pathology in synergy with other risk factors and comorbidities (e.g., age, gender, race, diabetes and hypertension) remains uncertain. There is currently no gold standard for assessing all relevant vascular beds in the eye, and the heterogeneous vascular biomarkers derived from multiple ocular imaging technologies are non-interchangeable and difficult to interpret as a whole. As a result of these disease complexities and imaging limitations, standard statistical methods often yield inconsistent results across studies and are unable to quantify or explain a patient's overall risk for ocular disease. Combining mathematical modeling with artificial intelligence holds great promise for advancing data analysis in ophthalmology and enabling individualized risk assessment from diverse, multi-input clinical and demographic biomarkers. Mechanism-driven mathematical modeling makes virtual laboratories available to investigate pathogenic mechanisms, advance diagnostic ability and improve disease management. Artificial intelligence provides a novel method for utilizing a vast amount of data from a wide range of patient types to diagnose and monitor ocular disease. This article reviews the state of the art and major unanswered questions related to ocular vascular anatomy and physiology, ocular imaging techniques, clinical findings in glaucoma and other eye diseases, and mechanistic modeling predictions, while laying a path for integrating clinical observations with mathematical models and artificial intelligence. Viable alternatives for integrated data analysis are proposed that aim to overcome the limitations of standard statistical approaches and enable individually tailored precision medicine in ophthalmology.
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Affiliation(s)
- Alon Harris
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.
| | | | - Brent Siesky
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Sunu Mathew
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Alice C Verticchio Vercellin
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA; University of Pavia, Pavia, Italy; IRCCS - Fondazione Bietti, Rome, Italy
| | - Lucas Rowe
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Julia Arciero
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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Retinal oximetry: Metabolic imaging for diseases of the retina and brain. Prog Retin Eye Res 2019; 70:1-22. [DOI: 10.1016/j.preteyeres.2019.04.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/27/2019] [Accepted: 04/10/2019] [Indexed: 12/20/2022]
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Eysteinsson T, Gudmundsdottir H, Hardarson AO, Berrino E, Selleri S, Supuran CT, Carta F. Carbonic Anhydrase Inhibitors of Different Structures Dilate Pre-Contracted Porcine Retinal Arteries. Int J Mol Sci 2019; 20:E467. [PMID: 30678227 PMCID: PMC6387369 DOI: 10.3390/ijms20030467] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/13/2019] [Accepted: 01/17/2019] [Indexed: 11/17/2022] Open
Abstract
Carbonic anhydrase inhibitors (CAIs), such as dorzolamide (DZA), are used as anti-glaucoma drugs to lower intraocular pressure, but it has been found that some of these drugs act as vasodilators of retinal arteries. The exact mechanism behind the vasodilatory effect is not yet clear. Here we have addressed the issue by using small vessel myography to examine the effect of CAIs of the sulfonamide and coumarin type on the wall tension in isolated segments of porcine retinal arteries. Vessels were pre-contracted by the prostaglandin analog U-46619, and CAIs with varying affinity for five different carbonic anhydrase (CA) isoenzymes found in human tissue tested. We found that all compounds tested cause a vasodilation of pre-contracted retinal arteries, but with varying efficacy, as indicated by the calculated mean EC50 of each compound, ranging from 4.12 µM to 0.86 mM. All compounds had a lower mean EC50 compared to DZA. The dilation induced by benzolamide (BZA) and DZA was additive, suggesting that they may act on separate mechanisms. No clear pattern in efficacy and affinity for CA isoenzymes could be discerned from the results, although Compound 5, with a low affinity for all isoenzymes except the human (h) CA isoform IV, had the greatest potency, with the lowest EC50 and inducing the most rapid and profound dilation of the vessels. The results suggest that more than one isozyme of CA is involved in mediating its role in controlling vascular tone in retinal arteries, with a probable crucial role played by the membrane-bound isoform CA IV.
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Affiliation(s)
- Thor Eysteinsson
- Department of Physiology, BioMedical Center, Faculty of Medicine, University of Iceland, 107 Reykjavik, Iceland; (H.G.); (A.O.H.)
| | - Hrönn Gudmundsdottir
- Department of Physiology, BioMedical Center, Faculty of Medicine, University of Iceland, 107 Reykjavik, Iceland; (H.G.); (A.O.H.)
| | - Arnar Oessur Hardarson
- Department of Physiology, BioMedical Center, Faculty of Medicine, University of Iceland, 107 Reykjavik, Iceland; (H.G.); (A.O.H.)
| | - Emanuela Berrino
- NEUROFARBA Department, University of Florence, Sezione di Scienze Farmaceutiche e Nutraceutiche, Via Ugo Schiff 6, 50019 Sesto Fiorentino (Florence), Italy; (E.B.); (S.S.); (C.T.S.); (F.C.)
| | - Silvia Selleri
- NEUROFARBA Department, University of Florence, Sezione di Scienze Farmaceutiche e Nutraceutiche, Via Ugo Schiff 6, 50019 Sesto Fiorentino (Florence), Italy; (E.B.); (S.S.); (C.T.S.); (F.C.)
| | - Claudiu T. Supuran
- NEUROFARBA Department, University of Florence, Sezione di Scienze Farmaceutiche e Nutraceutiche, Via Ugo Schiff 6, 50019 Sesto Fiorentino (Florence), Italy; (E.B.); (S.S.); (C.T.S.); (F.C.)
| | - Fabrizio Carta
- NEUROFARBA Department, University of Florence, Sezione di Scienze Farmaceutiche e Nutraceutiche, Via Ugo Schiff 6, 50019 Sesto Fiorentino (Florence), Italy; (E.B.); (S.S.); (C.T.S.); (F.C.)
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Liu G, Wu Q, Dwivedi P, Hu C, Zhu Z, Shen S, Chu J, Zhao G, Si T, Xu R. Hemoglobin-Laden Microcapsules for Simulating Oxygen Dynamics of Biological Tissue. ACS Biomater Sci Eng 2018; 4:3177-3184. [DOI: 10.1021/acsbiomaterials.8b00830] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Guangli Liu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Huangshan Road, Hefei, Anhui 230027, China
| | - Qiang Wu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Huangshan Road, Hefei, Anhui 230027, China
| | - Pankaj Dwivedi
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Huangshan Road, Hefei, Anhui 230027, China
| | - Chuanzhen Hu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Huangshan Road, Hefei, Anhui 230027, China
| | - Zhiqiang Zhu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Huangshan Road, Hefei, Anhui 230027, China
| | - Shuwei Shen
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Huangshan Road, Hefei, Anhui 230027, China
| | - Jiaru Chu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Huangshan Road, Hefei, Anhui 230027, China
| | - Gang Zhao
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Huangshan Road, Hefei, Anhui 230027, China
| | - Ting Si
- Department of Modern Mechanics, University of Science and Technology of China, Huangshan Road, Hefei, Anhui 230027, China
| | - Ronald Xu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Huangshan Road, Hefei, Anhui 230027, China
- Department of Biomedical Engineering, The Ohio State University, 1080 Carmack Road, Columbus, Ohio 43210, United States
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Yap ZL, Verma S, Lee YF, Ong C, Mohla A, Perera SA. Glaucoma related retinal oximetry: a technology update. Clin Ophthalmol 2018; 12:79-84. [PMID: 29379268 PMCID: PMC5757969 DOI: 10.2147/opth.s128459] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
There are two long-standing theories about the pathogenesis of glaucoma – barotrauma and the effect of vascular hypoxia. Currently, it is still unknown whether diminished blood flow is the cause or result of glaucomatous atrophy of ganglion cells and the optic nerve. Though many other imaging techniques used to directly assess ocular blood flow have been well studied, they are limited by their inability to directly assess metabolism in the ocular tissues or measure the oxygen carrying capacity in the vessels. Retinal oximetry is a relatively novel, noninvasive imaging technique that reliably measures oxygen saturation levels in the retinal vessels, offering surrogate markers for the metabolic demands of the eye. The clinical significance of these measurements has not been well established. Thus, this review gives an overview of ocular imaging and current retinal oximetry techniques, while contextualizing the important oximetry studies that have investigated the vascular theory behind glaucoma.
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Affiliation(s)
- Zhu Li Yap
- Singapore National Eye Center.,Singapore Eye Research Institute, Singapore
| | | | - Yi Fang Lee
- Singapore National Eye Center.,Singapore Eye Research Institute, Singapore
| | - Charles Ong
- Singapore National Eye Center.,Singapore Eye Research Institute, Singapore
| | - Aditi Mohla
- Singapore National Eye Center.,Singapore Eye Research Institute, Singapore
| | - Shamira A Perera
- Singapore National Eye Center.,Singapore Eye Research Institute, Singapore
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Wang J, Gao X, Du S, Li X, Huang W, Zhou M, Wang W, Chen S, Zhang Y, Gao Q, Zhang X. Aqueous humor concentration of VEGF and retinal oxygen saturation after unilateral acute primary angle closure. Acta Ophthalmol 2016; 94:380-5. [PMID: 25604675 DOI: 10.1111/aos.12664] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 12/11/2014] [Indexed: 12/28/2022]
Abstract
PURPOSE To measure the levels of vascular endothelial growth factor (VEGF) in aqueous humor in patients with unilateral acute primary angle closure (APAC) and retinal oxygen saturation (SO2 ) after trabeculectomy. METHODS Twelve patients, with unilateral trabeculectomy-required APAC, were recruited as the study group. Aqueous humor samples were collected prospectively for every subject. VEGF concentrations were analysed via enzyme-linked immunosorbent assay (ELISA), and retinal SO2 was measured using oximeter (Reykjavik, Iceland) at 1 month after trabeculectomy. RESULTS In the APAC eyes, the mean aqueous humor concentration of VEGF was 388.4 ± 260.1 pg/ml and positively correlated with preoperative intraocular pressure (ρ = 0.658, p = 0.020). In the normal controls, the mean SO2 levels in the larger arterioles and venules were 93.0 ± 5.9% and 59.5 ± 5.4% and the arteriovenous [A-V] difference was 33.5 ± 6.3%. In the study group, the arteriolar SO2 at 1 month after surgery (97.6 ± 19.4%, p = 0.147) did not differ significantly from the values in the control group. However, the mean venular SO2 was significantly lower than the control eyes (50.0 ± 9.1% versus 59.5 ± 5.4%, p = 0.004), and a remarkable increased A-V difference (47.6 ± 22.7% versus 33.5 ± 6.3%) was found in the APAC eyes (p = 0.037). CONCLUSIONS Lower venular SO2 and increased A-V difference existed in the APAC eyes after surgery, and it is possible that the saturation was even lower during the attack. Together with the elevated VEGF concentrations in aqueous humor, these provided indirect evidence that ocular hypoxia was constantly present during APAC attack.
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Affiliation(s)
- Jiawei Wang
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-Sen University; Guangzhou China
| | - Xinbo Gao
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-Sen University; Guangzhou China
| | - Shaolin Du
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-Sen University; Guangzhou China
| | - Xingyi Li
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-Sen University; Guangzhou China
| | - Wenbin Huang
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-Sen University; Guangzhou China
| | - Minwen Zhou
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-Sen University; Guangzhou China
| | - Wei Wang
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-Sen University; Guangzhou China
| | - Sida Chen
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-Sen University; Guangzhou China
| | - Yichi Zhang
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-Sen University; Guangzhou China
| | - Qianying Gao
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-Sen University; Guangzhou China
| | - Xiulan Zhang
- Zhongshan Ophthalmic Center; State Key Laboratory of Ophthalmology; Sun Yat-Sen University; Guangzhou China
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The association between ophthalmologic diseases and obstructive sleep apnea: a systematic review and meta-analysis. Sleep Breath 2016; 20:1145-1154. [PMID: 27230013 DOI: 10.1007/s11325-016-1358-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 05/04/2016] [Accepted: 05/10/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the association between obstructive sleep apnea (OSA) and ophthalmologic diseases, specifically glaucoma, nonarteritic anterior ischemic optic neuropathy (NAION), retinal vein occlusion (RVO), central serous chorioretinopathy (CSR), and floppy eyelid syndrome (FES), by performing a systematic review and meta-analysis of published studies. METHODS PubMed, Embase, and Scopus databases were searched for observational studies on OSA and its association with select ophthalmologic diseases. Data was pooled for random-effects modeling. The association between OSA and ophthalmologic diseases was summarized using an estimated pooled odds ratio with a 95 % confidence interval. RESULTS Relative to non-OSA subjects, OSA subjects have increased odds of diagnosis with glaucoma (pooled odds ratio (OR) = 1.242; P < 0.001) and floppy eyelids syndrome (pooled OR = 4.157; P < 0.001). In reverse, the overall pooled OR for OSA was 1.746 (P = 0.002) in the glaucoma group, 3.126 (P = 0.000) in the NAION group, and 2.019 (P = 0.028) in the CSR group. For RVO, one study with 5965 OSA patients and 29,669 controls demonstrated a 1.94-fold odds increase in OSA patients. CONCLUSIONS Our results suggest significant associations between OSA and glaucoma, NAION, CSR, and FES. Screening for OSA should be considered in patients with glaucoma, NAION, CSR, or FES.
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Im JC, Shin JP, Kim IT, Park DH. Recurrence of macular edema in eyes with branch retinal vein occlusion changes the diameter of unaffected retinal vessels. Graefes Arch Clin Exp Ophthalmol 2015; 254:1267-74. [DOI: 10.1007/s00417-015-3175-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 08/31/2015] [Accepted: 09/02/2015] [Indexed: 12/23/2022] Open
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Schröder K, Finis D, Harmel J, Ringelstein M, Hartung HP, Geerling G, Aktas O, Guthoff R. Acetazolamide therapy in a case of fingolimod-associated macular edema: early benefits and long-term limitations. Mult Scler Relat Disord 2015; 4:406-408. [PMID: 26346788 DOI: 10.1016/j.msard.2015.06.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 06/22/2015] [Accepted: 06/30/2015] [Indexed: 11/18/2022]
Abstract
UNLABELLED Fingolimod is a potent drug in relapsing forms of multiple sclerosis. Visual impairment due to fingolimod-associated macular edema (FAME) usually leads to discontinuation of fingolimod therapy. METHODS We report on a 24-year old woman with bilateral FAME. RESULTS We continued fingolimod and added oral acetazolamide, which led to recovery of visual acuity and regression of macular edema. However, fingolimod had to be discontinued when fluorescein angiography revealed an enlarged foveal avascular zone. DISCUSSION AND CONCLUSION Oral acetazolamide might be a treatment option for FAME, while ischemic conversion may be limiting. Ophthalmologic assessments are mandatory for follow-up when fingolimod therapy is continued after onset of FAME.
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Affiliation(s)
- Katharina Schröder
- Department of Ophthalmology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
| | - David Finis
- Department of Ophthalmology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
| | - Jens Harmel
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
| | - Marius Ringelstein
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
| | - Gerd Geerling
- Department of Ophthalmology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
| | - Orhan Aktas
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
| | - Rainer Guthoff
- Department of Ophthalmology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
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Ju WK, Kim KY, Noh YH, Hoshijima M, Lukas TJ, Ellisman MH, Weinreb RN, Perkins GA. Increased mitochondrial fission and volume density by blocking glutamate excitotoxicity protect glaucomatous optic nerve head astrocytes. Glia 2015; 63:736-53. [PMID: 25557093 PMCID: PMC4373968 DOI: 10.1002/glia.22781] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 12/03/2014] [Indexed: 12/31/2022]
Abstract
Abnormal structure and function of astrocytes have been observed within the lamina cribrosa region of the optic nerve head (ONH) in glaucomatous neurodegeneration. Glutamate excitotoxicity-mediated mitochondrial alteration has been implicated in experimental glaucoma. However, the relationships among glutamate excitotoxicity, mitochondrial alteration and ONH astrocytes in the pathogenesis of glaucoma remain unknown. We found that functional N-methyl-d-aspartate (NMDA) receptors (NRs) are present in human ONH astrocytes and that glaucomatous human ONH astrocytes have increased expression levels of NRs and the glutamate aspartate transporter. Glaucomatous human ONH astrocytes exhibit mitochondrial fission that is linked to increased expression of dynamin-related protein 1 and its phosphorylation at Serine 616. In BAC ALDH1L1 eGFP or Thy1-CFP transgenic mice, NMDA treatment induced axon loss as well as hypertrophic morphology and mitochondrial fission in astrocytes of the glial lamina. In human ONH astrocytes, NMDA treatment in vitro triggered mitochondrial fission by decreasing mitochondrial length and number, thereby reducing mitochondrial volume density. However, blocking excitotoxicity by memantine (MEM) prevented these alterations by increasing mitochondrial length, number and volume density. In glaucomatous DBA/2J (D2) mice, blocking excitotoxicity by MEM inhibited the morphological alteration as well as increased mitochondrial number and volume density in astrocytes of the glial lamina. However, blocking excitotoxicity decreased autophagosome/autolysosome volume density in both astrocytes and axons in the glial lamina of glaucomatous D2 mice. These findings provide evidence that blocking excitotoxicity prevents ONH astrocyte dysfunction in glaucomatous neurodegeneration by increasing mitochondrial fission, increasing mitochondrial volume density and length, and decreasing autophagosome/autolysosome formation. GLIA 2015;63:736-753.
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Affiliation(s)
- Won-Kyu Ju
- Department of Ophthalmology, Laboratory for Optic Nerve Biology, Hamilton Glaucoma Center, University of California San DiegoLa Jolla, California
| | - Keun-Young Kim
- Center for Research on Biological Systems, National Center for Microscopy and Imaging Research and Department of Neuroscience, University of California San DiegoLa Jolla, California
| | - You Hyun Noh
- Department of Ophthalmology, Laboratory for Optic Nerve Biology, Hamilton Glaucoma Center, University of California San DiegoLa Jolla, California
| | - Masahiko Hoshijima
- Center for Research on Biological Systems, National Center for Microscopy and Imaging Research and Department of Neuroscience, University of California San DiegoLa Jolla, California
- Department of Medicine, University of California San DiegoLa Jolla, California
| | - Thomas J Lukas
- Department of Molecular Pharmacology and Biological Chemistry, Northwestern UniversityChicago, Illinois
| | - Mark H Ellisman
- Center for Research on Biological Systems, National Center for Microscopy and Imaging Research and Department of Neuroscience, University of California San DiegoLa Jolla, California
| | - Robert N Weinreb
- Department of Ophthalmology, Laboratory for Optic Nerve Biology, Hamilton Glaucoma Center, University of California San DiegoLa Jolla, California
| | - Guy A Perkins
- Center for Research on Biological Systems, National Center for Microscopy and Imaging Research and Department of Neuroscience, University of California San DiegoLa Jolla, California
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Sulfamates of methyl triterpenoates are effective and competitive inhibitors of carbonic anhydrase II. Eur J Med Chem 2014; 86:95-102. [DOI: 10.1016/j.ejmech.2014.08.051] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 08/13/2014] [Accepted: 08/14/2014] [Indexed: 01/16/2023]
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Vandewalle E, Abegão Pinto L, Olafsdottir OB, De Clerck E, Stalmans P, Van Calster J, Zeyen T, Stefánsson E, Stalmans I. Oximetry in glaucoma: correlation of metabolic change with structural and functional damage. Acta Ophthalmol 2014; 92:105-10. [PMID: 23323611 DOI: 10.1111/aos.12011] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine whether retinal vessel oxygen saturation in patients with glaucoma is associated with structural optic disc and retinal nerve fibre layer (RNFL) changes and visual field (VF) defects. METHODS Fifty-nine patients with confirmed glaucoma were recruited at University Hospitals Leuven. Retinal oxygen saturation in patients with glaucoma was measured with a noninvasive spectrophotometric retinal oximeter (Oxymap ehf, Reykjavik, Iceland). VF and Heidelberg retinal tomographies (HRTs) were performed on the same day. Statistical analysis was performed using Student's t-test and Pearson's or Spearman correlation coefficient. RESULTS The mean oxygen saturation in venules was higher in patients with severe VF defects compared to those patients with mild VF defects (69 ± 3% versus 65 ± 6% respectively; p = 0.0003; n = 59). Accordingly, the arteriovenous (AV) difference in oxygen saturation was lower in patients with worse VF compared to those with better VF (29 ± 3% versus 33 ± 6% respectively; p = 0.002). The oxygen saturation in venules correlated with the VF mean defects (r = -0.42; p = 0.001; n = 59) as well as with the structural HRT parameters rim area and RNFL thickness (r = -0.39; p = 0.008 and r = -0.26; p = 0.05 respectively; n = 53). The AV difference decreased significantly as the VF defect worsened (r = 0.38; p = 0.003), as the rim area diminished (r = 0.29; p = 0.03) and as the RNFL thickness decreased (r = 0.27; p = 0.05). No correlation was found between the oxygen saturation in retinal arterioles and either of these parameters. CONCLUSION Severe glaucomatous damage is associated with increased oxygen saturation in retinal venules and decreased AV difference in oxygen saturation. These data suggest that in eyes with severe glaucomatous damage, reduced retinal oxygen consumption is consistent with tissue loss.
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Affiliation(s)
- Evelien Vandewalle
- Laboratory of Ophthalmology, KULeuven, Leuven, BelgiumDepartment of Ophthalmology, University Hospitals Leuven, Leuven, BelgiumDepartment of Pharmacology and Neurosciences, Faculty of Medicine, Lisbon University, Lisbon, PortugalDepartment of Ophthalmology, Centro Hospitalar de Lisboa Central, Lisbon, PortugalDepartment of Ophthalmology, University of Iceland, Reykjavik, Iceland
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Ekinci M, Hüseyinoğlu N, Hüseyin Çağatay H, Keleş S, Ceylan E, Gökçe G. Choroidal Thickening in Patients with Sleep Apnea Syndrome. Neuroophthalmology 2014; 38:8-13. [PMID: 27928267 DOI: 10.3109/01658107.2013.855241] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 09/13/2013] [Accepted: 09/13/2013] [Indexed: 01/15/2023] Open
Abstract
Sleep apnoea syndrome (SAS) is characterised by repetitive episodes of cessation of breathing during sleep, resulting in hypoxaemia and hypercapnia. Ophthalmological consequences such as glaucoma, non-arteritic anterior ischaemic neuropathy and papilloedema are relevant to hypoxaemia. The choroid is a vascular structure that performs several regulatory functions for the retina. Defects in this structure contribute to degenerative, inflammatory, and neovascular changes in the retina. The authors examined the choroidal thickness (CT) in sleep apnoea patients using optical coherence tomograpy (OCT). The sleep apnoea patients were divided into subgroups according to their apnoea-hypopnoea index (AHI) scores, and statistical analysis was performed using the AHI and minimal arterial oxygen saturation (min. Spo2) values. There was a medium-high negative correlation between CT and AHI (Spearman rho: r = -0.744, p = 0.000), and a positive correlation between CT and min. Spo2 values (Pearson correlation: r = 0.308, p = 0.000).
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Affiliation(s)
- Metin Ekinci
- Department of Ophthalmology, University of Kafkas Kars Turkey
| | | | | | - Sadullah Keleş
- Department of Ophthalmology, University of Atatürk Erzurum Turkey
| | - Erdinç Ceylan
- Erzurum Training and Research Hospital Ophthalmology Clinic Erzurum Turkey
| | - Gökçen Gökçe
- Sarıkamış Military Hospital Ophthalmolgy Clinic Kars Turkey
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Patient and surgeon experience during laser in situ keratomileusis using 2 femtosecond laser systems. J Cataract Refract Surg 2014; 40:423-9. [PMID: 24461333 DOI: 10.1016/j.jcrs.2013.08.056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 08/06/2013] [Accepted: 08/07/2013] [Indexed: 11/22/2022]
Abstract
PURPOSE To describe the subjective experience of patients and surgeons during laser in situ keratomileusis (LASIK) using the Intralase 60 kHz or the Visumax 500 kHz femtosecond laser. SETTING Singapore National Eye Centre, Singapore. DESIGN Prospective randomized clinical study. METHODS In myopic patients, LASIK was performed with the corneal flap created using the 60 kHz laser in 1 eye and the 500 kHz laser in the contralateral eye. Postoperatively, patients completed a standardized validated questionnaire about their subjective intraoperative experiences (eg, light perception, pain, fear). Surgeons reported their intraoperative experiences and preferences. RESULTS Loss of light perception occurred in 50.0% of 60 kHz laser cases and 0% of 500 kHz laser cases during docking and in 63.0% and 0% of cases, respectively, during laser flap creation (P < .0001). The mean pain score with the 60 kHz laser was significantly higher during docking (P < .0001) but not during laser flap cutting (P = .006). Subconjunctival hemorrhage occurred in 67.4% of eyes with the 60 kHz laser and in 2.2% of eyes with the 500 kHz laser (P < .0001). The 500 kHz laser was preferred by 78.3% of patients, while 21.7% preferred the 60 kHz laser (P < .0001). The surgeons preferred the 60 kHz laser in 50.0% of cases and the 500 kHz laser in 8.7% (P < .0001); 41.3% had no preference. CONCLUSIONS Patients preferred surgery with the 500 kHz laser with no loss of light perception, less pain, less fear, and less subconjunctival hemorrhage. Surgeons preferred the 60 kHz laser.
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Dietary ω-3 deficiency and IOP insult are additive risk factors for ganglion cell dysfunction. J Glaucoma 2013; 22:269-77. [PMID: 23221900 DOI: 10.1097/ijg.0b013e318237cac7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIM Dietary deficiencies in ω-3 polyunsaturated fatty acids are known to effect retinal function including retinal ganglion cell (RGC) activity, which may have implications for glaucoma. In this study we consider retinal function after dietary manipulation and intraocular pressure (IOP) stress designed to compromise RGCs. METHODS Sprague-Dawley dams were fed either ω-3 sufficient (ω-3, n=15) or deficient (ω-3, n=16) diets 5 weeks before conception with pups subsequently weaned onto their mothers diets. At 20 weeks of age, acute IOP elevation was induced repeatedly through anterior chamber cannulation to 70 mm Hg for 1 hour on 3 separate occasions separated by 1 week. Electroretinograms were recorded 1 week after each IOP elevation to assay the photoreceptors (PIII), ON-bipolar cells (PII), and ganglion/amacrine cells (STR). RESULTS Repeat IOP insult results in a specific RGC dysfunction (pSTR -14.5%, P<0.035) as does ω-3 deficiency (-26.4%, P<0.01). However, the combination of both causes an even larger RGC functional loss (-40.1%, P<0.001) than does either diet or IOP insult in isolation (P<0.001). CONCLUSIONS Both ω-3 deficiency and repeat acute IOP insult cause RGC dysfunction and the combination of these factors results in a cumulative effect. Our data indicate that sufficient dietary ω-3 improves RGC function making it less susceptible to IOP insult.
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Abstract
UNLABELLED ABSTRACT.: PURPOSE Malfunction of retinal blood flow or oxygenation is believed to be involved in various diseases. Among them are retinal vessel occlusions, diabetic retinopathy and glaucoma. Reliable, non-invasive technology for retinal oxygen measurements has been scarce and most of the knowledge on retinal oxygenation comes from animal studies. This thesis describes human retinal oximetry, performed with novel retinal oximetry technology. The thesis describes studies on retinal vessel oxygen saturation in (1) light and dark in healthy volunteers, (2) central retinal vein occlusion, (3) branch retinal vein occlusion, (4) central retinal artery occlusion, (5) diabetic retinopathy, (6) patients undergoing glaucoma surgery and (7) patients taking glaucoma medication. METHODS The retinal oximeter (Oxymap ehf., Reykjavik, Iceland) is based on a fundus camera. An attached image splitter allows the simultaneous capture of four images of the same area of the fundus. Two images are used for further analysis, one acquired with 586 nm light and one with 605 nm light. Light absorbance of retinal vessels is sensitive to oxygen saturation at 605 nm but not at 586 nm. Measurement of reflected light at these wavelengths allows estimation of oxygen saturation in the main retinal vessels. This is performed with custom-made analysis software. RESULTS LIGHT AND DARK: After 30 min in the dark, oxygen saturation in retinal arterioles of healthy volunteers was 92 ± 4% (mean ± SD, n = 15). After 5 min in 80 cd/m(2) light, the arteriolar saturation was 89 ± 5%. The decrease was statistically significant (p = 0.008). The corresponding values for retinal venules were 60 ± 5% in the dark and 55 ± 10% in the light (p = 0.020). Similar results were found after alternating 5 min periods of darkness and light. In a second experiment (n = 19), a significant decrease in retinal vessel oxygen saturation was found in 100 cd/m(2) light compared with darkness but 1 and 10 cd/m(2) light had no significant effect. CENTRAL RETINAL VEIN OCCLUSION: In patients with central retinal vein occlusion, the mean saturation in affected retinal venules was 49 ± 12%, while the mean value for venules in the fellow eye was 65 ± 6% (mean ± SD, p = 0.003, n = 8). The retinal arteriolar saturation was the same in affected (99 ± 3%) and the unaffected (99 ± 6%) eyes. The venous oxygen saturation showed much variation between affected eyes. BRANCH RETINAL VEIN OCCLUSION: Median oxygen saturation in venules affected by branch retinal vein occlusion was 59% (range, 12-93%, n = 22), while it was 63% (23-80%) in unaffected venules in the affected eye and 55% (39-80%) in venules in the fellow eye. The difference was not statistically significant (p > 0.05). There was a significant difference between affected arterioles (median 101%; range, 89-115%) and unaffected arterioles (95%, 85-104%) in the affected eye (p < 0.05, n = 18). CENTRAL RETINAL ARTERY OCCLUSION: In a patient with a day's history of central retinal artery occlusion due to temporal arteritis, the mean arteriolar saturation was 71 ± 9% and 63 ± 9% in the venules. One month later, after treatment with prednisolone, the mean arteriolar saturation was 100 ± 4% and the venous saturation 54 ± 5%. DIABETIC RETINOPATHY: When compared with healthy volunteers (n = 31), patients with all categories of diabetic retinopathy had on average 7-10 percentage points higher saturation in retinal arterioles (p < 0.05 for all categories, n = 6-8 in each category). In venules, the saturation was 8-12 percentage points higher (p < 0.05 for all categories). GLAUCOMA SURGERY: Oxygen saturation in retinal arterioles increased by 2 percentage points on average (p = 0.046, n = 19) with surgery, which lowered intraocular pressure from 23 ± 7 mmHg (mean ± SD) to 10 ± 4 mmHg (p < 0.0001). No other significant changes were found (p ≥ 0.35). DORZOLAMIDE: A significant reduction of 3 percentage points was found in arterioles (p < 0.01) and venules (p < 0.05) when patients with glaucoma or ocular hypertension changed from dorzolamide-timolol combination eye drops to timolol alone (n = 6). No change was found in patients, who started on timolol and switched to the combination therapy (p > 0.05, n = 7). CONCLUSIONS Dual wavelength oximetry can be used to non-invasively measure retinal vessel oxygen saturation in health and disease. The results indicate that retinal vessel oxygen saturation is (1) increased in the dark, (2) lower in venules affected by central retinal vein occlusions, (3) variable in branch retinal vein occlusion, (4) lower in retinal arterioles in central retinal artery occlusion, (5) increased in diabetic retinopathy, (6-7) mildly affected by glaucoma surgery or dorzolamide.
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Bui BV, He Z, Vingrys AJ, Nguyen CTO, Wong VHY, Fortune B. Using the electroretinogram to understand how intraocular pressure elevation affects the rat retina. J Ophthalmol 2013; 2013:262467. [PMID: 23431417 PMCID: PMC3570935 DOI: 10.1155/2013/262467] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 10/24/2012] [Indexed: 11/17/2022] Open
Abstract
Intraocular pressure (IOP) elevation is a key risk factor for glaucoma. Our understanding of the effect that IOP elevation has on the eye has been greatly enhanced by the application of the electroretinogram (ERG). In this paper, we describe how the ERG in the rodent eye is affected by changes in IOP magnitude, duration, and number of spikes. We consider how the variables of blood pressure and age can modify the effect of IOP elevation on the ERG. Finally, we contrast the effects that acute and chronic IOP elevation can have on the rodent ERG.
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Affiliation(s)
- Bang V. Bui
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Zheng He
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Algis J. Vingrys
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Christine T. O. Nguyen
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Vickie H. Y. Wong
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Brad Fortune
- Devers Eye Institute and Legacy Research Institute, Legacy Health, Portland, OR 97232, USA
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Innervation pattern of the preocular human central retinal artery. Exp Eye Res 2012; 110:142-7. [PMID: 23220730 DOI: 10.1016/j.exer.2012.11.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 11/26/2012] [Accepted: 11/29/2012] [Indexed: 11/23/2022]
Abstract
The central retinal artery (CRA) is the main vessel for inner retinal oxygen and nutrition supply. While the intraocular branches lack autonomic innervation, the innervation pattern of the extra-ocular part of this vessel along its course within the optic nerve is poorly investigated. This part however is essential for maintenance of retinal blood supply, in physiological and pathological conditions. Therefore, the aim of this study was the characterization of the autonomic innervation of the preocular CRA in humans with morphological methods. Meeting the Declaration of Helsinki, eyes of body or cornea donors were processed for single or double immunohistochemistry against tyrosine hydroxilase (TH), dopamine-β-hydroxylase (DBH), choline acetyl-transferase (ChAT), vesicular acetylcholine transporter (VAChT), neuronal nitric oxide synthase (nNOS), calcitonin gene-related peptide (CGRP), substance P (SP), vasoactive intestinal polypeptide (VIP), and cytochemistry for NADPH-diaphorase (NADPH-d). For documentation, light-, fluorescence-, and confocal laser-scanning microscopy were used. TH and DBH immunoreactive nerve fibres were detected in the CRA vessel wall, although a distinct perivascular plexus was missing. Further, nerve fibres immunoreactive for ChAT and VAChT were found, while CGRP, SP, and VIP were not detected. NADPH-d staining revealed scattered nerve fibres in the adventitia of the CRA and in close vicinity; however, nNOS-immunostaining could not confirm this finding. The CRA receives adrenergic and cholinergic innervations, indicating sympathetic and parasympathetic components, respectively. Remarkably, a peptidergic primary afferent innervation was missing. Since clinical results suggest an autoregulation of intraretinal vessels, further studies are needed to clarify the impact of CRA innervation for retinal perfusion.
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Conway ML, Wevill M, Benavente-Perez A, Hosking SL. Ocular blood-flow hemodynamics before and after application of a laser in situ keratomileusis ring. J Cataract Refract Surg 2010; 36:268-72. [DOI: 10.1016/j.jcrs.2009.09.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Revised: 08/07/2009] [Accepted: 09/03/2009] [Indexed: 11/17/2022]
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Sander EA, Nauman EA. Effects of reduced oxygen and glucose levels on ocular cells in vitro: implications for tissue models. Cells Tissues Organs 2009; 191:141-51. [PMID: 19641288 DOI: 10.1159/000231471] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2009] [Indexed: 11/19/2022] Open
Abstract
An important goal of tissue engineering is the development of better in vitro tissue models for the study and treatment of diseases, especially those that are difficult to model in animals, such as glaucoma. In order to properly interpret experimental results designed to mimic in vivo conditions, it is necessary to characterize the metabolic state of the in vitro culture. The goal of this study was to determine how porcine lamina cribrosa cells (PLC), porcine scleral fibroblasts (PSC) and rat astrocytes (RAS) respond metabolically to reduced glucose and oxygen levels compared to normal in vitro culture conditions. Throughout the culture period, cell number and the levels of glucose, lactate, pyruvate and glutamate were characterized. Cell number in the PLC and PSC was more sensitive to glucose level than oxygen, while the RAS exhibited sensitivities to both variables. While the pyruvate and glutamate levels did not vary substantially between groups, glucose consumption and lactate production were dependent on culture condition. In addition, the DeltaL/DeltaG ratio was dependent on glucose and oxygen levels, but not cell type at early time points. By day 7, however, the RAS exhibited ratios consistently lower than the other cell types. The results of this study serve as a basis for future studies into the degenerative matrix remodeling in the glaucomatous optic nerve head, and may prove insightful for other tissue engineering applications.
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Affiliation(s)
- Edward A Sander
- Department of Biomedical Engineering, Tulane University, New Orleans, LA, USA
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Kivell TL, Doyle SK, Madden RH, Mitchell TL, Sims EL. An interactive method for teaching anatomy of the human eye for medical students in ophthalmology clinical rotations. ANATOMICAL SCIENCES EDUCATION 2009; 2:173-178. [PMID: 19637292 DOI: 10.1002/ase.95] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Much research has shown the benefits of additional anatomical learning and dissection beyond the first year of medical school human gross anatomy, all the way through postgraduate medical training. We have developed an interactive method for teaching eye and orbit anatomy to medical students in their ophthalmology rotation at Duke University School of Medicine. We provide review lectures on the detailed anatomy of the adult human eye and orbit as well as the developmental anatomy of the eye. These lectures are followed by a demonstration of the anatomy of the orbit using conventional frontal and superior exposures on a prosected human cadaver. The anatomy is projected onto a large LCD screen using a mounted overhead camera. Following a brief lecture on clinically relevant anatomy, each student then dissects a fresh porcine (pig) eye under low magnification using a dissecting microscope. These dissections serve to identify structures extrinsic to the eyeball, including extraocular muscle attachments, small vessels, optic nerve stalk, and fascial sheath of the eyeball (Tenon's fascia). Dissection then shifts to the internal anatomy of the eyeball. The size and anatomy of the porcine eye is comparable with that of the human and the dissection provides students with a valuable hands-on learning opportunity that is otherwise not available in embalmed human cadavers. Students and clinical faculty feedback reveal high levels of satisfaction with the presentation of anatomy and its scheduling early during the ophthalmology clerkship.
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Affiliation(s)
- Tracy L Kivell
- Department of Evolutionary Anthropology, Duke University School of Medicine, Duke University, Durham, North Carolina 27708-0383, USA.
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Kyhn MV, Warfvinge K, Scherfig E, Kiilgaard JF, Prause JU, Klassen H, Young M, la Cour M. Acute retinal ischemia caused by controlled low ocular perfusion pressure in a porcine model. Electrophysiological and histological characterisation. Exp Eye Res 2009; 88:1100-6. [PMID: 19450446 DOI: 10.1016/j.exer.2009.01.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Revised: 01/18/2009] [Accepted: 01/23/2009] [Indexed: 01/06/2023]
Abstract
The purpose of this study was to establish, and characterize a porcine model of acute, controlled retinal ischemia. The controlled retinal ischemia was produced by clamping the ocular perfusion pressure (OPP) in the left eye to 5 mm Hg for 2 h. The OPP was defined as mean arterial blood pressure (MAP) minus the intraocular pressure (IOP). It was clamped to 0-30 mm Hg by continuous monitoring of MAP and adjustment of the IOP, which was controlled by cannulation of the anterior chamber. Inner retinal function was assessed by induced multifocal electroretinography (mfERG) with comparisons of the amplitudes obtained in the experimental, left eye, and the control, right eye. Quantitative histology was performed to measure the survival of ganglion cells, amacrine cells and horizontal cells 2-6 weeks after the ischemic insult. An OPP of 5 mm Hg for 2h induced significant reductions in the amplitudes of iN1 to 20% (CI: 13-30%), and iP2 to 14% (95% CI: 8-22%) of their baseline values. No signs of recovery were found within the 6-week observation period. Quantitative histology revealed a highly significant reduction in the number of ganglion cells, amacrine cells and horizontal cells after the ischemic insult. This model seems to be suitable for investigations of therapeutic initiatives in diseases involving acute retinal ischemia.
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Affiliation(s)
- Maria Voss Kyhn
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Denmark
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Hammer M, Vilser W, Riemer T, Schweitzer D. Retinal vessel oximetry-calibration, compensation for vessel diameter and fundus pigmentation, and reproducibility. JOURNAL OF BIOMEDICAL OPTICS 2008; 13:054015. [PMID: 19021395 DOI: 10.1117/1.2976032] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The purpose of this study was to measure the hemoglobin oxygenation in retinal vessels and to evaluate the sensitivity and reproducibility of the measurement. Using a fundus camera equipped with a special dual wavelength transmission filter and a color charge-coupled device camera, two monochromatic fundus images at 548 and 610 nm were recorded simultaneously. The optical densities of retinal vessels for both wavelengths and their ratio, which is known to be proportional to the oxygen saturation, were calculated. From 50-deg images, the used semiautomatic vessel recognition and tracking algorithm recognized and measured vessels of 100 microm or more in diameter. On average, arterial and venous oxygen saturations were measured at 98+/-10.1% and 65+/-11.7%, respectively. For measurements in the same vessel segments from the five images per subject, standard deviations of 2.52% and 3.25% oxygen saturation were found in arteries and veins, respectively. Respiration of 100% oxygen increased the mean arterial and venous oxygen saturation by 2% and 7% respectively. A simple system for noninvasive optical oximetry, consisting of a special filter in a fundus camera and software, was introduced. It is able to measure the oxygen saturation in retinal branch vessels with reproducibility and sensitivity suitable for clinical investigations.
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Affiliation(s)
- Martin Hammer
- University of Jena, Department of Ophthalmology, Jena, Germany.
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Porcine global flash multifocal electroretinogram: Possible mechanisms for the glaucomatous changes in contrast response function. Vision Res 2008; 48:1726-1734. [DOI: 10.1016/j.visres.2008.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2007] [Revised: 04/09/2008] [Accepted: 05/07/2008] [Indexed: 01/08/2023]
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Krishnamurthy VM, Kaufman GK, Urbach AR, Gitlin I, Gudiksen KL, Weibel DB, Whitesides GM. Carbonic anhydrase as a model for biophysical and physical-organic studies of proteins and protein-ligand binding. Chem Rev 2008; 108:946-1051. [PMID: 18335973 PMCID: PMC2740730 DOI: 10.1021/cr050262p] [Citation(s) in RCA: 561] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Vijay M. Krishnamurthy
- Department of Chemistry and Chemical Biology, Harvard University, 12 Oxford Street, Cambridge, Massachusetts 02138
| | - George K. Kaufman
- Department of Chemistry and Chemical Biology, Harvard University, 12 Oxford Street, Cambridge, Massachusetts 02138
| | - Adam R. Urbach
- Department of Chemistry and Chemical Biology, Harvard University, 12 Oxford Street, Cambridge, Massachusetts 02138
| | - Irina Gitlin
- Department of Chemistry and Chemical Biology, Harvard University, 12 Oxford Street, Cambridge, Massachusetts 02138
| | - Katherine L. Gudiksen
- Department of Chemistry and Chemical Biology, Harvard University, 12 Oxford Street, Cambridge, Massachusetts 02138
| | - Douglas B. Weibel
- Department of Chemistry and Chemical Biology, Harvard University, 12 Oxford Street, Cambridge, Massachusetts 02138
| | - George M. Whitesides
- Department of Chemistry and Chemical Biology, Harvard University, 12 Oxford Street, Cambridge, Massachusetts 02138
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Libby RT, Howell GR, Pang IH, Savinova OV, Mehalow AK, Barter JW, Smith RS, Clark AF, John SWM. Inducible nitric oxide synthase, Nos2, does not mediate optic neuropathy and retinopathy in the DBA/2J glaucoma model. BMC Neurosci 2007; 8:108. [PMID: 18093296 PMCID: PMC2211487 DOI: 10.1186/1471-2202-8-108] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Accepted: 12/19/2007] [Indexed: 12/17/2022] Open
Abstract
Background Nitric oxide synthase 2 (NOS2) contributes to neural death in some settings, but its role in glaucoma remains controversial. NOS2 is implicated in retinal ganglion cell degeneration in a rat glaucoma model in which intraocular pressure (IOP) is experimentally elevated by blood vessel cauterization, but not in a rat glaucoma model where IOP was elevated by injection of hypertonic saline. To test the importance of NOS2 for an inherited glaucoma, in this study we both genetically and pharmacologically decreased NOS2 activity in the DBA/2J mouse glaucoma model. Methods The expression of Nos2 in the optic nerve head was analyzed at both the RNA and protein levels at different stages of disease pathogenesis. To test the involvement of Nos2 in glaucomatous neurodegeneration, a null allele of Nos2 was backcrossed into DBA/2J mice and the incidence and severity of glaucoma was assessed in mice of each Nos2 genotype. Additionally, DBA/2J mice were treated with the NOS2 inhibitor aminoguanidine and the disease compared to untreated mice. Results Optic nerve head Nos2 RNA levels varied and increased during moderate but decreased at early and severe stages of disease. Despite the presence of a few NOS2 positive cells in the optic nerve head, NOS2 protein was not substantially increased during the glaucoma. Genetic deficiency of Nos2 or aminoguanidine treatment did not alter the IOP profile of DBA/2J mice. Additionally, neither Nos2 deficiency nor aminoguanidine had any detectable affect on the glaucomatous optic nerve damage. Conclusion Glaucomatous neurodegeneration in DBA/2J mice does not require NOS2 activity. Further experiments involving various models are needed to assess the general importance of Nos2 in glaucoma.
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Circadian changes of intraocular pressure and ocular perfusion pressure after timolol or latanoprost in Caucasians with normal-tension glaucoma. Graefes Arch Clin Exp Ophthalmol 2007; 246:389-96. [DOI: 10.1007/s00417-007-0704-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Revised: 09/20/2007] [Accepted: 10/01/2007] [Indexed: 10/22/2022] Open
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Abstract
Rho kinase (ROCK1 and ROCK2) is a serine/threonine kinase that serves as an important downstream effector of Rho GTPase, and plays a critical role in regulating the contractile tone of smooth muscle tissues in a calcium-independent manner. Several lines of experimental evidence indicate that modulating ROCK activity within the aqueous humor outflow pathway using selective inhibitors could achieve very significant benefits for the treatment of increased intraocular pressure in patients with glaucoma. The rationale for such an approach stems from experimental data suggesting that both ROCK and Rho GTPase inhibitors can increase aqueous humor drainage through the trabecular meshwork, leading to a decrease in intraocular pressure. In addition to their ocular hypotensive properties, inhibitors of both ROCK and Rho GTPase have been shown to enhance ocular blood flow, retinal ganglion cell survival and axon regeneration. These properties of the ROCK and Rho GTPase inhibitors indicate that targeting the Rho GTPase/ROCK pathway with selective inhibitors represents a novel therapeutic approach aimed at lowering increased intraocular pressure in glaucoma patients.
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Affiliation(s)
- Vasantha P Rao
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, USA.
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Voss Kyhn MC. Multifocal electroretinography (mfERG) in porcine eyes: establishment, sensitivity and functional implications of induced retinal lesions. ACTA ACUST UNITED AC 2007. [DOI: 10.1111/j.1600-0420.2007.00952.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Yu AL, Fuchshofer R, Birke M, Priglinger SG, Eibl KH, Kampik A, Bloemendal H, Welge-Lussen U. Hypoxia/reoxygenation and TGF-β increase αB-crystallin expression in human optic nerve head astrocytes. Exp Eye Res 2007; 84:694-706. [PMID: 17261280 DOI: 10.1016/j.exer.2006.12.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2006] [Revised: 10/27/2006] [Accepted: 12/05/2006] [Indexed: 10/23/2022]
Abstract
Reactive astrocytes in glaucomatous optic nerve changes are characterized by an increased expression of alphaB-crystallin and transforming growth factor-beta (TGF-beta). In the pathogenesis of glaucomatous optic nerve damage, ischemia/reperfusion injury may play an important role. The goal of the present study was to determine the influence of hypoxia/reoxygenation and TGF-beta on the expression of alphaB-crystallin in cultured human astrocytes of the optic nerve head (ONH). Cultured human astrocytes were incubated under hypoxic conditions (1% O2 for 4-12 h) with subsequent reoxygenation (12-24 h). Additionally, cells were treated with 1.0 ng/ml TGF-beta1 and TGF-beta2 for 12-48 h. Expression of alphaB-crystallin was examined by Northern- and Western-blotting. Levels of TGF-beta1 and TGF-beta2 were analyzed by RT-PCR analysis and ELISA. The effect of TGF-beta blocking on the hypoxia/reoxygenation modulated expression of alphaB-crystallin was investigated by simultaneous incubation with neutralizing antibodies against TGF-beta during the reoxygenation phase. Hypoxia/reoxygenation increased the expression of alphaB-crystallin at the mRNA (2.8- to 3.1-fold) and protein level (1.8- to 2.1-fold). Treatment with 1.0 ng/ml TGF-beta1 and TGF-beta2 for 12-48 h markedly enhanced alphaB-crystallin mRNA expression approximately three- to fourfold. Using Western blot analysis, this increase ranged from 2 to 3 times. Both cytokines showed a twofold increase after 12 and 24 h of reoxygenation at the mRNA and a two- to threefold increase at the protein level. Simultaneous treatment with neutralizing antibodies against both TGF-beta isoforms prevented the hypoxia/reoxygenation-mediated elevation of alphaB-crystallin. The process of hypoxia/reoxygenation is capable of inducing the expression of alphaB-crystallin and TGF-ss in cultured ONH astrocytes. Therefore, optimization of conditions leading to hypoxia/reoxygenation in the ONH of glaucomatous patients may help to lower the incidence of characteristic changes in the optic nerve.
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Affiliation(s)
- Alice L Yu
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
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Voss Kyhn M, Kiilgaard JF, Lopez AG, Scherfig E, Prause JU, la Cour M. The multifocal electroretinogram (mfERG) in the pig. ACTA ACUST UNITED AC 2007; 85:438-44. [PMID: 17559469 DOI: 10.1111/j.1600-0420.2006.00859.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To establish a method allowing multifocal electroretinography (mfERG) recording with simultaneous fundus monitoring on anaesthetized pigs. In addition we characterize the peaks of the porcine mfERG trace, and compare the visual streak area with the optic nerve head, a known non-response area. Finally we illustrate the feasibility of the method by performing mfERG after an induced laser burn in the visual streak. METHODS Fifteen pigs underwent mfERG recordings at baseline, and after 1 and 6 weeks of observation. One pig was evaluated before and after retinal diode laser treatment in the visual streak. RESULTS The porcine mfERG trace appears similar to the human mfERG trace, and can be described by three peaks named N1, P1 and N2. Significantly faster implicit time was found in the visual streak regarding N1 (P < 0.001) than in areas outside the visual streak. Amplitudes of all three peaks were increased in the visual streak (P < 0.005). The laser-treated area was characterized by a response similar to what is found at the location of the optic nerve head. CONCLUSION Porcine mfERG is similar in appearance to the human response and can be described by the same three peaks. Significantly higher amplitudes of all three peaks are found in the visual streak when compared to the optic nerve head and inferior retina. We have detected the functional deficit caused by a laser burn at the size of 3 x 3 mm.
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Affiliation(s)
- Maria Voss Kyhn
- Department of Ophthalmology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
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Costagliola C, Campa C, Parmeggiani F, Incorvaia C, Perri P, D'Angelo S, Lamberti G, Sebastiani A. Effect of 2% dorzolamide on retinal blood flow: a study on juvenile primary open-angle glaucoma patients already receiving 0.5% timolol. Br J Clin Pharmacol 2006; 63:376-9. [PMID: 16981897 PMCID: PMC2000725 DOI: 10.1111/j.1365-2125.2006.02768.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIM To investigate whether dorzolamide modifies peripapillary retinal haemodynamics in juvenile primary open-angle glaucoma (JPOAG) patients treated with timolol. METHODS In 40 JPOAG subjects, before and after dorzolamide coadministration with timolol, the following examinations were achieved: intraocular pressure (IOP), blood pressure (BP), ocular perfusion pressure (OPP), heart rate (HR), visual field and retinal flowmetry. RESULTS Adjunctive therapy with dorzolamide induced the following modifications: IOP reduction [1.75 mmHg, 95% confidence interval (CI) 1.23, 2.26; P < 0.05], OPP increase (5.09 mmHg, 95% CI 2.97, 7.20; P < 0.02) and retinal blood flow improvement (35.0 arbitrary units, 95% CI 12.20, 57.80; P < 0.03). BP, HR and visual field indices did not change. CONCLUSIONS Dorzolamide, in association or in fixed combination with timolol, significantly improves retinal blood flow in JPOAG patients.
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Affiliation(s)
- Ciro Costagliola
- Department of Ophthalmology, University of Ferrara, Ferrara, Italy.
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Kiilgaard JF, Andersen MVN, Wiencke AK, Scherfig E, la Cour M, Tezel TH, Prause JU. A new animal model of choroidal neovascularization. ACTA ACUST UNITED AC 2005; 83:697-704. [PMID: 16396647 DOI: 10.1111/j.1600-0420.2005.00566.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the ability of different methods to induce choroidal neovascularization (CNV) in the domestic pig. METHODS A total of 26 Danish landrace pigs was used. A sample of 22 eyes in 12 pigs underwent retinal photocoagulation with a xenon lamp, six eyes in four pigs underwent retinal photocoagulation with a diode laser, and mechanical rupture of Bruch's membrane (BM) was induced in 12 pigs following surgical debridement of the retinal pigment epithelium without damage to the neuroretina. RESULTS All 12 pigs (100%) in the group with mechanical rupture of BM developed CNV. The induced membranes were morphologically similar to CNV membranes in humans. Induced CNV was found in 13 of 22 (54%) xenon lamp-treated animals and in five of six (83%) diode laser-treated animals. The CNV in these groups was small and the morphology of the induced lesions was dominated by retinal gliosis and retinal neovascularization, probably due to a marked destruction of the neuroretina. CONCLUSIONS Surgical debridement of the retinal pigment epithelium followed by mechanical rupture of BM is a reproducible method of producing CNV in the domestic pig, whereas photocoagulation gives rise to glially derived subretinal fibrovascular membranes and primarily retinal neovascularization.
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Affiliation(s)
- Jens F Kiilgaard
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark.
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