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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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Storp JJ, Schatten H, Vietmeier FE, Merté RL, Lahme L, Zimmermann JA, Englmaier VA, Eter N, Brücher VC. The Preserflo MicroShunt Affects Microvascular Flow Density in Optical Coherence Tomography Angiography. Biomedicines 2023; 11:3254. [PMID: 38137475 PMCID: PMC10741543 DOI: 10.3390/biomedicines11123254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/28/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Intraocular pressure (IOP) lowering surgery has been shown to alter microvascular density in glaucoma patients. The aim of this study is to report changes in retinal flow density (FD) over the course of treatment with the Preserflo MicroShunt, using optical coherence tomography angiography (OCTA). 34 eyes from 34 patients who underwent Preserflo MicroShunt implantation were prospectively enrolled in this study. OCTA imaging was conducted at the superficial (SCP), deep (DCP) and radial peripapillary plexus (RPC) levels. The progression of FD and IOP was assessed at different time points from baseline to six months postoperatively for the entire patient population, as well as disease severity subgroups. The Preserflo MicroShunt achieved a significant reduction in IOP over the course of six months (median: 8 mmHg; p < 0.01). FD values of the SCP and DCP did not show significant fluctuations, even after adjusting for disease severity. FD of the RPC decreased significantly over the course of six months postoperatively from 42.31 at baseline to 39.59 at six months postoperatively (p < 0.01). The decrease in peripapillary FD was strongest in patients with advanced glaucoma (median: -3.58). These observations hint towards dysfunctional autoregulatory mechanisms in capillaries surrounding the optic nerve head in advanced glaucoma. In comparison, the microvascular structure of the macula appeared more resilient to changes in IOP.
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Affiliation(s)
- Jens Julian Storp
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Hannah Schatten
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
- Augenklinik Roth am St. Josef-Hospital, 53225 Bonn, Germany
| | - Friederike Elisabeth Vietmeier
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Ralph-Laurent Merté
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Larissa Lahme
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Julian Alexander Zimmermann
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Verena Anna Englmaier
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Viktoria Constanze Brücher
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
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Simsek M, Oral Y, Inan S, Akdogan M, Cem Sabaner M. Comparison of peripapillary vascular density as measured by optical coherence tomography angiography between various types of open-angle glaucoma. J Fr Ophtalmol 2023; 46:1047-1054. [PMID: 37620193 DOI: 10.1016/j.jfo.2023.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/22/2023] [Accepted: 03/22/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE The purpose of this study is to compare the peripapillary vascular density in patients with various types of open-angle glaucoma (primary open-angle glaucoma, pseudoexfoliative glaucoma and pigmentary glaucoma) with healthy subjects by optic coherence tomography angiography (OCTA). METHODS Twenty-seven eyes with diagnosed POAG, thirty-four eyes with diagnosed PXG, twenty eyes with diagnosed PG and thirty eyes of healthy individuals were included in our study. Peripapillary vessel density measurements were performed with all images; (AI-DD), intra-disc (ID-DD) and peripapillary (PP-DD); measurement of vascular density in the radial peripapillary capillary network was performed by OCTA. The Kruskal-Wallis test and post-hoc test were performed for statistical analysis. RESULTS AI-DD was 50.76±2.07% in the healthy group, 47.12±2.57% in POAG, 39.71±6.64% in PXG, and 43.37±1.55% in PG. ID-DD was 50.49±3.74% in the healthy group, 49.51±6.83% in POAG, 38.42±13.46% in PXG, and 40.9±4.45% in PG. PP-DD was 51.26±3.12% in the healthy group, 50.13±3.04% in POAG, 42.31±7.31% in PXG, and 47.6±1.40% in PG. While it was found that all image and intra-disc vascular density measurements were statistically significantly lower in the PG and PXG group compared to the healthy group and the POAG (P<0.001), there was no significant difference between PXG and PG or between the control group and POAG. CONCLUSIONS The lower radial peripapillary capillary density in PXG and PG compared to the POAG and healthy groups suggests that the blood flow around the optic disc is negatively affected in these patients.
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Affiliation(s)
- M Simsek
- Department of Ophthalmology, Mugla Education and Training Hospital, Kötekli, Marmaris Yolu No. 48, 48000 Menteşe/Muğla, Turkey.
| | - Y Oral
- Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - S Inan
- Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - M Akdogan
- Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - M Cem Sabaner
- Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Orii Y, Kunikane E, Yamada Y, Morioka M, Iwasaki K, Arimura S, Mizuno A, Inatani M. Ocular Distribution of Brimonidine and Brinzolamide after Topical Instillation of a 0.1% Brimonidine Tartrate and 1% Brinzolamide Fixed-Combination Ophthalmic Suspension: An Interventional Study. J Clin Med 2023; 12:4175. [PMID: 37445209 DOI: 10.3390/jcm12134175] [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: 04/20/2023] [Revised: 06/08/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
PURPOSE To evaluate the concentrations of brimonidine and brinzolamide in the vitreous and aqueous humor after instillation of a 0.1% brimonidine tartrate and 1% brinzolamide fixed-combination ophthalmic suspension. METHODS The present investigation involved patients with macular holes or idiopathic epiretinal membranes who were planning to undergo vitrectomy. One week prior to surgery, the patients received twice-daily topical treatment with 0.1% brimonidine tartrate and 1% brinzolamide fixed-combination ophthalmic suspension. Before vitrectomy, vitreous and aqueous humor samples were collected, and the mean concentrations of brimonidine and brinzolamide were determined through liquid chromatography-tandem spectrometry. RESULTS Ten eyes (nine phakic and one pseudophakic eyes; 10 patients) were examined. The concentration of brimonidine in vitreous and aqueous humor samples was 5.02 ± 2.24 and 559 ± 670 nM, respectively. The concentration of brimonidine in the vitreous humor, which is needed to activate α2 receptors, was >2 nM in all patients. The concentration of brinzolamide was 8.96 ± 4.65 and 1100 ± 813 nM, respectively. However, there was no significant correlation between the concentrations of brimonidine in the vitreous and aqueous humor samples. CONCLUSIONS Sufficient concentrations of brimonidine were detected in all vitreous samples. The dissociated correlation of the drug concentrations between aqueous and vitreous humors implies the possibility of another pathway to vitreous humor, different from the pathway to aqueous humor.
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Affiliation(s)
- Yusuke Orii
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | | | - Yutaka Yamada
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Masakazu Morioka
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Kentaro Iwasaki
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Shogo Arimura
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Akemi Mizuno
- Senju Pharmaceutical Co., Ltd., Osaka 541-0048, Japan
| | - Masaru Inatani
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
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Aydın E, Özgür E, İnsan A, Gürün E. Retrobulbar Blood Flow Parameters in Patients With Anisometropic Amblyopia. Cureus 2023; 15:e35025. [PMID: 36938275 PMCID: PMC10022835 DOI: 10.7759/cureus.35025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 02/17/2023] Open
Abstract
Introduction We aim to compare retrobulbar blood flow parameters between the amblyopic eye and the fellow eye in patients with anisometropic amblyopia. Methods Peak systolic velocity (PSV) and end-diastolic velocity (EDV) of the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary artery (PCA) were measured by color Doppler imaging (CDI), and the resistivity index (RI) and pulsatility index (PI) were calculated in 62 patients aged 12-40 years with anisometropic amblyopia. Results The mean PSV values of OA, CRA, and PCA in amblyopic and fellow eyes were 30.38 ± 10.34, 8.45 ± 2.27, and 8.03 ± 2.77, and 33.73 ± 14.46, 8.35 ± 2.05, and 8.81 ± 2.77, respectively. The mean EDV values of OA, CRA, and PCA in amblyopic and fellow eyes were 6.86 ± 2.64, 1.47 ± 1.59, and 1.94 ± 2.03, and 8.57 ± 4.30, 1.80 ± 1.73, and 2.32 ± 1.20, respectively. The mean RI values of OA, CRA, and PCA in amblyopic and fellow eyes were 0.77 ± 0.10, 0.85 ± 0.14, and 0.78 ± 0.15, and 0.75 ± 0.07, 0.79 ± 0.20, and 0.74 ± 0.13, respectively. OA-PSV and OA-EDV values were significantly lower in the amblyopic eye than in the healthy eye (p < 0.05). OA-RI values were significantly higher (p < 0.05) in the amblyopic eye than in the healthy eye. Conclusions Considering the decrease in PSV and EDV and the increase in RI, which are the blood flow parameters of the amblyopic eye, our study may provide guidance to focus on increasing blood flow in the treatment of amblyopia.
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Affiliation(s)
- Emre Aydın
- Ophthalmology, Rize Şar Hospital, Rize, TUR
| | - Eren Özgür
- Radiology, Istanbul Education and Research Hospital, Istanbul, TUR
| | - Aykut İnsan
- Radiology, Osmaniye State Hospital, Osmaniye, TUR
| | - Enes Gürün
- Radiology, Samsun University, Samsun, TUR
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Nivean PD, Ariga M, Chithra MR, Gohil P, Das S, Jaideep G. Efficacy of dorzolamide in improving ocular blood flow in patients with open-angle glaucoma: The Indian carbonic anhydrase inhibitor trial. Indian J Ophthalmol 2022; 70:4164-4167. [PMID: 36453306 PMCID: PMC9940594 DOI: 10.4103/ijo.ijo_1055_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Impaired ocular blood flow is an important risk factor in the pathogenesis of open-angle glaucoma (OAG). Studies have reported that dorzolamide 2% may be effective in improving ocular blood flow (OBF) in OAG patients. The objective of this study was to determine the efficacy of dorzolamide 2% (DORZOX, Cipla Ltd.) in improving retrobulbar blood flow in an Indian setting. Methods The study was conducted as an interventional pilot project in 24 healthy subjects and 19 OAG patients. Baseline OBF measurements were done for all glaucoma patients with color Doppler imaging (CDI). Baseline ocular perfusion pressure (OPP) was calculated for all participants. Glaucoma patients were given dorzolamide 2% thrice daily for 12 weeks. The primary efficacy endpoints were mean changes in the CDI parameters of the retrobulbar vessels and OPP posttreatment. The secondary endpoint was mean change in the intraocular pressure (IOP) and adverse events, if any. Results In comparison to healthy subjects, glaucoma patients displayed significantly reduced baseline OPP (P = 0.002). Treatment with dorzolamide 2% for 12 weeks led to a significant increase in OPP (P < 0.001) and a significant increase in end diastolic velocity (EDV) in all major ophthalmic arteries like ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary artery (SPCA) (P < 0.001, P = 0.04, and P = 0.0075, respectively). A significant reduction in the intraocular pressure (IOP; P = 0.007) was observed posttreatment, with no adverse events reported. Conclusion Dorzolamide 2% significantly improved parameters such as the EDV and OPP in major ophthalmic arteries. This pilot study shows promising results on using dorzolamide for treating Indian patients with OAG.
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Affiliation(s)
- Pratheeba D Nivean
- Glaucoma and Oculoplasty Consultant, M. N. Eye Hospital, Chennai, Tamil Nadu, India,Correspondence to: Dr. Pratheeba D Nivean, M. N. Eye Hospital Pvt. Ltd., Tondiarpet No. 781, T.H. Road, Tondiarpet, Chennai - 600 021, Tamil Nadu, India. E-mail:
| | - Murali Ariga
- Chairman, Swamy Eye Hospital, HOD, Sundaram Medical Foundation Research, Director, M. N. Eye Hospital, Chennai, Tamil Nadu, India
| | - M R Chithra
- Head of Glaucoma Department, RIO GOH, Chennai, Tamil Nadu, India
| | - Pooja Gohil
- Medical Affairs, Department of Ophthalmology, Maharashtra, India
| | - Sandhya Das
- Medical Affairs, Department of Ophthalmology, Maharashtra, India
| | - Gogtay Jaideep
- Executive Vice-President, Cipla Ltd, Mumbai, Maharashtra, India
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7
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Stoner A, Harris A, Oddone F, Belamkar A, Verticchio Vercellin AC, Shin J, Januleviciene I, Siesky B. Topical carbonic anhydrase inhibitors and glaucoma in 2021: where do we stand? Br J Ophthalmol 2021; 106:1332-1337. [PMID: 34433550 DOI: 10.1136/bjophthalmol-2021-319530] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/16/2021] [Indexed: 11/04/2022]
Abstract
Carbonic anhydrase inhibitors (CAIs) have been used for many decades in the treatment of glaucoma. Systemic CAIs were an early treatment option to lower intraocular pressure by reducing aqueous humour production; however, frequent side effects including polyuria and paresthesia contributed to the eventual development of topical CAIs. As topical drug development evolved over time, prostaglandin analogues and beta-blockers have become the gold standard of glaucoma therapies. Although prescribed less often than other classes of topical glaucoma therapies, topical CAIs continue to be used in combination therapies with beta-blockers and alpha agonists. Topical CAIs have also been demonstrated to alter biomarkers of ocular haemodynamics, which have relevance in glaucoma. The purpose of this review is to review and summarise the current state of topical CAI prescribing trends, known efficacy and suggested mechanisms and potential influence on ocular haemodynamics for the future of glaucoma management.
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Affiliation(s)
- Ari Stoner
- Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Alon Harris
- Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Aditya Belamkar
- Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Joshua Shin
- New York Medical College, Valhalla, New York, USA
| | | | - Brent Siesky
- Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Lin F, Li F, Gao K, He W, Zeng J, Chen Y, Chen M, Cheng W, Song Y, Peng Y, Jin L, Lin TPH, Wang Y, Tham CC, Cheung CY, Zhang X. Longitudinal Changes in Macular Optical Coherence Tomography Angiography Metrics in Primary Open-Angle Glaucoma With High Myopia: A Prospective Study. Invest Ophthalmol Vis Sci 2021; 62:30. [PMID: 33507229 PMCID: PMC7846949 DOI: 10.1167/iovs.62.1.30] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose To characterize longitudinal changes in macular microvasculature as quantified from optical coherence tomography angiography (OCTA) metrics in primary open-angle glaucoma (POAG) eyes with and without high myopia. Methods In total, 63 and 61 POAG eyes with and without high myopia, respectively, underwent swept-source OCTA imaging in at least four follow-up visits at an ophthalmic center, with a scanning protocol of 3- × 3-mm centered at the fovea. The foveal avascular zone (FAZ) area, FAZ circularity, and vessel density (VD) in both the superficial (SCP) and deep capillary plexuses (DCP) were measured. The rate of change in macular OCTA metrics over time was estimated using linear mixed-effects models in both groups of POAG eyes. Results The mean follow-up time and number of visits were 27.72 ± 8.57 months and 8.5 (8 to 13) times, and 30.95 ± 10.19 months and 10 (8‒13) times in POAG eyes with and without high myopia, respectively. VD in the DCP reduced significantly more quickly in POAG eyes with high myopia than in those without high myopia (−5.14%/year vs. −3.71%/year, P = 0.008). Moreover, lower baseline VD in the DCP was significantly associated with faster VD reduction in POAG with high myopia eyes (P < 0.001). Conversely, the VD reduction rate in the SCP, FAZ area, and FAZ circularity in both the SCP and DCP were similar in both groups (all Ps > 0.05). Conclusions VD in DCP reduced significantly more quickly in POAG eyes with high myopia over time. Density in the DCP reduced more quickly when baseline VD was low.
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Affiliation(s)
- Fengbin Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Kai Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wanbing He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jun Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yu Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Meiling Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Weijing Cheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yunhe Song
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuying Peng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Timothy P H Lin
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yumeng Wang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Pillunat KR, Pillunat LE. [Vasculat treatment concepts in glaucoma patients]. Ophthalmologe 2021; 118:431-438. [PMID: 33026527 DOI: 10.1007/s00347-020-01239-7] [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: 10/23/2022]
Abstract
BACKGROUND Approximately 40% of all open-angle glaucomas do not show high intraocular pressure (IOP). Vascular risk factors play an important role in the pathogeneses of normal pressure glaucoma but high pressure glaucoma is also often accompanied by significant vascular components. OBJECTIVE What are the practice relevant possibilities of vascular glaucoma treatment? MATERIAL AND METHODS An evaluation of scientific articles from PubMed dealing with vascular glaucoma was carried out. RESULTS The treatment of vascular risk factors in glaucoma patients requires a thorough medical history regarding vascular symptoms (peripheral vasospasm, tinnitus, migraine etc.) and information on the presence of systemic diseases. Furthermore, a 24h blood pressure profile and the determination of the fat metabolism status represent important and simple examinations. CONCLUSION Besides optimizing systemic blood pressure, reducing an increased central retinal venous pressure, treatment with statins, calcium channel blockers, Ginkgo biloba extract, increased physical exercise and fluid replacement are options to ameliorate vascular conditions. An interdisciplinary cooperation with general practitioners and internists is an important component of holistic treatment.
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Affiliation(s)
- Karin R Pillunat
- Universitätsaugenklinik Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - Lutz E Pillunat
- Universitätsaugenklinik Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
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10
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Quantitative assessment of retinal thickness and vessel density using optical coherence tomography angiography in patients with Alzheimer's disease and glaucoma. PLoS One 2021; 16:e0248284. [PMID: 33739997 PMCID: PMC7978346 DOI: 10.1371/journal.pone.0248284] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/23/2021] [Indexed: 12/18/2022] Open
Abstract
Purpose Assessment and a direct comparison of retinal vessel density with the thickness of inner retinal layer (IRL) and outer retinal layer (ORL) in the same regions of the macula in subjects with Alzheimer’s disease (AD) and primary open-angle glaucoma (POAG). Methods We analyzed data from 48 eyes of healthy control (HC) participants, 71 eyes with POAG, and 49 eyes of AD patients. Ophthalmic examination included optical coherence tomography (OCT) imaging to measure IRL and ORL thickness and OCT angiography (OCTA) in the same region for the imaging of vessel density in the superficial vascular plexus (SVP) and deep vascular plexus (DVP) of the retina. A direct comparison of vessel density and retinal layers thickness, which different dynamic ranges, was obtained by normalizing values as percentage losses. Results Patients with AD presented significantly greater losses of vascular density in the DVP and ORL thickness compared to POAG (p <0.001), but percentage losses of vessel density in SVP and IRL thickness were considerable in POAG compared to AD eyes (p<0.001). Positive associations among presence of AD were observed primarily in outer retina where a 1% decrease of ORL thickness was associated with about 24–29% increase in odds of the presence of AD. According to OCTA measurements, a 1% decrease of vessel density in DVP was positively associated with a 4–9% increase in odds of the presence of AD. In POAG positive associations among presence of disease were observed only in inner retina where 1% loss of IRL thickness and a 1% loss of vessel density in the SVP were positively associated with a 13–23% increase in risk of presence of the disease. Conclusions Analysis of ORL thickness and vessel density in DVP could potentially improve diagnostic capabilities and may provide a valuable approach for predicting of AD.
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Sharma N, Gulati A. Pb 2+ sensing by coumarin sulphonamide hybrids in aqueous medium. LUMINESCENCE 2021; 36:1172-1180. [PMID: 33713392 DOI: 10.1002/bio.4042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 01/07/2023]
Abstract
Metals play an important role in various metabolic activities in the human body, but above desired concentrations, a role reversal occurs that causes deadly outcomes viz., cancer. Metals cannot be cracked down and are non-biodegradable. It is the bioaccumulation of toxic metals inside the biomatrices, that further intensifies the research on different means of metal detoxification from different matrices. Among heavy toxic metals lead is a brutal carcinogen that requires pitiless sensors for its capturing. The use of heterocycles for metal sensing in supramolecular chemistry is preferred due to the strong chelation they offer to toxic metals. The C1-C3 probes were synthesized and studied for their Pb2+ binding ability. All the probes were prepared by treating bromoacetyl coumarin with camphor sulphonamide, 5-dimethylamino-1-naphthalene sulphonamide, and methyl-2-amino-sulphonyl benzoate at room temperature. The probes show selective binding with Pb2+ ions in aqueous acetonitrile among different tested metal ions viz., Cu2+ , Zn2+ , Ni2+ , Mn2+, and Pb2+ ions as shown in ultraviolet (UV)-visible, nuclear magnetic resonance (NMR), and high-performance liquid chromatography (HPLC) studies. These sulphur-containing probes bind very well with Pb2+ ions by offering selectivity in binding positions that capture lead ions at their minimum possible concentration.
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Affiliation(s)
- Nidhi Sharma
- Academy of Scientific and Innovative Research (AcSIR), CSIR - Central Road Research Institute, (CRRI), New Delhi, India.,Food and Nutraceutical Division, CSIR - Institute of Himalayan Bioresource Technology, Palampur, India
| | - Ashu Gulati
- Food and Nutraceutical Division, CSIR - Institute of Himalayan Bioresource Technology, Palampur, India
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Vukkadala T, Gowdar Kuberappa R, Azad SV, Kumar V. Resolution of bilateral foveal cysts in dome-shaped macula after treatment with topical dorzolamide. BMJ Case Rep 2021; 14:14/1/e237868. [PMID: 33408104 PMCID: PMC7789044 DOI: 10.1136/bcr-2020-237868] [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: 01/09/2023] Open
Abstract
Dome-shaped macula (DSM) is characterised by a convex anterior bulging of the macular area. It can further get complicated by accumulation of subretinal fluid (SRF). Foveal cysts that are bilateral, in a setting of DSM, are an entity not yet reported. Management options for DSM with SRF showed variable success. Topical carbonic anhydrase inhibitors (CAIs) have been successful in treating certain macular pathologies. The authors report a rare case of bilateral intraretinal foveal cyst in a myopic child with DSM with favourable response to topical dorzolamide. Topical CAIs may be considered a safe and effective option in such cases.
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Affiliation(s)
- Tejaswini Vukkadala
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Ranjitha Gowdar Kuberappa
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Shorya Vardhan Azad
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Vinod Kumar
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Ekici E, Moghimi S, Bowd C, Hou H, Penteado RC, Proudfoot J, Yang D, Weinreb RN. Capillary Density Measured by Optical Coherence Tomography Angiography in Glaucomatous Optic Disc Phenotypes. Am J Ophthalmol 2020; 219:261-270. [PMID: 32561168 DOI: 10.1016/j.ajo.2020.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/23/2020] [Accepted: 06/10/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE To compare optical coherence tomography angiography (OCTA)-measured capillary density of the optic disc among 4 glaucomatous optic disc phenotypes. DESIGN Cross-sectional study. METHODS Circumpapillary capillary density (cpCD) of 4 glaucomatous optic disc phenotypes in 193 eyes of 141 glaucoma patients and cpCD in 92 eyes of 55 healthy subjects from the Diagnostic Innovations in Glaucoma Study (DIGS) were compared. Areas under the receiver operating characteristic (AUROC) curves were used to evaluate diagnostic accuracy among groups after adjusting for confounders. RESULTS Four glaucoma phenotypes were assessed: focal ischemic (n = 45), generalized cup enlargement (n = 60), myopic glaucoma (n = 38), and senile sclerotic (n = 50). Sex, mean ocular perfusion pressure, intraocular pressure, mean deviation, and the quality score did not differ among phenotypes. However, there were differences in age (P = .050), race (P = .039), axial length (P = .033), and retinal nerve fiber layer thickness (P < .001) among the groups. After adjusting for confounders, senile sclerotic discs had the lowest cpCD (37.1% [95% confidence interval, 35.3-38.8]), followed by focal ischemic (41.8% [40.0-43.6]), myopic glaucoma (42.1% [40-44.2]), and generalized cup enlargement (45.5% [44-47]) (P < .001) discs. The adjusted AUROC curves of cpCD for discriminating between healthy and glaucomatous eyes were highest in senile sclerotic eyes (0.928) and lowest in generalized cup enlargement eyes (0.704). CONCLUSIONS OCTA-measured vessel density differs among optic disc phenotypes. Clinicians should be aware that the performance of OCTA for glaucoma diagnosis may be influenced by the optic disc phenotype.
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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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Demirtaş AA, Karahan M, Ava S, Çilem Han Ç, Keklikçi U. Evaluation of Diurnal Fluctuation in Parafoveal and Peripapillary Vascular Density Using Optical Coherence Tomography Angiography in Patients with Exfoliative Glaucoma and Primary Open-Angle Glaucoma. Curr Eye Res 2020; 46:96-106. [PMID: 32546011 DOI: 10.1080/02713683.2020.1784437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To determine the diurnal variations in parafoveal and peripapillary vessel density using optical coherence tomography angiography in patients with exfoliative glaucoma, patients with primary open-angle glaucoma and healthy individuals. MATERIALS AND METHODS In this prospective cross-sectional study, 36 exfoliative glaucoma patients, 34 primary open-angle glaucoma patients and 35 healthy individuals were examined. Optical coherence tomography angiography was used for examining the vessel density of peripapillary (radial peripapillary capillary) and parafoveal (superficial layer) regions. Optical coherence tomography angiography readings were obtained at 09:00, 11:00, 14:00 and 16:00 on the same day. Intraocular pressure values were assessed accordingly. The intraclass correlation coefficients were used to evaluate test-retest variability. RESULTS Diurnal variation in intraocular pressure or vessel density values was not found in any parafoveal or peripapillary region in any of the groups at any hour of measurement. The vessel density in the temporal sector of the exfoliative glaucoma group was significantly lower than in the primary open-angle glaucoma group at all time points. (Mann-Whitney U test; 09:00, P= .015; 11:00, P= .002; 14:00, P= .040; and 16:00, P= .048, respectively). The test-retest repeatability was high and almost excellent for the parafoveal and peripapillary regions in each group (XFG range: 0.757 - 0.985, POAG range: 0.834 - 0.985, and control range: 0.708 - 0.983). CONCLUSIONS It may be important to estimate the diurnal fluctuation occurring in retinal haemodynamics in patients with exfoliative glaucoma and primary open-angle glaucoma despite the lack of any considerable variation in intraocular pressure and retinal vessel density values in one day. The study found that at any point of time, vessel density of radial peripapillary capillary in temporal region was lower in exfoliative glaucoma patients than in primary open-angle glaucoma patients having the same glaucoma severity.
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Affiliation(s)
- Atılım Armağan Demirtaş
- Department of Ophthalmology, Health Sciences University, Tepecik Training and Research Hospital , Izmir, Turkey
| | - Mine Karahan
- Department of Ophthalmology, Dicle University Faculty of Medicine , Diyarbakır, Turkey
| | - Sedat Ava
- Department of Ophthalmology, Dicle University Faculty of Medicine , Diyarbakır, Turkey
| | - Çağla Çilem Han
- Department of Ophthalmology, Dicle University Faculty of Medicine , Diyarbakır, Turkey
| | - Uğur Keklikçi
- Department of Ophthalmology, Dicle University Faculty of Medicine , Diyarbakır, Turkey
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Hou H, Moghimi S, Proudfoot JA, Ghahari E, Penteado RC, Bowd C, Yang D, Weinreb RN. Ganglion Cell Complex Thickness and Macular Vessel Density Loss in Primary Open-Angle Glaucoma. Ophthalmology 2020; 127:1043-1052. [PMID: 32085875 DOI: 10.1016/j.ophtha.2019.12.030] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/12/2019] [Accepted: 12/27/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To characterize the change rate of ganglion cell complex (GCC) thickness and macular vessel density in healthy, preperimetric glaucoma and primary open-angle glaucoma (POAG) eyes. DESIGN Prospective, longitudinal study. PARTICIPANTS One hundred thirty-nine eyes (23 healthy eyes, 36 preperimetric glaucoma eyes, and 80 POAG eyes) of 94 patients who had at least 3 visits were included from the Diagnostic Innovations in Glaucoma Study. The mean follow-up was 2.0 years for healthy eyes, 2.6 years for preperimetric glaucoma eyes, and 2.6 years for POAG eyes. METHODS OCT angiography (OCTA)-based vessel density and OCT-based structural thickness of the same 3×3-mm2 GCC scan slab were evaluated. The dynamic range-based normalized rates of vessel density and thickness change were calculated and compared within each diagnostic group. The association between the rates of thickness and vessel density change and potential factors were evaluated. MAIN OUTCOME MEASURES The rates of GCC thinning and macular vessel density loss. RESULTS Significant rates of GCC thinning and macular vessel density decrease were detectable in all diagnostic groups (all P < 0.05). In healthy eyes and preperimetric glaucoma eyes, the normalized rates of GCC thinning and macular vessel density decrease were comparable (all P > 0.1). In contrast, the normalized rate (mean, 95% confidence interval) of macular vessel density decrease in the POAG eyes (-7.12 [-8.36, -5.88]%/year) was significantly faster than GCC thinning (-2.13 [-3.35, -0.90]%/year; P < 0.001). In the POAG group, more than two thirds of the eyes showed faster macular vessel density decrease than GCC thinning; faster macular vessel density decrease rate was associated significantly with worse glaucoma severity (P = 0.037). The association between GCC thinning rate and glaucoma severity was not significant (P = 0.586). Intraocular pressure during follow-up significantly affected the rate of GCC thinning in all groups (all P < 0.05) but showed no association with the rate of macular vessel density decrease. CONCLUSIONS Both GCC thinning and macular vessel density decrease were detectable over time in all diagnostic groups. In POAG eyes, macular vessel density decrease was faster than GCC thinning and was associated with severity of disease. Macular vessel density is useful for evaluating glaucoma progression, particularly in more advanced disease.
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Affiliation(s)
- Huiyuan Hou
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Sasan Moghimi
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - James A Proudfoot
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Elham Ghahari
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Rafaella C Penteado
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California; Department of Ophthalmology, University of São Paulo, São Paulo, Brazil
| | - Christopher Bowd
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Diya Yang
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Robert N Weinreb
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California.
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Chen NN, Chen CL, Lai CH. Resolution of Unilateral Dome-Shaped Macula With Serous Detachment After Treatment of Topical Carbonic Anhydrase Inhibitors. Ophthalmic Surg Lasers Imaging Retina 2019; 50:e218-e221. [DOI: 10.3928/23258160-20190806-16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 02/13/2019] [Indexed: 11/20/2022]
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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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Hou H, Moghimi S, Zangwill LM, Shoji T, Ghahari E, Penteado RC, Akagi T, Manalastas PIC, Weinreb RN. Macula Vessel Density and Thickness in Early Primary Open-Angle Glaucoma. Am J Ophthalmol 2019; 199:120-132. [PMID: 30496723 DOI: 10.1016/j.ajo.2018.11.012] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/23/2018] [Accepted: 11/16/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE To characterize and compare the ganglion cell complex (GCC) thickness and macula vessel density in preperimetric and early primary open-angle glaucoma (POAG) eyes. DESIGN Cross-sectional study. METHODS Fifty-seven healthy, 68 preperimetric, and 162 early POAG eyes enrolled in the Diagnostic Innovations in Glaucoma Study. Optical coherence tomography angiography (OCT-A)-based superficial macula vessel density and OCT-based GCC thickness were evaluated simultaneously. Percent loss from normal of GCC thickness and macula vessel density was compared. Area under the receiver operating characteristic curve was used to describe the diagnostic utility. RESULTS Both GCC thickness and vessel density were significantly lower in preperimetric and early POAG eyes compared to healthy eyes. Compared to the preperimetric POAG group, the early POAG group showed larger GCC thickness percent loss (whole image 4.72% vs 9.86%; all P < .01) but similar vessel density percent loss (whole image 4.97% vs 6.93%; all P > .05). In preperimetric POAG, GCC thickness and vessel density percent losses were similar (all P > .1). In contrast, in early POAG, GCC thickness percent loss was larger than that of vessel density (all P ≤ .001). To discriminate preperimetric or early glaucoma eyes from healthy eyes, GCC thickness and macula vessel density showed similar diagnostic accuracy (all P > .05). CONCLUSIONS Both GCC thinning and macula vessel density dropout were detectable in preperimetric and early POAG eyes. GCC loss was greater than macula vessel density loss in early perimetric POAG. However, OCT-A and OCT measurements showed similar efficiency to detect early glaucoma.
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Affiliation(s)
- Huiyuan Hou
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA; Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
| | - Takuhei Shoji
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA; Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Elham Ghahari
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
| | - Rafaella C Penteado
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
| | - Tadamichi Akagi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA; Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Patricia Isabel C Manalastas
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA.
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Richter GM, Sylvester B, Chu Z, Burkemper B, Madi I, Chang R, Reznik A, Varma R, Wang RK. Peripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance. Clin Ophthalmol 2018; 12:2285-2296. [PMID: 30510397 PMCID: PMC6231432 DOI: 10.2147/opth.s179816] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To quantify peripapillary microvasculature within the retinal nerve fiber layer (RNFL) in primary open-angle glaucoma (POAG) and normal eyes, determine association of perfusion parameters with structural and functional measures, and report diagnostic accuracy of perfusion parameters. Patients and methods POAG and normal patients underwent 6×6 mm2 optic nerve head scans (Angioplex optical coherence tomography angiography [OCTA]; Cirrus HD-OCT 5000) and Humphrey Field Analyzer II-i 24-2 visual field (VF) testing. Prototype software performed semiautomatic segmentation to create RNFL en face images and quantified vessel area density (VAD), vessel skeleton density (VSD), and vessel complexity index (VCI) in the optic nerve head globally and focally. Generalized estimating equations models assessed association of OCTA parameters with VF mean deviation (MD) and RNFL thickness. Results Thirty-eight POAG and 17 normal eyes were studied. Global VAD, VSD, and VCI were reduced in mild POAG vs normal (P<0.02) and moderate-severe vs mild POAG (P<0.04). Stepwise focal reductions across disease stage were demonstrated for OCTA parameters in the inferior hemisphere (P<0.05); reduction in OCTA parameters in mild POAG vs normal was demonstrated in inferior and superior quadrants (P<0.05). Reduced global VF MD was associated with reduced VAD, VSD, and VCI (P=0.0007, 0.0013, <0.0001; R2=0.449, 0.312, 0.399, respectively), and global RNFL thickness was associated with VAD, VSD, and VCI (P<0.0001; R2=0.499, 0.524, 0.542), superior and inferior hemifield MD were associated with corresponding VAD, VSD, and VCI (P≤0.001; R2 from 0.208 to 0.513). RNFL thickness in all quadrants was associated with corresponding OCTA parameters (P<0.05; R2 from 0.213 to 0.394), except temporal VAD and VCI. Area under curves for VAD, VSD, and VCI demonstrated good diagnostic ability (0.868, 0.855, 0.868; P<0.0001). Conclusion Glaucomatous eyes showed stepwise reductions in RNFL microcirculation across severity; focal reductions in the inferior hemisphere and inferior and superior quadrants were most significant. OCTA parameters had stronger associations with structural rather than functional measures of glaucoma.
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Affiliation(s)
- Grace M Richter
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA,
| | - Beau Sylvester
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA,
| | - Zhongdi Chu
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Bruce Burkemper
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA,
| | - Ingy Madi
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA,
| | - Ryuna Chang
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA,
| | - Alena Reznik
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA,
| | - Rohit Varma
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA,
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, WA, USA
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Dong YR, Huang SW, Cui JZ, Yoshitomi T. Effects of brinzolamide on rabbit ocular blood flow in vivo and ex vivo. Int J Ophthalmol 2018; 11:719-725. [PMID: 29862168 DOI: 10.18240/ijo.2018.05.03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 03/15/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate if significant improvement of optic disc blood flow (ODBF) occurs after instillation of brinzolamide onto rabbit eyes. METHODS Testing of bilateral intraocular pressure (IOP) and left ODBF in 10 male rabbits took place every 3h over a 24h period. Brinzolamide (1% ophthalmic solution, two drops at 9:00 and 21:00) was administered to the left eye. ODBF, assessed using laser speckle flowgraphy, was determined as the mean blur rate (MBR). Furthermore, the effect of brinzolamide on isolated rabbit ciliary arteries using isometric tension recording system was performed. RESULTS After brinzolamide instillation, IOP was significantly decreased in the left eye. MBR-vessel was greater at 18:00 and 21:00 (P<0.05) than in the controls. MBR-tissue and MBR-average were greater at 18:00 (P<0.05) than in the controls. For isolated arteries pre-contracted with a high-K solution, brinzolamide induced concentration-dependent relaxation, reaching 46.1%±9% (n=21) at 1 mmol/L. In Ca2+-free solutions, incubation with brinzolamide suppressed 1 µmol/L histamine-induced contractions (P<0.05). CONCLUSION Brinzolamide decreases IOP and increases ocular blood flow. The direct vasodilatory effect of brizolamide is mediated by suppression of Ca2+ release from intracellular calcium stores.
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Affiliation(s)
- Ya-Ru Dong
- Department of Ophthalmology, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China.,Department of Ophthalmology, Akita University School of Medicine, Akita 010-8543, Japan
| | - Shi-Wei Huang
- Department of Ophthalmology, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Ji-Zhe Cui
- Department of Ophthalmology, the Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Takeshi Yoshitomi
- Department of Ophthalmology, Akita University School of Medicine, Akita 010-8543, Japan
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Abstract
PURPOSE To provide the reader with information on the principal techniques of optical coherence tomography angiography (OCTA); the current literature on OCTA reproducibility; its applications to glaucoma detection and monitoring of progression; and the role of OCTA in the assessment of the vascular component in glaucoma pathogenesis. METHODS A literature review of the pertinent publications for the OCTA in relation to the development, techniques, and its use in glaucoma was carried out. RESULTS Rapid improvements in optical coherence tomography (OCT) technology have allowed for enhancement of both image resolution and scanning speed, and the development of vascular assessment modality. OCTA is the non-invasive in vivo imaging of the vasculature located within the retina and optic nerve head area. The principle of OCTA is to use the variations in OCT signals caused by moving particles as the contrast mechanism for imaging of flow. Several algorithms which aim to maximize the contrast signal and minimize the noise have been developed including the phase-based techniques, intensity-based techniques (e.g., split-spectrum amplitude decorrelation angiography (SSADA)), and complex-based techniques (e.g., optical microangiography (OMAG)). With its reliable technique, high image resolution, and current availability, OCTA has been widely used in the assessment of posterior segment diseases including glaucoma in which ocular perfusion dysfunction has been proposed as a pathophysiological mechanism. CONCLUSION OCTA may enhance our knowledge of glaucoma pathogenesis and offer an improvement in our ability to detect glaucomatous change.
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Affiliation(s)
- Sunee Chansangpetch
- a Department of Ophthalmology , University of California San Francisco , San Francisco , CA , USA.,b Department of Ophthalmology , Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross , Bangkok , Thailand
| | - Shan C Lin
- a Department of Ophthalmology , University of California San Francisco , San Francisco , CA , USA
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Chen G, Kong X, Lu D, Wu J, Liu Z. Kinetics of CO 2 diffusion in human carbonic anhydrase: a study using molecular dynamics simulations and the Markov-state model. Phys Chem Chem Phys 2018; 19:11690-11697. [PMID: 28435964 DOI: 10.1039/c7cp00887b] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Molecular dynamics (MD) simulations, in combination with the Markov-state model (MSM), were applied to probe CO2 diffusion from an aqueous solution into the active site of human carbonic anhydrase II (hCA-II), an enzyme useful for enhanced CO2 capture and utilization. The diffusion process in the hydrophobic pocket of hCA-II was illustrated in terms of a two-dimensional free-energy landscape. We found that CO2 diffusion in hCA-II is a rate-limiting step in the CO2 diffusion-binding-reaction process. The equilibrium distribution of CO2 shows its preferential accumulation within a hydrophobic domain in the protein core region. An analysis of the committors and reactive fluxes indicates that the main pathway for CO2 diffusion into the active site of hCA-II is through a binding pocket where residue Gln136 contributes to the maximal flux. The simulation results offer a new perspective on the CO2 hydration kinetics and useful insights toward the development of novel biochemical processes for more efficient CO2 sequestration and utilization.
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Affiliation(s)
- Gong Chen
- Key Laboratory of Industrial Biocatalysis, Ministry of Education, China.
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Diurnal Variations of Peripapillary and Macular Vessel Density in Glaucomatous Eyes Using Optical Coherence Tomography Angiography. J Glaucoma 2018; 27:336-341. [PMID: 29462016 DOI: 10.1097/ijg.0000000000000914] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to investigate the diurnal variation in peripapillary and macular vessel density (VD) measurements using optical coherence tomographic angiography (OCT-A) and its correlation to intraocular pressure (IOP) changes in glaucoma patients. METHODS Prospective, observational cross-sectional study including 37 patients (74 eyes; age, 63.8±12.9 y) with open-angle glaucoma. OCT-A imaging and IOP measurements were performed at 08:00, 11:00, 14:00, and 16:00 timepoints on a single day. At each timepoint, 2 scan protocols were used to generate 3-dimensional en face OCT angiograms: 4.5×4.5-mm scan centered on the optic nerve head and 6×6-mm scan centered on the fovea. For each scan mode, the "radial peripapillary capillary" segment, composed of the vasculature of the retinal nerve fiber layer and ganglion cell layer, was calculated. Two trained readers reviewed OCT-A image quality. Only scans with signal strength intensity (SSI) higher than 46 and without image artifacts interfering with measurements were included. Variation in VD measurements assessed using analysis of variance (ANOVA) and the association between VD and IOP changes assessed using linear mixed modeling methods. RESULTS The optic nerve head and peripapillary VD measurements at 14:00 and 16:00 timepoints were greater than the measurements at 08:00 and 11:00 timepoints. The 14:00 and 16:00 VD measurements were statistically significantly greater (P<0.05) than the 08:00 measurements for the whole en face (50.1% and 50.1% vs. 49.4%), inside disc (50.6% and 50.5% vs. 49.6%), and average peripapillary (58.2% and 58.5% vs. 57.5%) VDs. The macular VD measurements at the 14:00 timepoint were greater than the measurements at 08:00 and 11:00 timepoints. Changes in VD were significantly associated with changes in SSI but not IOP. CONCLUSIONS Diurnal changes in OCT-A-measured VD in glaucoma patients were small and clinically insignificant. These changes were not associated with IOP changes.
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Efficacy of carbonic anhydrase inhibitors in management of cystoid macular edema in retinitis pigmentosa: A meta-analysis. PLoS One 2017; 12:e0186180. [PMID: 29023491 PMCID: PMC5638411 DOI: 10.1371/journal.pone.0186180] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 09/26/2017] [Indexed: 11/26/2022] Open
Abstract
Background Carbonic anhydrase inhibitors (CAI) are often used in the treatment of cystoid macular edema (CME) in retinitis pigmentosa (RP) patients. The aim of this meta-analysis is to gain a better understanding of the overall efficacy of CAI treatment. Methods Databases including PubMed, EMBASE, and Cochrane Library were searched to identify relevant studies. Eligible studies were clinical trials of patients with RP assigned topical or oral CAIs such as dorzolamide and acetazolamide. Changes in central macular thickness (CMT) by OCT in μm and best-corrected visual acuity (BCVA) in log MAR equivalents were extracted and results compared between baseline and after treatment. Results 11 clinical reports were identified which included a total of 194 patients (358 eyes) available for analysis, with 59 patients (115 eyes) assigned oral CAI treatment and 135 patients (243 eyes) assigned topical CAI treatment. The combined results showed a significant reduction of macular edema, as calculated by baseline and final central macular thickness (CMT) based on OCT examination (46.02μm, 95%CI: -60.96, -31.08, I2 = 65%). However, the effect on visual acuity was inconsistent across studies. Conclusion Based on non randomized controlled clinical studies, RP patients with CME who were treated with CAIs had better anatomical outcomes, but the effect on visual acuity was contradictory across studies. Multicenter prospective randomized controlled trials would be ideal to definitively test its clinical efficacy in RP patients.
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Optical Coherence Tomography Angiography Vessel Density Measurements in Eyes With Primary Open-Angle Glaucoma and Disc Hemorrhage. J Glaucoma 2017; 26:888-895. [DOI: 10.1097/ijg.0000000000000758] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Carbonic Anhydrase Inhibitor with Topical NSAID Therapy to Manage Cystoid Macular Edema in a Case of Gyrate Atrophy. Eur J Ophthalmol 2017; 27:e179-e183. [DOI: 10.5301/ejo.5001010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose Gyrate atrophy of the choroid and retina (GACR) is a rare chorioretinal dystrophy characterized by a deficiency of the enzyme ornithine aminotransferase, inherited in an autosomal recessive pattern. Case Report We report a case of a 17-year-old girl with GACR, for whom the level of serum ornithine had been reduced by an arginine-restricted diet. The patient was responsive to an association of topical nonsteroidal anti-inflammatory drugs (NSAIDs) and a carbonic anhydrase inhibitor (CAI) to reduce cystoid macular edema (CME). Conclusions The efficacy of topical NSAIDs and systemic CAI association indicates that the imbalance in the distribution of retinal pigment epithelium membrane-bound carbonic anhydrase could play a major role in CME pathogenesis in GACR. To our knowledge, this is the first case of therapy with CAI treatment for GACR-related CME.
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Ohta Y, Takaseki S, Yoshitomi T. Effects of ripasudil hydrochloride hydrate (K-115), a Rho-kinase inhibitor, on ocular blood flow and ciliary artery smooth muscle contraction in rabbits. Jpn J Ophthalmol 2017; 61:423-432. [DOI: 10.1007/s10384-017-0524-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 04/07/2017] [Indexed: 12/20/2022]
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Rao HL, Pradhan ZS, Weinreb RN, Riyazuddin M, Dasari S, Venugopal JP, Puttaiah NK, Rao DA, Devi S, Mansouri K, Webers CA. Vessel Density and Structural Measurements of Optical Coherence Tomography in Primary Angle Closure and Primary Angle Closure Glaucoma. Am J Ophthalmol 2017; 177:106-115. [PMID: 28254626 DOI: 10.1016/j.ajo.2017.02.020] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 02/16/2017] [Accepted: 02/17/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the vessel density measurements of the optic nerve head (ONH), peripapillary, and macular regions on optical coherence tomography (OCT) angiography in eyes with primary angle closure (PAC) and primary angle closure glaucoma (PACG), and to compare their diagnostic abilities with the ONH rim area, peripapillary retinal nerve fiber layer (RNFL) thickness, and the macular ganglion cell complex (GCC) thickness measurements on OCT in PACG. DESIGN Cross-sectional study. METHODS Seventy-seven eyes of 50 control subjects, 65 eyes of 45 patients with PACG, and 31 eyes of 22 PAC patients with a history of high intraocular pressure underwent imaging with OCT. Area under receiver operating characteristic curves (AUC) and sensitivities at fixed specificities of vessel densities were compared with structural measurements. RESULTS All the vessel density and structural measurements were significantly lower (P < .05) in the PACG compared with the control group. Vessel densities in the PAC were similar (P > .05) to that of the controls; the superotemporal RNFL, however, was significantly thinner in the PAC group (127 μm vs 135 μm, P = .01). The AUC and sensitivity at 95% specificity of vessel densities within the ONH (0.76 and 42%) and macular region (0.69 and 18%) in PACG were significantly lower P < .001) than ONH rim area (0.90 and 77%) and GCC thickness (0.91 and 55%), respectively. AUC and sensitivity of peripapillary vessel density (0.85 and 53%) were similar (P = 0.25) to RNFL thickness (0.91 and 65%). CONCLUSIONS These results suggest that structural changes in PACG occur earlier than the reduction in retinal vessel densities.
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Abstract
Open-angle glaucoma (OAG) is characterized by optic nerve fiber atrophy and deterioration of the visual field, corresponding to damage to the optic nerve head. Intraocular pressure (IOP) is currently the only evidence-based, treatable risk factor for OAG. However, normal-tension glaucoma, the most common type of OAG in Asia, is a type of glaucoma with an unclear pathogenesis. Glaucoma is suspected to be a multifactorial disease with IOP-dependent and IOP-independent risk factors, including decreased ocular blood flow (OBF), oxidative stress, decreased axoplasmic flow, and genetic background. A number of epidemiological studies have generated strong evidence that OBF may be an especially important risk factor for the progression of glaucoma. Recent innovations in laser speckle flowgraphy and optical coherence tomography-based angiography have allowed us to noninvasively monitor changes in the microcirculation of the optic nerve head with high reproducibility. Laser speckle flowgraphy-derived measurement parameters include mean blur rate and pulse wave form parameters, whereas the main optical coherence tomography angiography-derived parameter is the vessel index. Decreases in these parameters are associated with the severity of glaucomatous damage, and changes are detectible even in the earliest, preperimetric stage of glaucoma. In the future, OBF analysis may improve significantly because of continuing progress in the development of the relevant instruments. This review will summarize possible connections between systemic and OBF abnormalities and OAG, describe the scientific rationale for these connections, and discuss their potential implications. Thus, this review will summarize the role of OBF in glaucoma pathogenesis and discuss the wide range of IOP-independent risk factors.
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Affiliation(s)
- Toru Nakazawa
- From the Department of Ophthalmology, Retinal Disease Control, Ophthalmology, and Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Ocular Blood Flow Autoregulation Mechanisms and Methods. J Ophthalmol 2015; 2015:864871. [PMID: 26576295 PMCID: PMC4631905 DOI: 10.1155/2015/864871] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 09/14/2015] [Indexed: 12/21/2022] Open
Abstract
The main function of ocular blood flow is to supply sufficient oxygen and nutrients to the eye. Local blood vessels resistance regulates overall blood distribution to the eye and can vary rapidly over time depending on ocular need. Under normal conditions, the relation between blood flow and perfusion pressure in the eye is autoregulated. Basically, autoregulation is a capacity to maintain a relatively constant level of blood flow in the presence of changes in ocular perfusion pressure and varied metabolic demand. In addition, ocular blood flow dysregulation has been demonstrated as an independent risk factor to many ocular diseases. For instance, ocular perfusion pressure plays key role in the progression of retinopathy such as glaucoma and diabetic retinopathy. In this review, different direct and indirect techniques to measure ocular blood flow and the effect of myogenic and neurogenic mechanisms on ocular blood flow are discussed. Moreover, ocular blood flow regulation in ocular disease will be described.
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Maślanka T. A review of the pharmacology of carbonic anhydrase inhibitors for the treatment of glaucoma in dogs and cats. Vet J 2015; 203:278-84. [DOI: 10.1016/j.tvjl.2014.12.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Revised: 10/11/2014] [Accepted: 12/15/2014] [Indexed: 11/29/2022]
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Synthesis, characterization, and antibacterial activities of novel sulfonamides derived through condensation of amino group containing drugs, amino acids, and their analogs. BIOMED RESEARCH INTERNATIONAL 2015; 2015:938486. [PMID: 25802872 PMCID: PMC4354722 DOI: 10.1155/2015/938486] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 02/09/2015] [Indexed: 11/30/2022]
Abstract
Novel sulfonamides were developed and structures of the new products were confirmed by elemental and spectral analysis (FT-IR, ESI-MS, 1HNMR, and 13CNMR). In vitro, developed compounds were screened for their antibacterial activities against medically important gram (+) and gram (−) bacterial strains, namely, S. aureus, B. subtilis, E. coli, and K. pneumoniae. The antibacterial activities have been determined by measuring MIC values (μg/mL) and zone of inhibitions (mm). Among the tested compounds, it was found that compounds 5a and 9a have most potent activity against E. coli with zone of inhibition: 31 ± 0.12 mm (MIC: 7.81 μg/mL) and 30 ± 0.12 mm (MIC: 7.81 μg/mL), respectively, nearly as active as ciprofloxacin (zone of inhibition: 32 ± 0.12 mm). In contrast, all the compounds were totally inactive against the gram (+) B. subtilis.
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Effect of Trabeculectomy on Ocular Hemodynamic Parameters in Pseudoexfoliative and Primary Open-angle Glaucoma Patients. J Glaucoma 2015; 24:e52-6. [DOI: 10.1097/ijg.0000000000000055] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Pautler SE, Browning DJ. Isolated posterior uveal effusion: expanding the spectrum of the uveal effusion syndrome. Clin Ophthalmol 2014; 9:43-9. [PMID: 25565767 PMCID: PMC4284045 DOI: 10.2147/opth.s75448] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Uveal effusion syndrome usually causes peripheral chorioretinal detachment, but posterior effusion may present as isolated macular edema with serous macular detachment in the setting of hyperopia and a thickened posterior choroid. Carbonic anhydrase inhibitors may be effective to treat this condition.
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Affiliation(s)
- Scott E Pautler
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - David J Browning
- Charlotte Ear Eye Nose and Throat Associates, Charlotte, NC, USA
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Remko M, Herich P, Gregáň F, Kožíšek J. Structure, acidity and basicity of a benzene disulfonamide inhibitor of carbonic anhydrase. J Mol Struct 2014. [DOI: 10.1016/j.molstruc.2013.11.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Holló G. Brinzolamide/timolol fixed combination for open-angle glaucoma and ocular hypertension. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/eop.09.7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Feke GT, Rhee DJ, Turalba AV, Pasquale LR. Effects of dorzolamide-timolol and brimonidine-timolol on retinal vascular autoregulation and ocular perfusion pressure in primary open angle glaucoma. J Ocul Pharmacol Ther 2013; 29:639-45. [PMID: 23530946 DOI: 10.1089/jop.2012.0271] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To assess whether dorzolamide 2%-timolol 0.5% (D/T) and/or brimonidine 0.2%-timolol 0.5% (B/T) alters retinal vascular autoregulation (RVA) and seated ocular perfusion pressure (sOPP) in primary open angle glaucoma (POAG) patients who demonstrate retinal vascular dysregulation (RVD) on timolol 0.5% alone. METHODS In this prospective, observer-masked, crossover study, 21 POAG patients with untreated intraocular pressure (IOP) >21 mmHg were treated for 6 weeks with timolol 0.5%. Subsequently, we measured inferior temporal retinal artery blood flow in the left eye with subjects seated and then while reclined for 30 min using the Canon Laser Blood Flowmeter. Subjects with a change in retinal blood flow in response to posture change outside of the range previously found in healthy subjects were designated as having RVD and randomized to either D/T or B/T for 6 weeks and re-tested. This was followed by treatment with the opposite medication. RESULTS Seven of the 21 subjects demonstrated RVD in response to posture change following timolol 0.5%. Multiple linear regression analysis indicated that lower sOPP was the main determinant of RVD (P=0.033). After treatment with D/T, all 7 converted from RVD to normal RVA status (P=0.001). Four of 6 subjects showed a similar return to normal RVA following B/T (P=0.066). Mid-morning sOPP was 41.1±5.5 mmHg post-timolol, 46.3±6.5 mmHg post-D/T, and 38.6±6.0 mmHg post-B/T (D/T vs. B/T, P=0.026). CONCLUSIONS D/T significantly improved RVA in POAG patients exhibiting RVD while on timolol 0.5% alone. D/T also increased sOPP compared to B/T. There was no significant difference (P=0.37) between D/T and B/T in improving RVA.
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Affiliation(s)
- Gilbert T Feke
- Massachusetts Eye & Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
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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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Gençer N, Bilen Ç, Demir D, Atahan A, Ceylan M, Küçükislamoğlu M. In vitro inhibition effect of some chalcones on erythrocyte carbonic anhydrase I and II. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2013; 41:384-8. [DOI: 10.3109/21691401.2012.761226] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Huber-van der Velden KK, Lux A, Severing K, Klamann MKJ, Winterhalter S, Remky A. Retrobulbar Hemodynamics Before and After Oculopression With and Without Dorzolamide. Curr Eye Res 2012; 37:719-25. [DOI: 10.3109/02713683.2012.675614] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Januleviciene I, Siaudvytyte L, Diliene V, Barsauskaite R, Paulaviciute-Baikstiene D, Siesky B, Harris A. Comparison of intraocular pressure, blood pressure, ocular perfusion pressure and blood flow fluctuations during dorzolamide versus timolol add-on therapy in prostaglandin analogue treated glaucoma subjects. Pharmaceuticals (Basel) 2012; 5:325-38. [PMID: 24281382 PMCID: PMC3763637 DOI: 10.3390/ph5030325] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 03/07/2012] [Accepted: 03/19/2012] [Indexed: 11/18/2022] Open
Abstract
Objective: To compare the effects of dorzolamide and timolol add-on therapy in open-angle glaucoma (OAG) patients previously treated with prostaglandin analogue (Pg), by evaluating fluctuations in the intraocular (IOP), blood (BP), ocular perfusion pressures (OPP) and retrobulbar blood flow (RBF) parameters. Methods: 35 OAG patients (35 eyes), 31 women (88.6%) age 63.3 (8.9) years were evaluated in a 3 month randomized, cross-over, single-masked study. During the experiments BP, heart rate, IOP and OPP were assessed 4 times per day (8–12–16–20 h). RBF was measured twice per day (8–20 h) using Color Doppler imaging in the ophthalmic (OA), central retinal (CRA), nasal (nSPCA) and temporal (tSPCA) posterior ciliary arteries. In each vessel, peak systolic velocity (PSV) and end-diastolic velocity (EDV) were assessed and vascular resistance (RI) calculated. Results: Both add-on therapies lowered IOP in a statistically significant manner from 15.7 ± 2.4 mmHg at latanoprost baseline to 14.9 ± 2.2 mmHg using dorzolamide (p < 0.001) and 14.2 ± 1.9 mmHg using timolol (p < 0.001). The IOP lowering effect was statistically significant at 20 h, favoring timolol as compared to dorzolamide (1.4 ± 2.4 vs. 0.2 ± 2.1 mmHg), (p < 0.05). Dorzolamide add-on therapy showed smaller IOP (2.0 ± 1.4), SPP (13.3 ± 7.9), systolic BP (13.5 ± 8.7) and diastolic BP (8.4 ± 5.4) fluctuations as compared to both latanoprost baseline or timolol add-on therapies. Higher difference between morning and evening BP was correlated to decreased evening CRA EDV in the timolol group (c = −0.41; p = 0.01). With increased MAP in the morning or evening hours, we found increased evening OA RI in timolol add-on group (c = 0.400, p = 0.02; c = 0.513, p = 0.002 accordingly). Higher MAP fluctuations were related to impaired RBF parameters during evening hours-decreased CRA EDV (c = −0.408; p = 0.01), increased CRA RI (c = 0.576; p < 0.001) and tSPCA RI (c = 0.356; p = 0.04) in the dorzolamide group and increased nSPCA RI (c = 0.351; p = 0.04) in the timolol add-on group. OPP fluctuations correlated with increased nSPCA RI (c = 0.453; p = 0.006) in the timolol group. OPP fluctuations were not related to IOP fluctuations in both add-on therapies (p < 0.05). Conclusions: Both dorzolamide and timolol add-on therapies lowered IOP in a statistically significant fashion dorzolamide add-on therapy showed lower fluctuations in IOP, SPP and BP. Higher variability of daytime OPP led to impaired RBF parameters in the evening.
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Affiliation(s)
- Ingrida Januleviciene
- Department of Ophthalmology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Eye Clinic of Kaunas University of Medicine, Eiveniu Str. 2, Kaunas 50009, Lithuania
- Authors to whom correspondence should be addressed; (I.J.); (A.H.); Tel.: +370-3732-6760 (I.J.); Tel.:+1-317-278-0177 (A.H.); Fax: +1-317-278-1007 (A.H.)
| | - Lina Siaudvytyte
- Department of Ophthalmology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Eye Clinic of Kaunas University of Medicine, Eiveniu Str. 2, Kaunas 50009, Lithuania
| | - Vaida Diliene
- Department of Ophthalmology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Eye Clinic of Kaunas University of Medicine, Eiveniu Str. 2, Kaunas 50009, Lithuania
| | - Ruta Barsauskaite
- Department of Ophthalmology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Eye Clinic of Kaunas University of Medicine, Eiveniu Str. 2, Kaunas 50009, Lithuania
| | - Daiva Paulaviciute-Baikstiene
- Department of Ophthalmology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Eye Clinic of Kaunas University of Medicine, Eiveniu Str. 2, Kaunas 50009, Lithuania
| | - Brent Siesky
- Glaucoma Research and Diagnostic Center, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Alon Harris
- Glaucoma Research and Diagnostic Center, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Authors to whom correspondence should be addressed; (I.J.); (A.H.); Tel.: +370-3732-6760 (I.J.); Tel.:+1-317-278-0177 (A.H.); Fax: +1-317-278-1007 (A.H.)
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Pemp B, Garhofer G, Lasta M, Schmidl D, Wolzt M, Schmetterer L. The effects of moxaverine on ocular blood flow in patients with age-related macular degeneration or primary open angle glaucoma and in healthy control subjects. Acta Ophthalmol 2012; 90:139-45. [PMID: 20456253 DOI: 10.1111/j.1755-3768.2010.01878.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE The phosphodiesterase inhibitor moxaverine has been shown to increase choroidal blood flow (BF) in young healthy subjects. The present study was performed to investigate the effect of intravenously administered moxaverine on ocular BF in patients with age-related macular degeneration (AMD), primary open angle glaucoma (POAG) and in age-matched control subjects. METHODS Twenty patients with AMD, 20 patients with POAG and 20 control subjects were included. Moxaverine 150 mg was applied intravenously over 30 min. BF was measured in the choroid and in the optic nerve head (ONH) using laser-Doppler flowmetry and in retinal vessels combining laser-Doppler velocimetry with retinal vessel analysis before and 30, 60 and 90 min after start of drug administration. BF velocities in the retrobulbar vessels were measured using colour Doppler imaging. RESULTS Moxaverine increased choroidal BF by 9 ± 22% (p = 0.012), ONH BF by 13 ± 33% (p = 0.021), mean flow velocity in the ophthalmic artery by 23 ± 34% (p < 0.001) and in the posterior ciliary arteries by 25 ± 35% (p < 0.001). Moxaverine had no significant effect on retinal vessel diameters and retinal BF. There were no significant differences in any of the measured parameters between the three groups. CONCLUSION The present study indicates that systemic administration of moxaverine increases choroidal and ONH BF in elderly patients with eye diseases associated with hypoperfusion and in age-matched controls. Further studies in patients are needed to investigate whether long-term treatment with moxaverine is clinically beneficial for patients with ocular diseases.
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Affiliation(s)
- Berthold Pemp
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria
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Supuran CT, Maresca A, Gregáň F, Remko M. Three new aromatic sulfonamide inhibitors of carbonic anhydrases I, II, IV and XII. J Enzyme Inhib Med Chem 2012; 28:289-93. [DOI: 10.3109/14756366.2011.649269] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C. T. Supuran
- Dipartimento di Chimica, Università di Firenze, Via della Lastruccia,
Sesto Fiorentino (Firenze), Italy
| | - A. Maresca
- Dipartimento di Chimica, Università di Firenze, Via della Lastruccia,
Sesto Fiorentino (Firenze), Italy
| | - F. Gregáň
- Department of Chemistry, Faculty of Natural Sciences, Matej Bell University,
Banská Bystrica, Slovakia
| | - M. Remko
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Comenius University,
Bratislava, Slovakia
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Siesky B, Harris A, Ehrlich R, Cantor L, Shoja MM, Rusia D, Hollander DA, Abrams L, Williams JM, Shoshani Y. Short-term effects of brimonidine/timolol and dorzolamide/timolol on ocular perfusion pressure and blood flow in glaucoma. Adv Ther 2012; 29:53-63. [PMID: 22246943 DOI: 10.1007/s12325-011-0092-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Indexed: 10/14/2022]
Abstract
INTRODUCTION To examine the comparative short-term effects of brimonidine/timolol and dorzolamide/timolol on ocular perfusion pressure and retrobulbar blood flow in patients with primary open angle glaucoma (OAG). METHODS In a prospective, randomized, double-blind, crossover study, intraocular pressure (IOP), blood pressure (BP), ocular perfusion pressure (OPP), and retrobulbar hemodynamics were assessed in 15 patients with OAG (mean age 68.1 years, eight women) with well controlled IOP. IOP was measured by Goldman applanation tonometery and color Doppler imaging was utilized to assess the retrobulbar blood vessels before and 1 month after treatment with topical brimonidine/timolol and dorzolamide/timolol. Statistical analysis was performed by Friedman two-way analysis of variance by ranks and post-hoc Wilcoxon signed rank test for multiple comparisons with Holm's sequential Bonferroni procedure. P values <0.05 were considered statistically significant. RESULTS The Friedman test and subsequent post-hoc analysis indicated that IOP, BP, OPP, and retrobulbar blood flow velocities did not significantly differ between brimonidine/timolol and dorzolamide/timolol after 1-month treatment administration in patients with OAG and well controlled IOP. CONCLUSION In this cohort of patients with OAG, short-term treatment with brimonidine/timolol and dorzolamide/timolol results in similar effects on OPP and retrobulbar blood flow velocities.
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Syed MF, Loucks EK. Update and optimal use of a brinzolamide-timolol fixed combination in open-angle glaucoma and ocular hypertension. Clin Ophthalmol 2011; 5:1291-6. [PMID: 21966204 PMCID: PMC3180501 DOI: 10.2147/opth.s13786] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Glaucoma encompasses a wide clinical spectrum of disease, with the common pathophysiology of progressive optic neuropathy leading to visual field loss. Elevated intraocular pressure (IOP) is a key risk factor in disease progression. Treatment is aimed at reduction of IOP to minimize continued optic nerve head damage. Pharmacologic treatment with various classes of IOP-lowering medications is generally employed before more aggressive surgical interventions. Monotherapy is generally accepted as initial therapy for glaucoma, but at least half of patients may require more than one IOP-lowering medication. One option is the fixed combination of brinzolamide 1% and timolol maleate 0.5%, which is commercially available in some countries as Azarga® for treatment of glaucoma not adequately responsive to monotherapy. These agents may also be used in an unfixed fashion, but fixed combination therapy is generally more convenient for patients, which may result in improved compliance, a reduction of the “washout effect” from instilling multiple drops, and a potential reduction in the side effects related to multiple doses of preservatives.
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Affiliation(s)
- Misha F Syed
- Department of Ophthalmology and Visual Sciences, The University of Texas Medical Branch, Galveston, TX, USA
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Shoshani YZ, Harris A, Rusia D, Spaeth GL, Siesky B, Pollack A, Wirostko B. Contrast sensitivity, ocular blood flow and their potential role in assessing ischaemic retinal disease. Acta Ophthalmol 2011; 89:e382-95. [PMID: 21518304 DOI: 10.1111/j.1755-3768.2011.02130.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To examine the definition, evaluation methodology, association to ocular blood flow and potential clinical value of contrast sensitivity (CS) testing in clinical and research settings, focusing in patients with ischemic retinal disease. METHODS A review of the medical literature focusing on CS and ocular blood flow in ischemic retinal disease. RESULTS CS may be more sensitive than other methods at detecting subtle defects or improvements in primarily central retinal ganglion cell function early on in a disease process. CS testing attempts to provide spatial detection differences which are not directly assessed with standard visual acuity chart testing. Analyzing all studies that have assessed both CS change and ocular blood flow, it is apparent that both choroidal circulation and retinal circulation may have an important role in influencing CS. CONCLUSION The concept that CS is directly influenced by ocular blood flow is supported by reviewing the studies involving both. Although the studies in the literature have not established a direct cause and effect relationship per se, the literature review makes it logical to assume that changes in retinal and choroidal blood flow influence CS. This raises the possibility that a subjective visual characteristic, specifically CS, may be able to be evaluated more objectively by studying blood flow. It appears appropriate to study the relationship between blood flow and CS more extensively to develop improved ways of measuring various aspects of blood flow to the eye and to best quantify early changes in visual function.
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Affiliation(s)
- Yochai Z Shoshani
- Department of Ophthalmology, Indiana School of Medicine, Indianapolis, Indiana 46202, USA
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Evaluation of hemodynamic parameters as predictors of glaucoma progression. J Ophthalmol 2011; 2011:164320. [PMID: 21577269 PMCID: PMC3090719 DOI: 10.1155/2011/164320] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Revised: 08/17/2010] [Accepted: 02/15/2011] [Indexed: 11/18/2022] Open
Abstract
Purpose. To evaluate hemodynamic parameters as possible predictors for glaucoma progression. Methods. An 18-month randomized double-masked cohort study including 30 open-angle glaucoma patients receiving fixed-combination treatment with Dorzolamide/Timolol (DTFC) or Latanoprost/Timolol (LTFC) (n = 15 per group) was performed. Intraocular pressure (IOP), arterial blood pressure (BP), ocular and diastolic perfusion pressures (OPP, DPP), color Doppler imaging, pulsatile ocular blood flow analysis, scanning laser polarimetry, and Humphrey visual field evaluations were included. Results. Both treatments showed statistically similar IOP reduction. Six patients in DTFC and 7 in LTFC group met glaucoma progression criteria. DTFC group had higher OPP, DPP, and lower vascular resistivity indices as compared to the LTFC. Progressing patients had higher nerve fiber index, lower systolic BP, OPP, DPP, higher ophthalmic and central retinal artery vascular resistance, and lower pulse volume (P < .05; t-test). Conclusions. Structural changes consistent with glaucoma progression correlate with non-IOP-dependent risk factors.
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Stankiewicz A, Misiuk-Hojło M, Grabska-Liberek I, Romanowska-Dixon B, Wierzbowska J, Wasyluk J, Mulak M, Szuścik I, Sierdziński J, Ehrlich R, Siesky B, Harris A. Intraocular pressure and ocular hemodynamics in patients with primary open-angle glaucoma treated with the combination of morning dosing of bimatoprost and dorzolamide hydrochloride. Acta Ophthalmol 2011; 89:e57-63. [PMID: 21223530 DOI: 10.1111/j.1755-3768.2010.02036.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS This prospective, multicenter, single-masked study evaluated the additive effect of dorzolamide hydrochloride 2% on the diurnal intraocular pressure (IOP) curve and retinal and retrobulbar hemodynamics in patients with primary open-angle glaucoma (POAG) treated with morning-dosed bimatoprost 0.03%. METHODS Eighty-nine patients (aged, 60.7 ± 11.8 years, range 33-80; 68 women) with POAG received bimatoprost dosed once in the morning for 1 month, after which dorzolamide was added twice daily for 2 months. IOP (Goldmann) and arterial blood pressure (BP) and diurnal ocular perfusion pressures (OPP) were measured every 2 hr for 24 hr. Heidelberg retina flowmetry of the retinal microcirculation was recorded four times daily in 64 patients and colour Doppler imaging of the ophthalmic and central retinal arteries was recorded five times daily in 25 patients. All measurements were taken after the two phases of treatment and compared using anova analysis with Bonferroni adjustment. RESULTS Mean baseline IOP was 16.5 ± 3.4 mmHg. Mean diurnal IOP with dorzolamide adjunctive therapy (12.9 ± 2.1 mmHg) was significantly lower compared to mean IOP with bimatoprost monotherapy (13.6 ± 2.2 mmHg) (p = 0.03). Adjunctive dorzolamide therapy significantly decreased vascular resistance in the ophthalmic artery (p = 0.02). Mean diastolic BP and OPP were significantly lower after adjunctive therapy. There were no changes in retinal microcirculation between the two phases of treatment. CONCLUSIONS Adjunctive dorzolamide therapy to morning-dosed bimatoprost 0.03% reduced diurnal IOP and vascular resistance in the ophthalmic artery but did not alter retinal circulation in this group of patients with POAG.
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