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Zhong YL, Liu H, Huang X. Altered dynamic large-scale brain networks and combined machine learning in primary angle-closure glaucoma. Neuroscience 2024; 558:11-21. [PMID: 39154845 DOI: 10.1016/j.neuroscience.2024.08.013] [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: 05/12/2024] [Revised: 07/16/2024] [Accepted: 08/08/2024] [Indexed: 08/20/2024]
Abstract
Primary angle-closure glaucoma (PACG) is a severe and irreversible blinding eye disease characterized by progressive retinal ganglion cell death. However, prior research has predominantly focused on static brain activity changes, neglecting the exploration of how PACG impacts the dynamic characteristics of functional brain networks. This study enrolled forty-four patients diagnosed with PACG and forty-four age, gender, and education level-matched healthy controls (HCs). The study employed Independent Component Analysis (ICA) techniques to extract resting-state networks (RSNs) from resting-state functional magnetic resonance imaging (rs-fMRI) data. Subsequently, the RSNs was utilized as the basis for examining and comparing the functional connectivity variations within and between the two groups of resting-state networks. To further explore, a combination of sliding time window and k-means cluster analyses identified seven stable and repetitive dynamic functional network connectivity (dFNC) states. This approach facilitated the comparison of dynamic functional network connectivity and temporal metrics between PACG patients and HCs for each state. Subsequently, a support vector machine (SVM) model leveraging functional connectivity (FC) and FNC was applied to differentiate PACG patients from HCs. Our study underscores the presence of modified functional connectivity within large-scale brain networks and abnormalities in dynamic temporal metrics among PACG patients. By elucidating the impact of changes in large-scale brain networks on disease evolution, researchers may enhance the development of targeted therapies and interventions to preserve vision and cognitive function in PACG.
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Affiliation(s)
- Yu-Lin Zhong
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi 330006, China
| | - Hao Liu
- School of Ophthalmology and Optometry, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China
| | - Xin Huang
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi 330006, China.
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2
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Gao Y, Wang R, Mou K, Zhang Y, Xu H, Liu Y, Yang F, Gao Y, Wang X, Bao L, Zhang J, Chen Q, Yin H, Zhang M. Association of outer retinal and choroidal alterations with neuroimaging and clinical features in posterior cortical atrophy. Alzheimers Res Ther 2024; 16:187. [PMID: 39160571 PMCID: PMC11331764 DOI: 10.1186/s13195-024-01551-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/08/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND Posterior cortical atrophy (PCA) is a rare condition characterized by early-onset and progressive visual impairment. Individuals with PCA have relatively early-onset and progressive dementia, posing certain needs for early detection. Hence, this study aimed to investigate the association of alterations in outer retinal and choroidal structure and microvasculature with PCA neuroimaging and clinical features and the possible effects of apolipoprotein E(APOE) ε4 allele on outer retinal and choroidal alterations in participants with PCA, to detect potential ocular biomarkers for PCA screening. METHODS This cross-sectional study included PCA and age- and sex-matched healthy control participants from June 2022 to December 2023. All participants with PCA completed a comprehensive neurological evaluation. All participants were recorded baseline information and underwent an ophthalmic evaluation. Quantitative analyses were performed using swept-source optical coherence tomography (SS-OCT) and angiography (SS-OCTA). Adaptive optics scanning laser ophthalmoscopy (AO-SLO) was performed in some patients. In participants with PCA, the influence of APOE ε4 on outer retinal and choroidal alterations and the correlation of outer retinal and choroidal alterations with PCA neuroimaging and clinical features in participants with PCA were investigated. RESULTS A total of 28 participants (53 eyes) with PCA and 56 healthy control participants (112 eyes) were included in the current study. Compared with healthy control participants, participants with PCA had significantly reduced outer retinal thickness (ORT) (p < 0.001), choriocapillaris vessel density (VD) (p = 0.007), choroidal vascular index (CVI) (p = 0.005) and choroidal vascular volume (CVV) (p = 0.003). In participants with PCA, APOE ε4 carriers showed thinner ORT (p = 0.009), and increased choriocapillaris VD (p = 0.004) and CVI (p = 0.004). The PCA neuroimaging features were positively associated with the ORT, CVI and CVV. Furthermore, differential correlations were observed of PCA clinical features with the CRT, CVV and CVI. CONCLUSIONS Our findings highlighted the association of outer retinal and choroidal alterations with PCA neuroimaging and clinical features in participants with PCA. Noninvasive SS-OCT and SS-OCTA can provide potential biomarkers for the diagnosis and management of PCA, improving awareness of PCA syndrome among ophthalmologists, neurologists, and primary care providers.
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Affiliation(s)
- Yuzhu Gao
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Ophthalmology and Research Laboratory of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ruihan Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Kefan Mou
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yifan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Hanyue Xu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yilin Liu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Feng Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yunxia Gao
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiaoyue Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Li Bao
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jie Zhang
- Advanced Ophthalmology Laboratory (AOL), Robotrak Technologies, Nanjing, China
| | - Qin Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Hongbo Yin
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Ming Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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Reynolds GL, Plant G, Epps S, Sebastian R, Bennetto L. Glaucoma: what the neurologist needs to know. Pract Neurol 2024:pn-2023-003905. [PMID: 38906698 DOI: 10.1136/pn-2023-003905] [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: 05/27/2024] [Indexed: 06/23/2024]
Abstract
Glaucoma is a progressive optic neuropathy resulting from pathological changes at the optic disc due to elevated intraocular pressure. Its diagnosis, treatment and follow-up are almost entirely conducted in ophthalmology clinics, with screening conducted by community optometrists. Despite this, neurologists may encounter glaucoma in both its acute presentation (as angle closure, presenting as acute headache) and its chronic forms (often as optic neuropathy of unknown cause). An awareness of the underlying pathological process, and the key distinguishing signs and symptoms, will allow neurologists to identify the glaucomatous process rapidly. Timely referral is essential as glaucoma invariably results in progressive visual loss without treatment. This review therefore condenses the wide field of glaucoma into a practical summary, aimed at practitioners with limited clinical experience of this ophthalmic condition.
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Affiliation(s)
- Gavin L Reynolds
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Eye Hospital, Bristol, UK
| | - Gordon Plant
- National Hospital for Neurology and Neurosurgery, London, UK
| | - Simon Epps
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Eye Hospital, Bristol, UK
| | - Rani Sebastian
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Eye Hospital, Bristol, UK
| | - Luke Bennetto
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Eye Hospital, Bristol, UK
- Department of Neuroscience, North Bristol NHS Trust Southmead Hospital, Bristol, UK
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4
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Lenoble Q, Lossouarn A, Rouland JF, Boucart M. Reduced peripheral vision in glaucoma and boundary extension. Clin Exp Optom 2024; 107:234-241. [PMID: 35946410 DOI: 10.1080/08164622.2022.2107892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 10/15/2022] Open
Abstract
CLINICAL RELEVANCE Peripheral vision is known to be critical for spatial navigation. However, visual cognition, which impacts peripheral vision, has not been studied extensively in glaucoma. BACKGROUND Spatial memory was assessed with a known to induce a robust memory distortion called "boundary extension" in which participants erroneously remember seeing more of a scene than was present in the sensory input. METHODS Fifteen patients with glaucoma and 15 age-matched normally sighted controls participated in the experiment. Participants were shown 10 photographs of natural scenes randomly displayed for 0.5 s or 10 s. Following each scene, the participant was asked to draw it from memory. RESULTS On average, boundary extension was larger, by 12%, for patients than for controls, but the difference was significant for 4 photographs. Patients tended to add more space between the object and the edges than there was between the objects and the border of the photograph. A control experiment in which participants were asked to draw isolated objects without scene context resulted in a significant reduction of the memory distortion in both groups, but patients still drew the objects smaller than controls. CONCLUSION The reduced field of view in glaucoma has an impact on spatial memory for scenes and on perception of size.
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Affiliation(s)
- Quentin Lenoble
- Lille Neuroscience & Cognition, Université Lille, Lille, France
| | - Adrien Lossouarn
- Service d'ophtalmologie, Centre Hospitalier Universitaire de Lille, Lille, France
| | | | - Muriel Boucart
- Lille Neuroscience & Cognition, Université Lille, Lille, France
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Jing L, Yan T, Zhou J, Xie Y, Qiu J, Wang Y, Lu W. Elevated Intraocular Pressure Moderated Brain Morphometry in High-tension Glaucoma: a Structural MRI Study. Clin Neuroradiol 2024; 34:173-179. [PMID: 37798542 DOI: 10.1007/s00062-023-01351-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/19/2023] [Indexed: 10/07/2023]
Abstract
High-tension glaucoma (HTG) is one of the most common forms of primary open angle glaucoma. The purpose of this study was to assess in HTG brain, whether the elevated intraocular pressure (IOP) had an effect on the brain morphological alterations via structural MRI. We acquired T1WI structural MRI images from 56 subjects including 36 HTG patients and 20 healthy controls. We tested whether the brain morphometry was associated with the mean IOP in HTG patients. Moreover, we conducted moderation analysis to assess the interactions between subject type (HTG - healthy controls) and IOP. In HTG group, cortical thickness was negatively correlated with the mean IOP in the left rostral middle frontal gyrus, left pars triangularis, right precentral gyrus, left postcentral gyrus, left superior temporal gyrus (p < 0.05, FDR corrected). Four of the five regions negatively correlated with mean IOP showed reduced cortical thickness in HTG group compared with healthy controls, which were the left rostral middle frontal gyrus, left pars triangularis, left postcentral gyrus and left superior temporal gyrus (p < 0.05, FDR corrected). IOP moderated the interaction between subject type and cortical thickness of the left rostral middle frontal gyrus (p = 0.0017), left pars triangularis (p = 0.0011), left postcentral gyrus (p = 0.0040) and left superior temporal gyrus (p = 0.0066). Elevated IOP may result brain morphometry alterations such as cortical thinning. The relationship between IOP and brain morphometry underlines the importance of the IOP regulation for HTG patients.
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Affiliation(s)
- Liang Jing
- Center of Radiation Therapy, Taian Tumor Hospital, Taian, China
| | - Tingqin Yan
- Department of Ophthalmology, Taian City Central Hospital, Taian, China
| | - Jian Zhou
- Department of Radiology, Taian City Central Hospital, Taian, China
| | - Yuanzhong Xie
- Department of Radiology, Taian City Central Hospital, Taian, China
| | - Jianfeng Qiu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Yi Wang
- Department of Ophthalmology, The Second Affiliated hospital of Shandong First Medical University, Taian, China.
| | - Weizhao Lu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China.
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China.
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6
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Blanckaert E, Rouland JF, Davost T, Warniez A, Boucart M. Higher susceptibility to central crowding in glaucoma. Clin Exp Optom 2024; 107:227-233. [PMID: 36183782 DOI: 10.1080/08164622.2022.2124848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/09/2022] [Accepted: 09/06/2022] [Indexed: 10/07/2022] Open
Abstract
CLINICAL RELEVANCE Crowding limits many daily life activities, such as reading and the visual search for objects in cluttered environments. Excessive sensitivity to crowding, especially in central vision, may amplify the difficulties of patients with ocular pathologies. It is thus important to investigate what limits visual activities and how to improve it. BACKGROUND Numerous studies have reported reduced contrast sensitivity in central vision in patients with glaucoma. However, deficits have also been observed for letter recognition at high contrast, suggesting that contrast alone cannot completely account for impaired central perception. METHOD Seventeen patients and fifteen age-matched controls were randomly presented with letters in central or parafoveal vision at 5° eccentricity for 200 ms. They were asked to decide whether the central T was upright or inverted. The T was either presented in isolation (uncrowded) or flanked by two Hs (crowded) at various spacings. Contrast was manipulated: 60% and 5%. RESULTS Compared to controls, patients exhibited a significant effect of crowding in central vision, with higher accuracy for the isolated T than for HTH only at low contrast. In parafoveal vision, an effect of crowding was also observed only in patients. The spacing to escape crowding varied as a function of contrast. Larger spacing was required at low contrast than at high contrast. Susceptibility to crowding was related to central visual field defect for central presentations and to contrast sensitivity for parafoveal presentations, only at low contrast. Controls were at ceiling level both for central and parafoveal presentations. CONCLUSION Crowding limits visual perception, impeding reading and object recognition in cluttered environments. Visual field defects and lower contrast sensitivity in glaucoma can increase susceptibility to central and parafoveal crowding, the deleterious effect of which can be improved by manipulating contrast and spacing between elements.
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Affiliation(s)
- Edouard Blanckaert
- Department of Ophthalmology, Lille University Hospital, Hôpital Huriez, Lille, France
| | - Jean François Rouland
- Department of Ophthalmology, Lille University Hospital, Hôpital Huriez, Lille, France
- Lille Neurosciences and Cognition, University of Lille, Lille, France
| | - Theophile Davost
- Department of Ophthalmology, Lille University Hospital, Hôpital Huriez, Lille, France
| | - Aude Warniez
- Lille Neurosciences and Cognition, University of Lille, Lille, France
| | - Muriel Boucart
- Lille Neurosciences and Cognition, University of Lille, Lille, France
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7
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Tang QY, Huang BL, Huang X. Altered functional connectivity between the default mode network in primary angle-closure glaucoma patients. Neuroreport 2024; 35:129-135. [PMID: 38251458 DOI: 10.1097/wnr.0000000000001995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Previous studies have recognized glaucoma as a neurodegenerative disease that causes extensive brain damage and is closely associated with cognitive function. In this study, we employed functional MRI to examine the intrinsic functional connectivity patterns of the default mode network (DMN) in patients diagnosed with primary angle-closure glaucoma (PACG), exploring its association with cognitive dysfunction. A total of 34 patients diagnosed with PACG and 34 healthy controls (HC), who were matched in terms of sex, age, and education, were included in the control group. The posterior cingulate cortex (PCC) was selected as the region of interest to examine functional connectivity alterations. Compared with the HC group, functional connectivity was attenuated in left anterior cingulum cortex and left paracentral lobule between with PCC in the PACG group, the results are statistically significant. Our study revealed that patients with PACG exhibit weakened functional connectivity within the DMN. This finding suggests the presence of a neurological mechanism that is associated with both visual dysfunction and cognitive impairments in PACG patients. Furthermore, our study provides neuroimaging evidence that can aid in the exploration of spontaneous neurological alterations and facilitate a deeper investigation of alterations in the visual conduction pathways of PACG patients.
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Affiliation(s)
- Qiu-Yu Tang
- College of Clinical Medicine, Jiangxi University of Chinese Medicine
| | - Bing-Lin Huang
- College of Clinical Medicine, Jiangxi University of Chinese Medicine
| | - Xin Huang
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
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8
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Jauregui A, Neag EJ, Almobayed A, Lens A, Bhattacharya SK. Optimized Lipidomics Extraction of Sphingosine and Sphinganine from Optic Nerve for Signaling Studies. Methods Mol Biol 2024; 2816:25-33. [PMID: 38977585 DOI: 10.1007/978-1-0716-3902-3_3] [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] [Indexed: 07/10/2024]
Abstract
Interconvertible sphingolipid metabolites represent germane constituents of eukaryotic membranes and are vital in the regulation of cellular homeostasis, proliferation, survival, and induction of autophagy. This protocol describes a step-by-step method for extractions of sphingosine and sphinganine from mammalian tissue samples, particularly from the murine optic nerve. These lipids are partitioned into a binary mixture of chloroform and methanol in a modified Bligh and Dyer method. This is followed with reverse phase ultrahigh-performance liquid chromatography fractionation with a C18+ column and subsequent tandem mass spectrometry (UHPLC-MS-MS) analysis of the biological abundance. These free sphingoid bases dissociate to form structurally distinctive carbocation product ions that can be confirmed with annotations of lipidomic databases or in-house fragmentation software.
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Affiliation(s)
- Alexa Jauregui
- Bascom Palmer Eye Institute, Miller School of Medicine at University of Miami, Miami, FL, USA
- Miami Integrative Metabolomics Research Center, Miami, FL, USA
| | - Emily J Neag
- Bascom Palmer Eye Institute, Miller School of Medicine at University of Miami, Miami, FL, USA
- Miami Integrative Metabolomics Research Center, Miami, FL, USA
- Michigan State University College of Osteopathic Medicine, East Lansing, MI, USA
| | - Amr Almobayed
- Bascom Palmer Eye Institute, Miller School of Medicine at University of Miami, Miami, FL, USA
- Miami Integrative Metabolomics Research Center, Miami, FL, USA
| | - Alexandra Lens
- Bascom Palmer Eye Institute, Miller School of Medicine at University of Miami, Miami, FL, USA
- Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Sanjoy K Bhattacharya
- Bascom Palmer Eye Institute, Miller School of Medicine at University of Miami, Miami, FL, USA.
- Miami Integrative Metabolomics Research Center, Miami, FL, USA.
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9
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Zueva MV, Neroeva NV, Zhuravleva AN, Bogolepova AN, Kotelin VV, Fadeev DV, Tsapenko IV. Fractal Phototherapy in Maximizing Retina and Brain Plasticity. ADVANCES IN NEUROBIOLOGY 2024; 36:585-637. [PMID: 38468055 DOI: 10.1007/978-3-031-47606-8_31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
The neuroplasticity potential is reduced with aging and impairs during neurodegenerative diseases and brain and visual system injuries. This limits the brain's capacity to repair the structure and dynamics of its activity after lesions. Maximization of neuroplasticity is necessary to provide the maximal CNS response to therapeutic intervention and adaptive reorganization of neuronal networks in patients with degenerative pathology and traumatic injury to restore the functional activity of the brain and retina.Considering the fractal geometry and dynamics of the healthy brain and the loss of fractality in neurodegenerative pathology, we suggest that the application of self-similar visual signals with a fractal temporal structure in the stimulation therapy can reactivate the adaptive neuroplasticity and enhance the effectiveness of neurorehabilitation. This proposition was tested in the recent studies. Patients with glaucoma had a statistically significant positive effect of fractal photic therapy on light sensitivity and the perimetric MD index, which shows that methods of fractal stimulation can be a novel nonpharmacological approach to neuroprotective therapy and neurorehabilitation. In healthy rabbits, it was demonstrated that a long-term course of photostimulation with fractal signals does not harm the electroretinogram (ERG) and retina structure. Rabbits with modeled retinal atrophy showed better dynamics of the ERG restoration during daily stimulation therapy for a week in comparison with the controls. Positive changes in the retinal function can indirectly suggest the activation of its adaptive plasticity and the high potential of stimulation therapy with fractal visual stimuli in a nonpharmacological neurorehabilitation, which requires further study.
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Affiliation(s)
- Marina V Zueva
- Department of Clinical Physiology of Vision, Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - Natalia V Neroeva
- Department of Pathology of the Retina and Optic Nerve, Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - Anastasia N Zhuravleva
- Department of Glaucoma, Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - Anna N Bogolepova
- Department of neurology, neurosurgery and medical genetics, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Vladislav V Kotelin
- Department of Clinical Physiology of Vision, Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - Denis V Fadeev
- Scientific Experimental Center Department, Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - Irina V Tsapenko
- Department of Clinical Physiology of Vision, Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
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10
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Munuera I, Aragon-Navas A, Villacampa P, Gonzalez-Cela MA, Subías M, Pablo LE, Garcia-Feijoo J, Herrero-Vanrell R, Garcia-Martin E, Bravo-Osuna I, Rodrigo MJ. Chronic Glaucoma Induced in Rats by a Single Injection of Fibronectin-Loaded PLGA Microspheres: IOP-Dependent and IOP-Independent Neurodegeneration. Int J Mol Sci 2023; 25:9. [PMID: 38203183 PMCID: PMC10779403 DOI: 10.3390/ijms25010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 11/30/2023] [Accepted: 12/10/2023] [Indexed: 01/12/2024] Open
Abstract
To evaluate a new animal model of chronic glaucoma induced using a single injection of fibronectin-loaded biodegradable PLGA microspheres (Ms) to test prolonged therapies. 30 rats received a single injection of fibronectin-PLGA-Ms suspension (MsF) in the right eye, 10 received non-loaded PLGA-Ms suspension (Control), and 17 were non-injected (Healthy). Follow-up was performed (24 weeks), evaluating intraocular pressure (IOP), optical coherence tomography (OCT), histology and electroretinography. The right eyes underwent a progressive increase in IOP, but only induced cohorts reached hypertensive values. The three cohorts presented a progressive decrease in ganglion cell layer (GCL) thickness, corroborating physiological age-related loss of ganglion cells. Injected cohorts (MsF > Control) presented greater final GCL thickness. Histological exams explain this paradox: the MsF cohort showed lower ganglion cell counts but higher astrogliosis and immune response. A sequential trend of functional damage was recorded using scotopic electroretinography (MsF > Control > Healthy). It seems to be a function-structure correlation: in significant astrogliosis, early functional damage can be detected by electroretinography, and structural damage can be detected by histological exams but not by OCT. Males presented higher IOP and retinal and GCL thicknesses and lower electroretinography. A minimally invasive chronic glaucoma model was induced by a single injection of biodegradable Ms.
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Affiliation(s)
- Ines Munuera
- Department of Ophthalmology, Miguel Servet University Hospital, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain; (I.M.); (M.S.); (L.E.P.); (M.J.R.)
| | - Alba Aragon-Navas
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (A.A.-N.); (M.A.G.-C.); (R.H.-V.); (I.B.-O.)
| | - Pilar Villacampa
- Department of Physiological Sciences, Faculty of Medicine and Health Sciences, University of Barcelona and Bellvitge Biomedical Research Institute (IDIBELL), Feixa Llarga s/n, 08907 l’Hospitalet de Llobregat, Spain;
| | - Miriam A. Gonzalez-Cela
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (A.A.-N.); (M.A.G.-C.); (R.H.-V.); (I.B.-O.)
| | - Manuel Subías
- Department of Ophthalmology, Miguel Servet University Hospital, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain; (I.M.); (M.S.); (L.E.P.); (M.J.R.)
- Biotech Vision SLP (Spin-Off Company), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain
| | - Luis E. Pablo
- Department of Ophthalmology, Miguel Servet University Hospital, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain; (I.M.); (M.S.); (L.E.P.); (M.J.R.)
- Biotech Vision SLP (Spin-Off Company), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain
- Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, 28040 Madrid, Spain;
| | - Julian Garcia-Feijoo
- Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, 28040 Madrid, Spain;
- Department of Ophthalmology, San Carlos Clinical Hospital, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), 28040 Madrid, Spain
| | - Rocio Herrero-Vanrell
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (A.A.-N.); (M.A.G.-C.); (R.H.-V.); (I.B.-O.)
- Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, 28040 Madrid, Spain;
| | - Elena Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain; (I.M.); (M.S.); (L.E.P.); (M.J.R.)
- Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, 28040 Madrid, Spain;
| | - Irene Bravo-Osuna
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (A.A.-N.); (M.A.G.-C.); (R.H.-V.); (I.B.-O.)
- Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, 28040 Madrid, Spain;
| | - Maria J. Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain; (I.M.); (M.S.); (L.E.P.); (M.J.R.)
- Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, 28040 Madrid, Spain;
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11
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Boccaccini A, Cavaterra D, Carnevale C, Tanga L, Marini S, Bocedi A, Lacal PM, Manni G, Graziani G, Sbardella D, Tundo GR. Novel frontiers in neuroprotective therapies in glaucoma: Molecular and clinical aspects. Mol Aspects Med 2023; 94:101225. [PMID: 38000334 DOI: 10.1016/j.mam.2023.101225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023]
Abstract
In the last years, neuroprotective therapies have attracted the researcher interests as modern and challenging approach for the treatment of neurodegenerative diseases, aimed at protecting the nervous system from injuries. Glaucoma is a neurodegenerative disease characterized by progressive excavation of the optic nerve head, retinal axonal injury and corresponding vision loss that affects millions of people on a global scale. The molecular basis of the pathology is largely uncharacterized yet, and the therapeutic approaches available do not change the natural course of the disease. Therefore, in accordance with the therapeutic regimens proposed for other neurodegenerative diseases, a modern strategy to treat glaucoma includes prescription of drugs with neuroprotective activities. With respect to this, several preclinical and clinical investigations on a plethora of different drugs are currently ongoing. In this review, first, the conceptualization of the rationale for the adoption of neuroprotective strategies for retina is summarized. Second, the molecular aspects highlighting glaucoma as a neurodegenerative disease are reported. In conclusion, the molecular and pharmacological properties of most promising direct neuroprotective drugs used to delay glaucoma progression are examined, including: neurotrophic factors, NMDA receptor antagonists, the α2-adrenergic agonist, brimonidine, calcium channel blockers, antioxidant agents, nicotinamide and statins.
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Affiliation(s)
| | - Dario Cavaterra
- Dipartimento di Scienze e Tecnologie Chimiche, Università di Tor Vergata, Via Della Ricerca Scientifica 1, 00133, Rome, Italy
| | | | | | - Stefano Marini
- Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università di Roma Tor Vergata, Via Montpellier n. 1, 00133, Roma, Italy
| | - Alessio Bocedi
- Dipartimento di Scienze e Tecnologie Chimiche, Università di Tor Vergata, Via Della Ricerca Scientifica 1, 00133, Rome, Italy
| | - Pedro M Lacal
- Laboratory of Molecular Oncology, IDI-IRCCS, Via Monti di Creta 104, 00167, Rome, Italy
| | - Gianluca Manni
- IRCCS - Fondazione Bietti, Rome, Italy; Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università di Roma Tor Vergata, Via Montpellier n. 1, 00133, Roma, Italy
| | - Grazia Graziani
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
| | | | - Grazia Raffaella Tundo
- Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università di Roma Tor Vergata, Via Montpellier n. 1, 00133, Roma, Italy.
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12
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Garric C, Wamain Y, Rouland JF, Lenoble Q. Glaucoma-associated abnormalities in cortical activity during a visuocognitive task. Clin Neurophysiol 2023; 156:47-56. [PMID: 37866076 DOI: 10.1016/j.clinph.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/27/2023] [Accepted: 09/04/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE To investigate neurophysiological dynamics during a visuocognitive task in glaucoma patients vs. healthy controls. METHODS Fifteen patients with early-stage primary open-angle glaucoma (POAG) and fifteen age-matched healthy participants underwent a "go/no-go" task, monitored with EEG. Participants had to semantically categorize visual objects in central vision, with animal or furniture as targets according to the experimental block. RESULTS Early visual processing was delayed by 50 ms in patients with POAG compared to controls. The patients displayed a smaller difference between animal and furniture categorization during higher-level cognitive processing (at 400-600 ms). Regarding behavioral data, the groups differed in accuracy performance and decision criterion. As opposed to the control group, patients did not display facilitation and a higher accuracy rate for animal stimuli. However, patients maintained a consistent decision criterion throughout the experiment, whereas controls displayed a shift towards worse decision criteria in furniture trials, with higher error rate. CONCLUSIONS The comparative analysis of behavioral and neurophysiological data revealed in POAG patients a delay in early visual processing, and potential high-level cognitive compensation during late, task-dependent activations. SIGNIFICANCE To our knowledge, our findings provide the first evidence of modification in cognitive brain dynamics associated with POAG.
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Affiliation(s)
- Clémentine Garric
- Univ. Lille, INSERM, CHU Lille, U1172 - LilNCog - Lille Neuroscience and Cognition, F-59000 Lille, France.
| | - Yannick Wamain
- Univ. Lille, CNRS, CHU Lille, UMR 9193, SCALab, Sciences Cognitives et Sciences Affectives, F-59000 Lille, France.
| | - Jean-François Rouland
- Ophthalmology Department, Claude Huriez Hospital, University of Lille, F-59000 Lille, France.
| | - Quentin Lenoble
- Univ. Lille, INSERM, CHU Lille, U1172 - LilNCog - Lille Neuroscience and Cognition, F-59000 Lille, France.
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13
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Amato R, Canovai A, Melecchi A, Maci S, Quintela F, Fonseca BA, Cammalleri M, Dal Monte M. Efficacy of a Spearmint (Mentha spicata L.) Extract as Nutritional Support in a Rat Model of Hypertensive Glaucoma. Transl Vis Sci Technol 2023; 12:6. [PMID: 37917085 PMCID: PMC10627303 DOI: 10.1167/tvst.12.11.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023] Open
Abstract
Purpose Glaucoma is an eye-brain axis disorder characterized by loss of retinal ganglion cells (RGCs). Although the role of intraocular pressure (IOP) elevation in glaucoma has been established, the reduction of oxidative stress and inflammation has emerged as a promising target for neuronal tissue-supporting glaucoma management. Therefore, we evaluated the effect of a proprietary spearmint extract (SPE) on RGC density, activity, and neuronal health markers in a rat model of hypertensive glaucoma. Methods Animals were divided in four groups: untreated healthy control and three glaucomatous groups receiving orally administered vehicle, SPE-low dose, or SPE-high dose for 28 days. Ocular hypertension was induced through intracameral injection of methylcellulose at day 15. At day 29, rats underwent electroretinogram (ERG) recordings, and retinas were analyzed for RGC density and markers of neural trophism, oxidative stress, and inflammation. Results SPE exerted dose-dependent response benefits on all markers except for IOP elevation. SPE significantly improved RGC-related ERG responses, cell density, neurotrophins, oxidative stress, and inflammation markers. Also, in SPE-high rats, most of the parameters were not statistically different from those of healthy controls. Conclusions SPE, a plant-based, polyphenolic extract, could be an effective nutritional support for neuronal tissues. Translational Relevance These results suggest that SPE not only may be a complementary approach in support to hypotensive treatments for the management of glaucoma but may also serve as nutritional support in other ocular conditions where antioxidant, anti-inflammatory, and neuroprotective mechanism are often disrupted.
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Affiliation(s)
- Rosario Amato
- Department of Biology, University of Pisa, Pisa, Italy
| | | | | | - Samanta Maci
- Kemin Human Nutrition and Health, a Division of Kemin Foods L.C., Lisbon, Portugal
| | - Filipa Quintela
- Kemin Human Nutrition and Health, a Division of Kemin Foods L.C., Lisbon, Portugal
| | | | - Maurizio Cammalleri
- Department of Biology, University of Pisa, Pisa, Italy
- Interdepartmental Research Center Nutrafood “Nutraceuticals and Food for Health,” University of Pisa, Pisa, Italy
| | - Massimo Dal Monte
- Department of Biology, University of Pisa, Pisa, Italy
- Interdepartmental Research Center Nutrafood “Nutraceuticals and Food for Health,” University of Pisa, Pisa, Italy
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14
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Vasconcelos CFM, Ribas VT, Petrs-Silva H. Shared Molecular Pathways in Glaucoma and Other Neurodegenerative Diseases: Insights from RNA-Seq Analysis and miRNA Regulation for Promising Therapeutic Avenues. Cells 2023; 12:2155. [PMID: 37681887 PMCID: PMC10486375 DOI: 10.3390/cells12172155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023] Open
Abstract
Advances in RNA-sequencing technologies have led to the identification of molecular biomarkers for several diseases, including neurodegenerative diseases, such as Alzheimer's, Parkinson's, Huntington's diseases and Amyotrophic Lateral Sclerosis. Despite the nature of glaucoma as a neurodegenerative disorder with several similarities with the other above-mentioned diseases, transcriptional data about this disease are still scarce. microRNAs are small molecules (~17-25 nucleotides) that have been found to be specifically expressed in the CNS as major components of the system regulating the development signatures of neurodegenerative diseases and the homeostasis of the brain. In this review, we sought to identify similarities between the functional mechanisms and the activated pathways of the most common neurodegenerative diseases, as well as to discuss how those mechanisms are regulated by miRNAs, using RNA-Seq as an approach to compare them. We also discuss therapeutically suitable applications for these disease hallmarks in clinical future studies.
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Affiliation(s)
- Carlos Franciney Moreira Vasconcelos
- University of Medicine of Göttingen, 37075 Göttingen, Germany
- Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
| | - Vinicius Toledo Ribas
- Institute of Biological Sciences, Universidade Federal de Minas Gerais (ICB/UFMG), Belo Horizonte 31270-901, Brazil;
| | - Hilda Petrs-Silva
- Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
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15
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Maiello G, Kwon M. Despite Impaired Binocular Function, Binocular Disparity Integration Across the Visual Field Is Spared in Normal Aging and Glaucoma. Invest Ophthalmol Vis Sci 2023; 64:2. [PMID: 37129906 PMCID: PMC10158989 DOI: 10.1167/iovs.64.5.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/07/2023] [Indexed: 05/03/2023] Open
Abstract
Purpose To examine how binocularly asymmetric glaucomatous visual field damage affects binocular disparity processing across the visual field. Methods We recruited 18 patients with primary open-angle glaucoma, 16 age-matched controls, and 13 young controls. Participants underwent standard clinical assessments of binocular visual acuity, binocular contrast sensitivity, stereoacuity, and perimetry. We employed a previously validated psychophysical procedure to measure how sensitivity to binocular disparity varied across spatial frequencies and visual field sectors (i.e., with full-field stimuli spanning the central 21° of the visual field and with stimuli restricted to annular regions spanning 0°-3°, 3°-9°, or 9°-21°). We employed measurements with annular stimuli to model different possible scenarios regarding how disparity information is combined across visual field sectors. We adjudicated between potential mechanisms by comparing model predictions to the patterns observed with full-field stimuli. Results Perimetry confirmed that patients with glaucoma exhibited binocularly asymmetric visual field damage (P < 0.001). Across participant groups, foveal regions preferentially processed disparities at finer spatial scales, whereas periphery regions were tuned for coarser scales (P < 0.001). Disparity sensitivity also decreased from fovea to periphery (P < 0.001) and across participant groups (Ps < 0.01). Finally, similar to controls, patients with glaucoma exhibited near-optimal disparity integration, specifically at low spatial frequencies (P < 0.001). Conclusions Contrary to the conventional view that glaucoma spares central vision, we find that glaucomatous damage causes a widespread loss of disparity sensitivity across both foveal and peripheral regions. Despite these losses, cortical integration mechanisms appear to be well preserved, suggesting that patients with glaucoma make the best possible use of their remaining binocular function.
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Affiliation(s)
- Guido Maiello
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - MiYoung Kwon
- Department of Psychology, Northeastern University, Boston, Massachusetts, United States
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16
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Liu P, Luo B, Chen L, Wang QX, Zhai LH, Wu HY, Zhao YL, Yuan G, Jiang GH, Zhang J. Preliminary Diffusion-Tensor Imaging Evidence for Trans-Synaptic Axonal Degeneration in Dysthyroid Optic Neuropathy Due to Thyroid-Associated Ophthalmopathy. J Magn Reson Imaging 2023; 57:834-844. [PMID: 35864716 DOI: 10.1002/jmri.28352] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The mechanism driving dysthyroid optic neuropathy (DON) is unclear. Diffusion-tensor imaging (DTI) allows for noninvasively assessing the microstructure of the entire visual pathway and may facilitate a better understanding of the mechanism of DON. PURPOSE To assess microstructural changes of the whole visual pathway and to investigate the potential mechanism of trans-synaptic damage(TSD) pathogenesis in DON with DTI. STUDY TYPE Cross-sectional. POPULATION Sixty-four patients with bilateral thyroid-associated ophthalmopathy (TAO), 30 with and 34 without DON, and 30 age- and sex-matched healthy controls (HCs). FIELD STRENGTH/SEQUENCE 3 T/DTI (A single-shot diffusion-weighted echo-planar imaging sequence). ASSESSMENT Differences in DTI parameters including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) in each segment (optic nerve, tract, and radiation) of the entire visual pathway among the groups were compared. The parameters of visual evoked potentials (VEPs), visual field tests, and mean retinal nerve fiber layer (mRNFL) thickness on optical coherence tomography were also compared across patients. STATISTICAL TESTS Student's t-test, chi-square test; ANOVA with post-hoc testing, interclass correlation coefficient, and correlation analysis. Significance level: P < 0.05. RESULTS TAO patients with DON showed significantly reduced mRNFL thickness and abnormal VEPs. There was a tendency for gradually reduced FA and AD, and increased RD and MD from HCs, with non-DON to with DON in optic nerve and tract, statistically. For radiation, the RD and MD showed statistical increase, the AD and FA just showed numerical decrease (P = 0.119 and 0.059, respectively). For DON, the FA and MD of visual pathway segments showed correlations with abnormal VEPs. DATA CONCLUSION DTI may be a useful tool for detecting microstructural changes in the entire visual pathway in DON. The changes in RNFL thickness and DTI parameters suggested TSD as a potential pathogenic mechanism of DON. EVIDENCE LEVEL 4 Technical Efficacy: Stage 5.
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Affiliation(s)
- Ping Liu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China.,Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Ban Luo
- Department of Ophthalmology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Lang Chen
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Qiu-Xia Wang
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Lin-Han Zhai
- Department of Radiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Hong-Yu Wu
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Ya-Li Zhao
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Gang Yuan
- Department of Endocrinology and Metabolism, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Gui-Hua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jing Zhang
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
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17
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Li DJ, Huang BL, Peng Y, Liang LY, Liu H. Altered dynamic functional connectivity in the primary visual cortex in patients with primary angle-closure glaucoma. Front Neurosci 2023; 17:1131247. [PMID: 36816121 PMCID: PMC9932926 DOI: 10.3389/fnins.2023.1131247] [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: 12/24/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
Purpose Glaucoma is the main blindness-causing disease in the world. Previous neuroimaging studies demonstrated that glaucoma not only causes the loss of optic ganglion cells but also leads to the abnormal function of the optic nerve pathway and the visual cortex. However, previous studies also reported that patients with glaucoma have dysfunction in the visual cortex in a static state. Whether or not patients with primary angle-closure glaucoma (PACG) were accompanied by dynamic functional connectivity (FC) changes in the primary visual cortex (V1) remains unknown. Methods A total of 34 patients with PACG (23 men and 11 women) and 34 well-matched healthy controls (HCs) were enrolled in the study. The dynamic functional connectivity (dFC) with the sliding window method was applied to investigate the dynamic functional connectivity changes in the V1. Results Compared with HCs, patients with PACG showed increased dFC values between left V1 and bilateral calcarine (CAL). Meanwhile, patients with PACG showed increased dFC values between right V1 and bilateral CAL. Conclusion Our study demonstrated that patients with PACG showed increased dFC within the visual network, which might indicate the increased variability FC in the V1 in patients with PACG.
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Affiliation(s)
- Dong-Jin Li
- Health Management Center, The First People’s Hospital of Jiujiang City, Jiujiang, Jiangxi, China
| | - Bing-Lin Huang
- College of Clinical Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China,*Correspondence: Bing-Lin Huang,
| | - Yuan Peng
- Department of Ophthalmology, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China
| | - Ling-Yan Liang
- College of Graduate, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China
| | - Hui Liu
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi, China
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18
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Liu W, Guo R, Huang D, Ji J, Gansevoort RT, Snieder H, Jansonius NM. Co-occurrence of chronic kidney disease and glaucoma: Epidemiology and etiological mechanisms. Surv Ophthalmol 2023; 68:1-16. [PMID: 36088997 DOI: 10.1016/j.survophthal.2022.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 08/26/2022] [Accepted: 09/02/2022] [Indexed: 02/01/2023]
Abstract
As the histology, physiology, and pathophysiology of eyes and kidneys show substantial overlap, it has been suggested that eye and kidney diseases, such as glaucoma and chronic kidney disease (CKD), may be closely interlinked. We review the relationship between CKD and various subtypes of glaucoma, including primary open-angle glaucoma, primary angle- closure glaucoma, normal tension glaucoma, pseudoexfoliation syndrome, and several glaucoma endophenotypes. We also discuss the underlying pathogenic mechanisms and common risk factors for CKD and glaucoma, including atherosclerosis, the renin-angiotensin system, genes and genetic polymorphisms, vitamin D deficiency, and erythropoietin. The prevalence of glaucoma appears elevated in CKD patients, and vice versa, and the literature points to many intriguing associations; however, the associations are not always confirmed, and sometimes apparently opposite observations are reported. Glaucoma and CKD are complex diseases, and their mutual influence is only partially understood.
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Affiliation(s)
- Wei Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ruru Guo
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Dandan Huang
- Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jian Ji
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ron T Gansevoort
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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19
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Aragón-Navas A, Rodrigo MJ, Garcia-Herranz D, Martinez T, Subias M, Mendez S, Ruberte J, Pampalona J, Bravo-Osuna I, Garcia-Feijoo J, Pablo LE, Garcia-Martin E, Herrero-Vanrell R. Mimicking chronic glaucoma over 6 months with a single intracameral injection of dexamethasone/fibronectin-loaded PLGA microspheres. Drug Deliv 2022; 29:2357-2374. [PMID: 35904152 PMCID: PMC9341346 DOI: 10.1080/10717544.2022.2096712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
To create a chronic glaucoma animal model by a single intracameral injection of biodegradable poly lactic-co-glycolic acid (PLGA) microspheres (Ms) co-loaded with dexamethasone and fibronectin (MsDexaFibro). MsDexaFibro were prepared by a water-in-oil-in-water emulsion method including dexamethasone in the organic phase and fibronectin in the inner aqueous phase. To create the chronic glaucoma model, an interventionist and longitudinal animal study was performed using forty-five Long Evans rats (4-week-old). Rats received a single intracameral injection of MsDexafibro suspension (10%w/v) in the right eye. Ophthalmological parameters such as clinical signs, intraocular pressure (IOP), neuro-retinal functionality by electroretinography (ERG), retinal structural analysis by optical coherence tomography (OCT), and histology were evaluated up to six months. According to the results obtained, the model proposed was able to induce IOP increasing in both eyes over the study, higher in the injected eyes up to 6 weeks (p < 0.05), while preserving the ocular surface. OCT quantified progressive neuro-retinal degeneration (mainly in the retinal nerve fiber layer) in both eyes but higher in the injected eye. Ganglion cell functionality decreased in injected eyes, thus smaller amplitudes in PhNR were detected by ERG. In conclusion, a new chronic glaucoma animal model was created by a single injection of MsDexaFibro very similar to open-angle glaucoma occurring in humans. This model would impact in different fields such as ophthalmology, allowing long period of study of this pathology; pharmacology, evaluating the neuroprotective activity of active compounds; and pharmaceutical technology, allowing the correct evaluation of the efficacy of long-term sustained ocular drug delivery systems.
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Affiliation(s)
- Alba Aragón-Navas
- Complutense University, Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid Spain, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain.,Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain.,Research Institute of the San Carlos Clinical Hospital (IdISSC), Grupo de Investigación Innovación Farmacéutica en Oftalmología, Madrid, Spain
| | - María J Rodrigo
- Instituto de Investigación Sanitaria de Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,National Ocular Pathology Network (OFTARED) Carlos III Health Institute, Madrid, Spain
| | - David Garcia-Herranz
- Complutense University, Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid Spain, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain.,Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain.,Research Institute of the San Carlos Clinical Hospital (IdISSC), Grupo de Investigación Innovación Farmacéutica en Oftalmología, Madrid, Spain
| | - Teresa Martinez
- Instituto de Investigación Sanitaria de Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain
| | - Manuel Subias
- Instituto de Investigación Sanitaria de Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain
| | - Silvia Mendez
- Instituto de Investigación Sanitaria de Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain
| | - Jesús Ruberte
- Center of Animal Biotechnology and Gene Therapy (CBATEG), Universitat Autònoma de Barcelona, Bellaterra, Spain.,CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain.,Department of Animal Health and Anatomy, School of Veterinary Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Judit Pampalona
- Center of Animal Biotechnology and Gene Therapy (CBATEG), Universitat Autònoma de Barcelona, Bellaterra, Spain.,CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain.,Department of Animal Health and Anatomy, School of Veterinary Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Irene Bravo-Osuna
- Complutense University, Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid Spain, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain.,Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain.,Research Institute of the San Carlos Clinical Hospital (IdISSC), Grupo de Investigación Innovación Farmacéutica en Oftalmología, Madrid, Spain.,National Ocular Pathology Network (OFTARED) Carlos III Health Institute, Madrid, Spain
| | - Julian Garcia-Feijoo
- National Ocular Pathology Network (OFTARED) Carlos III Health Institute, Madrid, Spain.,Department of Ophthalmology, San Carlos Clinical Hospital, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - Luis E Pablo
- Instituto de Investigación Sanitaria de Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,National Ocular Pathology Network (OFTARED) Carlos III Health Institute, Madrid, Spain
| | - Elena Garcia-Martin
- Instituto de Investigación Sanitaria de Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,National Ocular Pathology Network (OFTARED) Carlos III Health Institute, Madrid, Spain
| | - Rocío Herrero-Vanrell
- Complutense University, Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid Spain, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain.,Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain.,Research Institute of the San Carlos Clinical Hospital (IdISSC), Grupo de Investigación Innovación Farmacéutica en Oftalmología, Madrid, Spain.,National Ocular Pathology Network (OFTARED) Carlos III Health Institute, Madrid, Spain
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20
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Li K, Wang Q, Wang L, Huang Y. Cognitive dysfunctions in high myopia: An overview of potential neural morpho-functional mechanisms. Front Neurol 2022; 13:1022944. [PMID: 36408499 PMCID: PMC9669364 DOI: 10.3389/fneur.2022.1022944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/10/2022] [Indexed: 10/28/2023] Open
Abstract
Dementia and cognitive impairment (CIM) carry high levels of mortality. Visual impairment (VI) is linked with CIM risk. High myopia (HM) is a chronic disease frequently leading to irreversible blindness. Current opinion has shifted from retinal injury as the cause of HM to the condition being considered an eye-brain disease. However, the pathogenesis of this disease and the manner in which neural structures are damaged are poorly understood. This review comprehensively discusses the relationship between HM, the central nervous system, and CIM, together with the novel concept of three visual pathways, and possible research perspectives.
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Affiliation(s)
- Kaixiu Li
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Qun Wang
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Liqiang Wang
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yifei Huang
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
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21
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Wang Y, Chen L, Cai F, Gao J, Ouyang F, Chen Y, Yin M, Hua C, Zeng X. Altered functional connectivity of the thalamus in primary angle-closure glaucoma patients: A resting-state fMRI study. Front Neurol 2022; 13:1015758. [PMID: 36277918 PMCID: PMC9583913 DOI: 10.3389/fneur.2022.1015758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Background and objectives Glaucoma is one of the leading irreversible causes of blindness worldwide, and previous studies have shown that there is abnormal functional connectivity (FC) in the visual cortex of glaucoma patients. The thalamus is a relay nucleus for visual signals; however, it is not yet clear how the FC of the thalamus is altered in glaucoma. This study investigated the alterations in thalamic FC in patients with primary angle-closure glaucoma (PACG) by using resting-state functional MRI (rs-fMRI). We hypothesized that PACG patients have abnormal FC between the thalamus and visual as well as extravisual brain regions. Methods Clinically confirmed PACG patients and age- and gender-matched healthy controls (HCs) were evaluated by T1 anatomical and functional MRI on a 3 T scanner. Thirty-four PACG patients and 33 HCs were included in the rs-fMRI analysis. All PACG patients underwent complete ophthalmological examinations; included retinal nerve fiber layer thickness (RNFLT), intraocular pressure (IOP), average cup-to-disc ratio (A-C/D), and vertical cup-to-disc ratio (V-C/D). After the MRI data were preprocessed, the bilateral thalamus was chosen as the seed point; and the differences in resting-state FC between groups were evaluated. The brain regions that significantly differed between PACG patients and HCs were identified, and the correlations were then evaluated between the FC coefficients of these regions and clinical variables. Results Compared with the HCs, the PACG patients showed decreased FC between the bilateral thalamus and right transverse temporal gyrus, between the bilateral thalamus and left anterior cingulate cortex, and between the left thalamus and left insula. Concurrently, increased FC was found between the bilateral thalamus and left superior frontal gyrus in PACG patients. The FC between the bilateral thalamus and left superior frontal gyrus was positively correlated with RNFLT and negatively correlated with the A-C/D and V-C/D. The FC between the left thalamus and left insula was negatively correlated with IOP. Conclusion Extensive abnormal resting-state functional connections between the thalamus and visual and extravisual brain areas were found in PACG patients, and there were certain correlations with clinical variables, suggesting that abnormal thalamic FC plays an important role in the progression of PACG.
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Affiliation(s)
- Yuanyuan Wang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linglong Chen
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Fengqin Cai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Junwei Gao
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Feng Ouyang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ye Chen
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Mingxue Yin
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Chengpeng Hua
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Xianjun Zeng
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22
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Van Hook MJ. Influences of Glaucoma on the Structure and Function of Synapses in the Visual System. Antioxid Redox Signal 2022; 37:842-861. [PMID: 35044228 PMCID: PMC9587776 DOI: 10.1089/ars.2021.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/31/2021] [Indexed: 11/12/2022]
Abstract
Significance: Glaucoma is an age-related neurodegenerative disorder of the visual system associated with sensitivity to intraocular pressure (IOP). It is the leading irreversible cause of vision loss worldwide, and vision loss results from damage and dysfunction of the retinal output neurons known as retinal ganglion cells (RGCs). Recent Advances: Elevated IOP and optic nerve injury triggers pruning of RGC dendrites, altered morphology of excitatory inputs from presynaptic bipolar cells, and disrupted RGC synaptic function. Less is known about RGC outputs, although evidence to date indicates that glaucoma is associated with altered mitochondrial and synaptic structure and function in RGC-projection targets in the brain. These early functional changes likely contribute to vision loss and might be a window into early diagnosis and treatment. Critical Issues: Glaucoma affects different RGC populations to varying extents and along distinct time courses. The influence of glaucoma on RGC synaptic function as well as the mechanisms underlying these effects remain to be determined. Since RGCs are an especially energetically demanding population of neurons, altered intracellular axon transport of mitochondria and mitochondrial function might contribute to RGC synaptic dysfunction in the retina and brain as well as RGC vulnerability in glaucoma. Future Directions: The mechanisms underlying differential RGC vulnerability remain to be determined. Moreover, the timing and mechanisms of RGCs synaptic dysfunction and degeneration will provide valuable insight into the disease process in glaucoma. Future work will be able to capitalize on these findings to better design diagnostic and therapeutic approaches to detect disease and prevent vision loss. Antioxid. Redox Signal. 37, 842-861.
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Affiliation(s)
- Matthew J. Van Hook
- Department of Ophthalmology & Visual Science and Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Department of Cellular & Integrative Physiology, Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
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23
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McDonald MA, Stevenson CH, Kersten HM, Danesh-Meyer HV. Eye Movement Abnormalities in Glaucoma Patients: A Review. Eye Brain 2022; 14:83-114. [PMID: 36105571 PMCID: PMC9467299 DOI: 10.2147/eb.s361946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/09/2022] [Indexed: 11/23/2022] Open
Abstract
Glaucoma is a common condition that relies on careful clinical assessment to diagnose and determine disease progression. There is growing evidence that glaucoma is associated not only with loss of retinal ganglion cells but also with degeneration of cortical and subcortical brain structures associated with vision and eye movements. The effect of glaucoma pathophysiology on eye movements is not well understood. In this review, we examine the evidence surrounding altered eye movements in glaucoma patients compared to healthy controls, with a focus on quantitative eye tracking studies measuring saccades, fixation, and optokinetic nystagmus in a range of visual tasks. The evidence suggests that glaucoma patients have alterations in several eye movement domains. Patients exhibit longer saccade latencies, which worsen with increasing glaucoma severity. Other saccadic abnormalities include lower saccade amplitude and velocity, and difficulty inhibiting reflexive saccades. Fixation is pathologically altered in glaucoma with reduced stability. Optokinetic nystagmus measures have also been shown to be abnormal. Complex visual tasks (eg reading, driving, and navigating obstacles), integrate these eye movements and result in behavioral adaptations. The review concludes with a summary of the evidence and recommendations for future research in this emerging field.
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Affiliation(s)
- Matthew A McDonald
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Clark H Stevenson
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Hannah M Kersten
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.,Eye Institute, Auckland, New Zealand
| | - Helen V Danesh-Meyer
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.,Eye Institute, Auckland, New Zealand
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24
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Sujanthan S, Shmuel A, Mendola JD. Visually driven functional MRI techniques for characterization of optic neuropathy. Front Hum Neurosci 2022; 16:943603. [PMID: 36158617 PMCID: PMC9500431 DOI: 10.3389/fnhum.2022.943603] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022] Open
Abstract
Optic neuropathies are conditions that cause disease to the optic nerve, and can result in loss of visual acuity and/or visual field defects. An improved understanding of how these conditions affect the entire visual system is warranted, to better predict and/or restore the visual loss. In this article, we review visually-driven functional magnetic resonance imaging (fMRI) studies of optic neuropathies, including glaucoma and optic neuritis (ON); we also discuss traumatic optic neuropathy (TON). Optic neuropathy-related vision loss results in fMRI deficit within the visual cortex, and is often strongly correlated with clinical severity measures. Using predominantly flickering checkerboard stimuli, glaucoma studies indicated retinotopic-specific cortical alteration with more prominent deficits in advanced than in early glaucoma. Some glaucoma studies indicate a reorganized visual cortex. ON studies have indicated that the impacted cortical areas are briefly hyperactive. For ON, brain deficits are greater in the acute stages of the disease, followed by (near) normalization of responses of the LGN, visual cortex, and the dorsal visual stream, but not the ventral extrastriate cortex. Visually-driven fMRI is sensitive, at least in ON, in discriminating patients from controls, as well as the affected eye from the fellow eye within patients. The use of a greater variety of stimuli beyond checkerboards (e.g., visual motion and object recognition) in recent ON studies is encouraging, and needs to continue to disentangle the results in terms of change over time. Finally, visually-driven fMRI has not yet been applied in TON, although preliminary efforts suggest it may be feasible. Future fMRI studies of optic neuropathies should consider using more complex visual stimuli, and inter-regional analysis methods including functional connectivity. We suggest that a more systematic longitudinal comparison of optic neuropathies with advanced fMRI would provide improved diagnostic and prognostic information.
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Affiliation(s)
- Sujeevini Sujanthan
- Department of Ophthalmology and Visual Sciences, McGill University, Montreal, QC, Canada
- *Correspondence: Sujeevini Sujanthan
| | - Amir Shmuel
- Departments of Neurology, Neurosurgery, Physiology and Biomedical Engineering, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Janine Dale Mendola
- Department of Ophthalmology and Visual Sciences, McGill University, Montreal, QC, Canada
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25
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Chen RB, Zhong YL, Liu H, Huang X. Machine learning analysis reveals abnormal functional network hubs in the primary angle-closure glaucoma patients. Front Hum Neurosci 2022; 16:935213. [PMID: 36092649 PMCID: PMC9450012 DOI: 10.3389/fnhum.2022.935213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Primary angle-closure glaucoma (PACG) is a serious and irreversible blinding eye disease. Growing studies demonstrated that PACG patients were accompanied by vision and vision-related brain region changes. However, whether the whole-brain functional network hub changes occur in PACG patients remains unknown. Purpose The purpose of the study was to investigate the brain function network hub changes in PACG patients using the voxel-wise degree centrality (DC) method. Materials and methods Thirty-one PACG patients (21 male and 10 female) and 31 healthy controls (HCs) (21 male and 10 female) closely matched in age, sex, and education were enrolled in the study. The DC method was applied to investigate the brain function network hub changes in PACG patients. Moreover, the support vector machine (SVM) method was applied to distinguish PACG patients from HC patients. Results Compared with HC, PACG patients had significantly higher DC values in the right fusiform, left middle temporal gyrus, and left cerebelum_4_5. Meanwhile, PACG patients had significantly lower DC values in the right calcarine, right postcentral gyrus, left precuneus gyrus, and left postcentral gyrus. Furthermore, the SVM classification reaches a total accuracy of 72.58%, and the ROC curve of the SVM classifier has an AUC value of 0.85 (r = 0.25). Conclusion Our results showed that PACG patients showed widespread brain functional network hub dysfunction relative to the visual network, auditory network, default mode network, and cerebellum network, which might shed new light on the neural mechanism of optic atrophy in PACG patients.
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Affiliation(s)
- Ri-Bo Chen
- Department of Radiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Yu-Lin Zhong
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Hui Liu
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Xin Huang
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- *Correspondence: Xin Huang,
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26
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Yan Z, Lai M, Jia Y, Deng C, Zhuo Y. CircXPO5 Plays a Neuroprotective Function in the Lateral Geniculate Nucleus of Glaucoma by Regulating GRIN2A. Brain Sci 2022; 12:780. [PMID: 35741665 PMCID: PMC9221081 DOI: 10.3390/brainsci12060780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/30/2022] [Accepted: 06/10/2022] [Indexed: 12/05/2022] Open
Abstract
PURPOSE Previous studies have found the neurodegeneration and atrophy of glaucomatous lateral geniculate nucleus (LGN), but the mechanism is still unknown. Circular RNA (circRNA) plays some important roles in physiological and pathological progression of the disease. In this study, we focused on the differentially expressed circRNAs and the mechanism for circXPO5 in LGN degeneration in a macaque glaucoma model. METHODS Using RNA-seq, we analyzed the differentially expressed circRNAs in a macaque glaucoma model. An RT-QPCR was used to check the expression of selected differentially expressed circRNAs, candidate miRNAs and mRNAs. A competing endogenous RNA (ceRNA) network analysis was performed to examine the mechanism of circXPO5 action. RESULTS circXPO5 significantly decreased in the glaucoma model and a ceRNA network analysis revealed that circXPO5 can bind to miR-330-5p, which also binds to GRIN2A (ionotropic receptor NMDA type subunit 2A). QPCR detection showed a decrease in GRIN2A and an increase in miR-330-5p. CONCLUSIONS Our earlier studies revealed that the GRIN2A gene regulates the calcium signal pathway. Decreasing of GRIN2A related with neuron apoptosis and neurodegeneration. These findings indicate that the reduction in circXPO5 may have a protective effect on neuronal apoptosis in the visual central system of glaucoma.
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Affiliation(s)
- Zhichao Yan
- Department of Glaucoma and Neuro-Ophthalmology, Shenzhen Eye Hospital, Shenzhen Eye Institute, Jinan University, School of Optometry, Shenzhen University, Shenzhen 518040, China;
- Department of Ophthalmology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Mingying Lai
- Department of Glaucoma and Neuro-Ophthalmology, Shenzhen Eye Hospital, Shenzhen Eye Institute, Jinan University, School of Optometry, Shenzhen University, Shenzhen 518040, China;
| | - Yu Jia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China; (Y.J.); (C.D.)
| | - Caibin Deng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China; (Y.J.); (C.D.)
| | - Yehong Zhuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China; (Y.J.); (C.D.)
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27
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Chen S, Wang Y, Wu X, Chang J, Jin W, Li W, Song P, Wu Y, Zhu J, Qian Y, Shen C, Yu Y, Dong F. Degeneration of the Sensorimotor Tract in Degenerative Cervical Myelopathy and Compensatory Structural Changes in the Brain. Front Aging Neurosci 2022; 14:784263. [PMID: 35444527 PMCID: PMC9014124 DOI: 10.3389/fnagi.2022.784263] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/09/2022] [Indexed: 12/19/2022] Open
Abstract
Degenerative cervical myelopathy is a progressive neurodegenerative disease, that has become increasingly prevalent in the aging population worldwide. The current study determined the factors affecting degeneration in the sensorimotor tract with degenerative cervical myelopathy and its relationship with brain structure. We divided patients into hyperintensity (HS) and non-hyperintensity (nHS) groups and measured the fractional anisotropy and apparent diffusion coefficients of the lateral corticospinal tract (CST), fasciculus gracilis and fasciculus cuneatus (FGC). Voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) techniques were used to estimate brain structure changes. Correlation of the modified Japanese Orthopaedic Association (mJOA) score, light touch, pinprick, motor score, and fractional anisotropy (FA) ratios of the CST at different levels were analyzed. Compared to healthy controls, the FA ratios of CST in the HS and nHS groups were decreased at all levels, and the apparent diffusion coefficient (ADC) ratio was increased only at C4/5 levels in the HS group. The FA ratio of FGC was decreased at the C3/4 and C4/5 levels in the HS group and only decreased at the C4/5 level in the nHS group. The ADC ratio was decreased only at the C4/5 level in the HS group. VBM analysis revealed that the volume of the precentral gyrus, postcentral gyrus, and paracentral lobule increased in patients compared to controls. TBSS analysis found no statistical significance between the sensory and motor tracts in white matter. The volume of clusters in HS and nHS groups negatively correlated with the C1/2 FA ratio of the CST. The results showed that the degeneration distance of the CST was longer than the FGC, and the degeneration distance was related to the degree of compression and spinal cord damage. Structural compensation and the neurotrophin family may lead to enlargement of the brain.
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Affiliation(s)
- Senlin Chen
- Department of Orthopedics, Department of Spine Surgery, The First Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Ying Wang
- Department of Radiology, The First Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Xianyong Wu
- Department of Orthopedics, Department of Spine Surgery, The First Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Jianchao Chang
- Department of Orthopedics, Department of Spine Surgery, The First Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Weiming Jin
- Department of Orthopedics, Department of Spine Surgery, The First Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Wei Li
- Department of Orthopedics, Department of Spine Surgery, The First Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Peiwen Song
- Department of Orthopedics, Department of Spine Surgery, The First Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Yuanyuan Wu
- Department of Medical Imaging, The First Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Yinfeng Qian
- Department of Radiology, The First Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Cailiang Shen
- Department of Orthopedics, Department of Spine Surgery, The First Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of AnHui Medical University, Hefei, China
| | - Fulong Dong
- Department of Orthopedics, Department of Spine Surgery, The First Affiliated Hospital of AnHui Medical University, Hefei, China
- *Correspondence: Fulong Dong
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28
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Visual Tract Degradation in Bilateral Normal-Tension Glaucoma-Cortical Thickness Maps and Volumetric Study of Visual Pathway Areas. J Clin Med 2022; 11:jcm11071907. [PMID: 35407515 PMCID: PMC8999724 DOI: 10.3390/jcm11071907] [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] [Received: 01/28/2022] [Revised: 03/14/2022] [Accepted: 03/26/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of the study was to evaluate changes in the central visual pathways during the early and advanced stages of bilateral normal-tension glaucoma (NTG). METHODS The studied groups constituted patients with bilateral normal-tension glaucoma of the same stage (n = 45) and age-matched healthy volunteers (n = 17). All patients underwent ophthalmic examination and examination on a 1.5 Tesla Magnetic Resonance Scanner (Optima 360, GE Healthcare). Volume and cortical thickness analyses were performed using the open-source automated software package FreeSurfer. RESULTS There was a significant difference in lateral geniculate nuclei volume between the control and advanced glaucoma groups in the right hemisphere (p = 0.03) and in the left hemisphere between the early and advanced glaucoma patients (p = 0.026). The optic chiasm volume differed significantly between the control and advanced NTG groups (p = 0.0003) and between early and advanced glaucoma patients (p = 0.004). Mean cortical thickness analysis revealed a significant increase in values in the advanced glaucoma group in the right Brodmann area 17 (BA17) (p = 0.007) and right BA18 (p = 0.049) as compared to early NTG. In the left BA18 area, the mean thickness of the cortex in the early glaucoma group was significantly lower than in the control group (p = 0.03). CONCLUSIONS The increase in the grey matter thickness in the V1 region with more-advanced glaucoma stages may reflect compensatory hypertrophy. Additionally, the regions of the brain early affected during glaucoma with reduced thickness were the right lateral occipital gyrus and left lingual gyrus. The most prominent change during the course of glaucoma was the increase in grey matter thickness in the right cuneus.
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29
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Wareham LK, Liddelow SA, Temple S, Benowitz LI, Di Polo A, Wellington C, Goldberg JL, He Z, Duan X, Bu G, Davis AA, Shekhar K, Torre AL, Chan DC, Canto-Soler MV, Flanagan JG, Subramanian P, Rossi S, Brunner T, Bovenkamp DE, Calkins DJ. Solving neurodegeneration: common mechanisms and strategies for new treatments. Mol Neurodegener 2022; 17:23. [PMID: 35313950 PMCID: PMC8935795 DOI: 10.1186/s13024-022-00524-0] [Citation(s) in RCA: 94] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/18/2022] [Indexed: 02/06/2023] Open
Abstract
Across neurodegenerative diseases, common mechanisms may reveal novel therapeutic targets based on neuronal protection, repair, or regeneration, independent of etiology or site of disease pathology. To address these mechanisms and discuss emerging treatments, in April, 2021, Glaucoma Research Foundation, BrightFocus Foundation, and the Melza M. and Frank Theodore Barr Foundation collaborated to bring together key opinion leaders and experts in the field of neurodegenerative disease for a virtual meeting titled "Solving Neurodegeneration". This "think-tank" style meeting focused on uncovering common mechanistic roots of neurodegenerative disease and promising targets for new treatments, catalyzed by the goal of finding new treatments for glaucoma, the world's leading cause of irreversible blindness and the common interest of the three hosting foundations. Glaucoma, which causes vision loss through degeneration of the optic nerve, likely shares early cellular and molecular events with other neurodegenerative diseases of the central nervous system. Here we discuss major areas of mechanistic overlap between neurodegenerative diseases of the central nervous system: neuroinflammation, bioenergetics and metabolism, genetic contributions, and neurovascular interactions. We summarize important discussion points with emphasis on the research areas that are most innovative and promising in the treatment of neurodegeneration yet require further development. The research that is highlighted provides unique opportunities for collaboration that will lead to efforts in preventing neurodegeneration and ultimately vision loss.
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Affiliation(s)
- Lauren K Wareham
- Department of Ophthalmology and Visual Sciences, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shane A Liddelow
- Neuroscience Institute, NYU Grossman School of Medicine, New York, NY, USA
| | - Sally Temple
- Neural Stem Cell Institute, NY, 12144, Rensselaer, USA
| | - Larry I Benowitz
- Department of Neurosurgery and F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Adriana Di Polo
- Department of Neuroscience, University of Montreal, Montreal, QC, Canada
| | - Cheryl Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jeffrey L Goldberg
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, CA, Palo Alto, USA
| | - Zhigang He
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, MA, Boston, USA
| | - Xin Duan
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Guojun Bu
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Albert A Davis
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Karthik Shekhar
- Department of Chemical and Biomolecular Engineering and Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Anna La Torre
- Department of Cell Biology and Human Anatomy, University of California Davis, Davis, CA, USA
| | - David C Chan
- Division of Biology and Biological Engineering, California Institute of Technology, CA, 91125, Pasadena, USA
| | - M Valeria Canto-Soler
- CellSight Ocular Stem Cell and Regeneration Research Program, Department of Ophthalmology, Sue Anschutz-Rodgers Eye Center, University of Colorado, Aurora, CO, USA
| | - John G Flanagan
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, CA, USA
| | | | | | | | | | - David J Calkins
- Department of Ophthalmology and Visual Sciences, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, USA.
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Mendoza M, Shotbolt M, Faiq MA, Parra C, Chan KC. Advanced Diffusion MRI of the Visual System in Glaucoma: From Experimental Animal Models to Humans. BIOLOGY 2022; 11:454. [PMID: 35336827 PMCID: PMC8945790 DOI: 10.3390/biology11030454] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/10/2022] [Indexed: 11/18/2022]
Abstract
Glaucoma is a group of ophthalmologic conditions characterized by progressive retinal ganglion cell death, optic nerve degeneration, and irreversible vision loss. While intraocular pressure is the only clinically modifiable risk factor, glaucoma may continue to progress at controlled intraocular pressure, indicating other major factors in contributing to the disease mechanisms. Recent studies demonstrated the feasibility of advanced diffusion magnetic resonance imaging (dMRI) in visualizing the microstructural integrity of the visual system, opening new possibilities for non-invasive characterization of glaucomatous brain changes for guiding earlier and targeted intervention besides intraocular pressure lowering. In this review, we discuss dMRI methods currently used in visual system investigations, focusing on the eye, optic nerve, optic tract, subcortical visual brain nuclei, optic radiations, and visual cortex. We evaluate how conventional diffusion tensor imaging, higher-order diffusion kurtosis imaging, and other extended dMRI techniques can assess the neuronal and glial integrity of the visual system in both humans and experimental animal models of glaucoma, among other optic neuropathies or neurodegenerative diseases. We also compare the pros and cons of these methods against other imaging modalities. A growing body of dMRI research indicates that this modality holds promise in characterizing early glaucomatous changes in the visual system, determining the disease severity, and identifying potential neurotherapeutic targets, offering more options to slow glaucoma progression and to reduce the prevalence of this world's leading cause of irreversible but preventable blindness.
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Affiliation(s)
- Monica Mendoza
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY 11201, USA; (M.M.); (M.S.)
| | - Max Shotbolt
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY 11201, USA; (M.M.); (M.S.)
| | - Muneeb A. Faiq
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY 10017, USA; (M.A.F.); (C.P.)
| | - Carlos Parra
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY 10017, USA; (M.A.F.); (C.P.)
| | - Kevin C. Chan
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY 11201, USA; (M.M.); (M.S.)
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY 10017, USA; (M.A.F.); (C.P.)
- Department of Radiology, Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY 10016, USA
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Temporal contrast adaptation in the analysis of visual function in primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2022; 260:2959-2970. [PMID: 35294637 PMCID: PMC9418089 DOI: 10.1007/s00417-022-05619-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/20/2022] [Accepted: 03/02/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To explore the utility of the recovery time (RT) after temporal contrast adaptation in primary open-angle glaucoma (POAG) visual function analysis, especially in severe and end-stage glaucoma, by the Erlanger Flicker Test (EFT). METHODS This study included 80 POAG eyes (45 subjects) and 20 normal eyes (20 subjects). POAG eyes were divided into 5 groups. The diagnostic efficacy of the EFT was assessed, and the RT of POAG eyes at different stages was compared. The EFT results were compared with glaucomatous structure and function test results. A nomogram was developed to predict disease progression by the RT and structural indicators. RESULTS In the normal eyes, as the test contrast increased, the RT gradually decreased. The EFT test-retest reproducibility was good, with intraclass correlation coefficient values of 0.6 (P < 0.05) for each test contrast. At 12%, 25%, and 35% contrast, the RT in the severe and end-stage glaucoma eyes was significantly prolonged compared with the control group (P < 0.05). The RT at different contrasts was significantly correlated with visual acuity, mean defect, mean sensitivity, and general and individual quadrant optic nerve fiber layer thickness (P ≤ 0.001). The receiver operating curve indicated that RT12% showed the best overall area under the curve (0.863). We included RT25% and average optic nerve fiber layer thickness in constructing the nomogram. POAG eyes were further divided into 8 stages. According to the probability distribution, this model showed good performance for visual function analysis in advanced glaucoma. CONCLUSIONS Combined with traditional glaucomatous structural and functional parameters, the EFT can be used in the diagnosis and visual function analysis of POAG, especially for severe and end-stage glaucoma. It could be a potential test for disease staging in severe and end-stage glaucoma.
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De Moraes CG, John SWM, Williams PA, Blumberg DM, Cioffi GA, Liebmann JM. Nicotinamide and Pyruvate for Neuroenhancement in Open-Angle Glaucoma: A Phase 2 Randomized Clinical Trial. JAMA Ophthalmol 2021; 140:11-18. [PMID: 34792559 DOI: 10.1001/jamaophthalmol.2021.4576] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Open-angle glaucoma may continue to progress despite significant lowering of intraocular pressure (IOP). Preclinical research has suggested that enhancing mitochondrial function and energy production may enhance retinal ganglion cell survival in animal models of glaucoma, but there is scant information on its effectiveness in a clinical setting. Objective To test the hypothesis that a combination of nicotinamide and pyruvate can improve retinal ganglion cell function in human glaucoma as measured with standard automated perimetry. Design, Setting, and Participants In this phase 2, randomized, double-blind, placebo-controlled clinical trial at a single academic institution, 197 patients were assessed for eligibility. Of these, 42 patients with treated open-angle glaucoma and moderate visual field loss in at least 1 eye were selected for inclusion and randomized. A total of 32 completed the study and were included in the final analysis. The mean (SD) age was 64.6 (9.8) years. Twenty-one participants (66%) were female. Participant race and ethnicity data were collected via self-report to ensure the distribution reflected that observed in clinical practice in the US but are not reported here to protect patient privacy. Recruitment took place in April 2019 and patients were monitored through December 2020. Data were analyzed from January to May 2021. Interventions Ascending oral doses of nicotinamide (1000 to 3000 mg) and pyruvate (1500 to 3000 mg) vs placebo (2:1 randomization). Main Outcomes and Measures Number of visual field test locations improving beyond normal variability in the study eye. Secondary end points were the rates of change of visual field global indices (mean deviation [MD], pattern standard deviation [PSD], and visual field index [VFI]). Results Twenty-two of 29 participants (76%) randomized to the intervention group and 12 of 13 participants (92%) randomized to placebo received their allocation, and 32 participants (32 eyes; ratio 21:11) completed the study (21 from the intervention group and 11 from the placebo group). Median (IQR) follow-up time was 2.2 (2.0-2.4) months. No serious adverse events were reported during the study. The number of improving test locations was significantly higher in the treatment group than in the placebo group (median [IQR], 15 [6-25] vs 7 [6-11]; P = .005). Rates of change of PSD suggested improvement with treatment compared with placebo (median, -0.06 vs 0.02 dB per week; 95% CI, 0.02 to 0.24; P = .02) but not MD (0.04 vs -0.002 dB per week; 95% CI, -0.27 to 0.09; P = .35) or VFI (0.09 vs -0.02% per week; 95% CI, -0.53 to 0.36; P = .71). Conclusions and Relevance A combination of nicotinamide and pyruvate yielded significant short-term improvement in visual function, supporting prior experimental research suggesting a role for these agents in neuroprotection for individuals with glaucoma and confirming the need for long-term studies to establish their usefulness in slowing progression. Trial Registration ClinicalTrials.gov Identifier: NCT03797469.
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Affiliation(s)
- Carlos Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York
| | - Simon W M John
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York.,Howard Hughes Medical Institute, Chevy Chase, Maryland.,Zuckerman Mind Brain Behavior Institute, Columbia University, New York, New York
| | - Pete A Williams
- Division of Eye and Vision, Department of Clinical Neuroscience, St Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Dana M Blumberg
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York
| | - George A Cioffi
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York
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Rodrigo MJ, Garcia-Herranz D, Aragón-Navas A, Subias M, Martinez-Rincón T, Mendez-Martínez S, Cardiel MJ, García-Feijoo J, Ruberte J, Herrero-Vanrell R, Pablo L, Garcia-Martin E, Bravo-Osuna I. Long-term corticosteroid-induced chronic glaucoma model produced by intracameral injection of dexamethasone-loaded PLGA microspheres. Drug Deliv 2021; 28:2427-2446. [PMID: 34763590 PMCID: PMC8592597 DOI: 10.1080/10717544.2021.1998245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
PURPOSE To evaluate a new chronic glaucoma model produced by intracameral injection of dexamethasone-loaded poly lactic-co-glycolic acid microspheres (Dex-PLGA-Ms) over six months. METHODS Healthy rats received two injections (at baseline and Week 4) of Dex-PLGA-Ms into the anterior chamber of the right eye. Clinical signs and intraocular pressure (IOP) were weekly recorded. The structure of the retina and optic nerve was in vivo evaluated using optical coherence tomography (OCT) every two weeks and functionally using dark- and light-adapted electroretinography at 0-12-24 weeks. Histological studies were also performed. RESULTS IOP progressively increased up to hypertension (23.22 ± 3.63 mmHg) in both eyes but did so later in left eyes. OCT quantified a decrease in full-thickness retina posterior pole (R), retinal-nerve-fiber layer (RNFL), and ganglion-cell layer (GCL) thickness up to 24 weeks. Right eyes showed higher neuroretinal thickness loss up to week 8. RNFL experienced the highest percentage thickness loss at the inferior-superior axis, while in GCL the inner sectors of the horizontal axis (Nasal-Temporal) suffered the greatest decrease in thickness. Retinal ganglion cell, photoreceptor, and intermediate cell functionality decreased over time. Increased deposition of collagen IV was also found in zonular fibers and the ciliary body. CONCLUSIONS This work shows the usefulness of drug delivery systems, not to treat pathology but to induce it. Only two injections of Dex-PLGA-Ms in the anterior chamber of rat eyes were enough to progressively create ocular hypertension and subsequent functional and structural neuroretinal degeneration, at least over 6 months.
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Affiliation(s)
- M J Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain.,National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Madrid, Spain
| | - D Garcia-Herranz
- Complutense University of Madrid. Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain.,Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - A Aragón-Navas
- Complutense University of Madrid. Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain.,Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - M Subias
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - T Martinez-Rincón
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - S Mendez-Martínez
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), University of Zaragoza, Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - M J Cardiel
- Miguel Servet Ophthalmology Research Group (GIMSO), University of Zaragoza, Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain.,Department of Pathology, Lozano Blesa University Hospital, Zaragoza, Spain
| | - J García-Feijoo
- Complutense University of Madrid. Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415. National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Spain.,Servicio de Oftalmología, Hospital Clínico San Carlos, Madrid, Spain.,Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain
| | - J Ruberte
- Animal Biotechnology and Gene Therapy Centre (CBATEG), Universitat Autònoma de Barcelona, Bellaterra, Spain.,Networked Biomedical Research Centre for Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain.,Department of Animal Health and Anatomy, School of Veterinary Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - R Herrero-Vanrell
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Madrid, Spain.,Complutense University of Madrid. Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain.,Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - L Pablo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Madrid, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), University of Zaragoza, Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - E Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Madrid, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), University of Zaragoza, Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - I Bravo-Osuna
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Madrid, Spain.,Complutense University of Madrid. Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain.,Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain
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Topuz B, Aydin HM. Preparation of decellularized optic nerve grafts. Artif Organs 2021; 46:618-632. [PMID: 34714559 DOI: 10.1111/aor.14098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Decellularized tissues based on well-conserved extracellular matrices (ECMs) are a common area of research in tissue engineering. Although several decellularization protocols have been suggested for several types of tissues, studies on the optic nerve have been limited. METHODS We report decellularization protocol with different detergent for the preparation of acellular optic nerve and tissues were examined. DNA, glycosaminoglycan (GAG), and collagen content of the groups were evaluated with biochemical analyses and examined with histological staining. Mechanical properties, chemical components as well as cytotoxic properties of tissues were compared. RESULTS According to the results, it was determined that TX-100 (Triton X-100) was insufficient in decellularization when used alone. In addition, it was noticed that 85% of GAG content was preserved by using TX-100 and TX-100-SD (sodium deoxycholate), while this ratio was calculated as 30% for SDS. In contrast, the effect of the decellularization protocols on ECM structure of the tissues was evaluated by scanning and transmission electron microscopy (SEM and TEM) and determined their mechanical properties. Cytotoxicity analyses were exhibited minimum 95% cell viability for all groups, suggesting that there are no cytotoxic properties of the methods on L929 mouse fibroblast cells. CONCLUSIONS The combination of TX-100-SD and TX-100-SDS (sodium dodecyl sulfate) were was determined as the most effective methods to the literature for optic nerve decellularization.
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Affiliation(s)
- Bengisu Topuz
- Bioengineering Division, Institute of Science, Hacettepe University, Ankara, Turkey
| | - Halil Murat Aydin
- Bioengineering Division, Institute of Science, Hacettepe University, Ankara, Turkey.,Centre for Bioengineering, Hacettepe University, Ankara, Turkey
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Marchesi N, Fahmideh F, Boschi F, Pascale A, Barbieri A. Ocular Neurodegenerative Diseases: Interconnection between Retina and Cortical Areas. Cells 2021; 10:2394. [PMID: 34572041 PMCID: PMC8469605 DOI: 10.3390/cells10092394] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 12/13/2022] Open
Abstract
The possible interconnection between the eye and central nervous system (CNS) has been a topic of discussion for several years just based on fact that the eye is properly considered an extension of the brain. Both organs consist of neurons and derived from a neural tube. The visual process involves photoreceptors that receive light stimulus from the external environment and send it to retinal ganglionic cells (RGC), one of the cell types of which the retina is composed. The retina, the internal visual membrane of the eye, processes the visual stimuli in electric stimuli to transfer it to the brain, through the optic nerve. Retinal chronic progressive neurodegeneration, which may occur among the elderly, can lead to different disorders of the eye such as glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR). Mainly in the elderly population, but also among younger people, such ocular pathologies are the cause of irreversible blindness or impaired, reduced vision. Typical neurodegenerative diseases of the CSN are a group of pathologies with common characteristics and etiology not fully understood; some risk factors have been identified, but they are not enough to justify all the cases observed. Furthermore, several studies have shown that also ocular disorders present characteristics of neurodegenerative diseases and, on the other hand, CNS pathologies, i.e., Alzheimer disease (AD) and Parkinson disease (PD), which are causes of morbidity and mortality worldwide, show peculiar alterations at the ocular level. The knowledge of possible correlations could help to understand the mechanisms of onset. Moreover, the underlying mechanisms of these heterogeneous disorders are still debated. This review discusses the characteristics of the ocular illnesses, focusing on the relationship between the eye and the brain. A better comprehension could help in future new therapies, thus reducing or avoiding loss of vision and improve quality of life.
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Affiliation(s)
| | | | | | | | - Annalisa Barbieri
- Department of Drug Sciences, Pharmacology Section, University of Pavia, Viale Taramelli 14, 27100 Pavia, Italy; (N.M.); (F.F.); (F.B.); (A.P.)
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Three "Red Lines" for Pattern Recognition-Based Differential Diagnosis Using Optical Coherence Tomography in Clinical Practice. J Neuroophthalmol 2021; 41:385-398. [PMID: 34415273 DOI: 10.1097/wno.0000000000001173] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Optical coherence tomography (OCT) devices for imaging of the eye are broadly available. The test is noninvasive, rapid, and well-tolerated by patients. This creates a large number of OCT images and patient referrals. Interpretation of OCT findings at the interface between neurological and ophthalmologic conditions has become a key skill in the neuro-ophthalmology service. Similar to the interpretation of visual fields, recogntion of the vertical and horizontal medians are helpful. A third "red line" is added, which will be reviewed here. EVIDENCE Levels 1a to 5 evidence. ACQUISITION Literature research. RESULTS There is level 1a evidence that neurodegeneration of the brain is associated with inner retinal layer atrophy. Predominantly, this is driven by retrograde (trans-synaptic) axonal degeneration from the brain to the eye. This process typically stops at the level of the inner nuclear layer (INL). Anterograde (Wallerian) axonal degeneration from the eye to the brain can trespass the INL. The geography of atrophy and swelling of individual macular retinal layers distinguishes prechiasmal from postchiasmal pathology. The emerging patterns are a front-back "red line" at the INL; a vertical "red line" through the macula for chiasmal/postchiasmal pathology; and a horizontal "red line" through the macular for pathology pointing to the optic disc. This is summarized by illustrative case vignettes. CONCLUSIONS The interpretation of patterns of individual retinal layer atrophy (3 "red lines") needs to be combined with recognition of localized layer thickening (edema, structural) at the macula. Certain macular patterns point to pathology at the level of the optic disc. This requires revision of the optic disc OCT and will guide need for further investigations. The 3 "red lines" proposed here may be found useful in clinical practice and the related mnemonics ("half moon," "sunset," "rainbow") for teaching.
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Montesano G, Quigley HA, Crabb DP. Improving the Power of Glaucoma Neuroprotection Trials Using Existing Visual Field Data. Am J Ophthalmol 2021; 229:127-136. [PMID: 33905747 DOI: 10.1016/j.ajo.2021.04.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Selecting reliable visual field (VF) test takers could improve the power of randomized clinical trials in glaucoma. We test this hypothesis via simulations using a large real world data set. DESIGN Methodology analysis: assessment of how improving reliability affects sample size estimates. METHODS A variability index (VI) estimating intertest variability was calculated for each subject using the residuals of the regression of the mean deviation over time for the first 6 tests in a series of at least 10 examinations for 2,804 patients. Using data from the rest of the series, we simulate VFs at regular intervals for 2 years. To simulate the neuroprotective effect (NE), we reduced the observed progression rate by 20%, 30%, or 50%. The main outcome measure was the sample size to detect a significant difference (P < .05) at 80% power. RESULTS In the first experiment, we simulated a trial including one eye per subject, either selecting randomly from the database or prioritizing patients with low VI. We could not reach 80% power for the low NE with the available patients, but the sample size was reduced by 38% and 49% for the 30% and 50% NE, respectively. In the second experiment, we simulated 2 eyes per subject, one of which was the control eye. The sample size (smaller overall) was reduced by 26% and 38% for the 30% and 50% NE by prioritizing patients with low VI. CONCLUSIONS Selecting patients with low intertest variability can significantly improve the power and reduce the sample size needed in a trial.
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Affiliation(s)
- Giovanni Montesano
- City, University of London Optometry and Visual Sciences (G.M., D.P.C.), London, United Kingdom; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (G.M.), London, United Kingdom
| | - Harry A Quigley
- Wilmer Institute, Johns Hopkins School of Medicine (H.A.Q.), Baltimore, MD, USA
| | - David P Crabb
- City, University of London Optometry and Visual Sciences (G.M., D.P.C.), London, United Kingdom.
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Utility of the Modified Isolated-check Visual Evoked Potential Technique in Functional Glaucoma Assessment. J Glaucoma 2021; 30:e21-e22. [PMID: 32925520 DOI: 10.1097/ijg.0000000000001667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Parisi V, Ziccardi L, Tanga L, Roberti G, Barbano L, Carnevale C, Manni G, Oddone F. Neural Conduction Along Postretinal Visual Pathways in Glaucoma. Front Aging Neurosci 2021; 13:697425. [PMID: 34408643 PMCID: PMC8365149 DOI: 10.3389/fnagi.2021.697425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study was conducted in order to evaluate retinal ganglion cell (RCG) function and the neural conduction along the postretinal large and small axons and its correlation with retinal nerve fiber layer thickness (RNFL-T) in open-angle glaucoma (OAG) eyes. Methods: Thirty-seven OAG patients (mean age: 51.68 ± 9.83 years) with 24-2 Humphrey mean deviation (MD) between -2.5 and -20 dB and IOP <21 mmHg on pharmacological treatment (OAG group) and 20 age-matched controls (control group) were enrolled. In both groups, simultaneous pattern electroretinograms (PERG) and visual evoked potentials (VEP), in response to checks stimulating macular or extramacular areas (the check edge subtended 15' and 60' of visual arc, respectively), and RNFL-T (measured in superior, inferior, nasal, and temporal quadrants) were assessed. Results: In the OAG group, a significant (ANOVA, p < 0.01) reduction of 60' and 15' PERG P50-N95 and VEP N75-P100 amplitudes and of RNFL-T [overall (average of all quadrants) or temporal] with respect to controls was found; the values of 60' and 15' PERG P50 and VEP P100 implicit times and of retinocortical time (RCT; difference between VEP P100 and PERG P50 implicit times) were significantly (p < 0.01) increased with respect to control ones. The observed increased RCTs were significantly linearly correlated (Pearson's test, p < 0.01) with the reduced PERG amplitude and MD values, whereas no significant linear correlation (p < 0.01) with RNFL-T (overall or temporal) values was detected. Conclusions: In OAG, there is an impaired postretinal neural conduction along both large and small axons (increased 60' and 15' RCTs) that is related to RGC dysfunction, but independent from the RNFL morphology. This implies that, in OAG, the impairment of postretinal neural structures can be electrophysiologically identified and may contribute to the visual field defects, as suggested by the linear correlation between the increase of RCT and MD reduction.
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Affiliation(s)
| | | | | | | | | | | | - Gianluca Manni
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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Kumar S, Ramakrishnan H, Viswanathan S, Akopian A, Bloomfield SA. Neuroprotection of the Inner Retina Also Prevents Secondary Outer Retinal Pathology in a Mouse Model of Glaucoma. Invest Ophthalmol Vis Sci 2021; 62:35. [PMID: 34297802 PMCID: PMC8300060 DOI: 10.1167/iovs.62.9.35] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/24/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose We examined structural and functional changes in the outer retina of a mouse model of glaucoma. We examined whether these changes are a secondary consequence of damage in the inner retina and whether neuroprotection of the inner retina also prevents outer retinal changes. Methods We used an established microbead occlusion model of glaucoma whereby intraocular pressure (IOP) was elevated. Specific antibodies were used to label rod and cone bipolar cells (BCs), horizontal cells (HCs), and retinal ganglion cells (RGCs), as well as synaptic components in control and glaucomatous eyes, to assess structural damage and cell loss. ERG recordings were made to assess outer retina function. Results We found structural and functional damage of BCs, including significant cell loss and dendritic/axonal remodeling of HCs, following IOP elevation. The first significant loss of both BCs occurred at 4 to 5 weeks after microbead injection. However, early changes in the dendritic structure of RGCs were observed at 3 weeks, but significant changes in the rod BC axon terminal structure were not seen until 4 weeks. We found that protection of inner retinal neurons in glaucomatous eyes by pharmacological blockade of gap junctions or genetic ablation of connexin 36 largely prevented outer retinal damage. Conclusions Together, our results indicate that outer retinal impairments in glaucoma are a secondary sequalae of primary damage in the inner retina. The finding that neuroprotection of the inner retina can also prevent outer retinal damage has important implications with regard to the targets for effective neuroprotective therapy.
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Affiliation(s)
- Sandeep Kumar
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, New York, United States
| | - Hariharasubramanian Ramakrishnan
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, New York, United States
| | - Suresh Viswanathan
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, New York, United States
| | - Abram Akopian
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, New York, United States
| | - Stewart A. Bloomfield
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, New York, United States
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Re R, Messenio D, Marano G, Spinelli L, Pirovano I, Contini D, Colombo R, Boracchi P, Biganzoli E, Cubeddu R, Torricelli A. Monitoring the haemodynamic response to visual stimulation in glaucoma patients. Sci Rep 2021; 11:13567. [PMID: 34193904 PMCID: PMC8245402 DOI: 10.1038/s41598-021-92857-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 06/16/2021] [Indexed: 11/23/2022] Open
Abstract
In this paper, we used time-domain functional near infrared spectroscopy (TD-fNIRS) to evaluate the haemodynamic response function (HRF) in the occipital cortex following visual stimulation in glaucomatous eyes as compared to healthy eyes. A total of 98 subjects were enrolled in the study and clinically classified as healthy subjects, glaucoma patients (primary open-angle glaucoma) and mixed subjects (i.e. with a different classification for the two eyes). After quality check data were used from HRF of 73 healthy and 62 glaucomatous eyes. The amplitudes of the oxygenated and deoxygenated haemoglobin concentrations, together with their latencies with respect to the stimulus onset, were estimated by fitting their time course with a canonical HRF. Statistical analysis showed that the amplitudes of both haemodynamic parameters show a significant association with the pathology and a significant discriminating ability, while no significant result was found for latencies. Overall, our findings together with the ease of use and noninvasiveness of TD-NIRS, make this technique a promising candidate as a supporting tool for a better evaluation of the glaucoma pathology.
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Affiliation(s)
- R Re
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy. .,Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Piazza Leonardo da Vinci 32, 20133, Milan, Italy.
| | - D Messenio
- Department of Clinical Sciences, Eye Clinic, ASST Fatebenefratelli Sacco Hospital, University of Milan, Milan, Italy
| | - G Marano
- Laboratorio di Statistica Medica, Biometria ed Epidemiologia "G.A. Maccacaro", Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Via Vanzetti 5, Milan, Italy
| | - L Spinelli
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Piazza Leonardo da Vinci 32, 20133, Milan, Italy
| | - I Pirovano
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy.,Istituto di Tecnologie Biomediche, Consiglio Nazionale delle Ricerche, via Fratelli Cervi 93, 20090, Segrate, MI, Italy
| | - D Contini
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy
| | - R Colombo
- Department of Clinical Sciences, Eye Clinic, ASST Fatebenefratelli Sacco Hospital, University of Milan, Milan, Italy
| | - P Boracchi
- Laboratorio di Statistica Medica, Biometria ed Epidemiologia "G.A. Maccacaro", Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Via Vanzetti 5, Milan, Italy
| | - E Biganzoli
- Laboratorio di Statistica Medica, Biometria ed Epidemiologia "G.A. Maccacaro", Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Via Vanzetti 5, Milan, Italy.,Unità di Statistica Medica, Biometria e Bioinformatica, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Vanzetti 5, Milan, Italy
| | - R Cubeddu
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy
| | - A Torricelli
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy.,Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Piazza Leonardo da Vinci 32, 20133, Milan, Italy
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42
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Trans-synaptic degeneration in the visual pathway: Neural connectivity, pathophysiology, and clinical implications in neurodegenerative disorders. Surv Ophthalmol 2021; 67:411-426. [PMID: 34146577 DOI: 10.1016/j.survophthal.2021.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 12/13/2022]
Abstract
There is a strong interrelationship between eye and brain diseases. It has been shown that neurodegenerative changes can spread bidirectionally in the visual pathway along neuronal projections. For example, damage to retinal ganglion cells in the retina leads to degeneration of the visual cortex (anterograde degeneration) and vice versa (retrograde degeneration). The underlying mechanisms of this process, known as trans-synaptic degeneration (TSD), are unknown, but TSD contributes to the progression of numerous neurodegenerative disorders, leading to clinical and functional deterioration. The hierarchical structure of the visual system comprises of a strong topographic connectivity between the retina and the visual cortex and therefore serves as an ideal model to study the cellular effect, clinical manifestations, and deterioration extent of TSD. With this review we provide comprehensive information about the neural connectivity, synapse function, molecular changes, and pathophysiology of TSD in visual pathways. We then discuss its bidirectional nature and clinical implications in neurodegenerative diseases. A thorough understanding of TSD in the visual pathway can provide insights into progression of neurodegenerative disorders and its potential as a therapeutic target.
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43
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Chronic Glaucoma Using Biodegradable Microspheres to Induce Intraocular Pressure Elevation. Six-Month Follow-Up. Biomedicines 2021; 9:biomedicines9060682. [PMID: 34208744 PMCID: PMC8235213 DOI: 10.3390/biomedicines9060682] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/05/2021] [Accepted: 06/11/2021] [Indexed: 02/06/2023] Open
Abstract
Background: To compare two prolonged animal models of glaucoma over 24 weeks of follow-up. A novel pre-trabecular model of chronic glaucoma was achieved by injection of biodegradable poly lactic-co-glycolic acid (PLGA) microspheres (10–20 µm) (Ms20/10) into the ocular anterior chamber to progressively increase ocular hypertension (OHT). Methods: Rat right eyes were injected to induce OHT: 50% received a suspension of Ms20/10 in the anterior chamber at 0, 2, 4, 8, 12, 16 and 20 weeks, and the other 50% received a sclerosing episcleral vein injection biweekly (EPIm). Ophthalmological clinical signs, intraocular pressure (IOP), neuroretinal functionality measured by electroretinography (ERG), and structural analysis of the retina, retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) protocols using optical coherence tomography (OCT) and histological exams were performed. Results: Both models showed progressive neuroretinal degeneration (p < 0.05), and contralateral eye affectation. The Ms20/10 model showed a more progressive increase in IOP and better preservation of ocular surface. Although no statistical differences were found between models, the EPIm showed a tendency to produce thicker retinal and thinner GCL thicknesses, slower latency and smaller amplitude as measured using ERG, and more aggressive disturbances in retinal histology. In both models, while the GCL showed the greatest percentage loss of thickness, the RNFL showed the greatest and earliest rate of thickness loss. Conclusions: The intracameral model with biodegradable microspheres resulted more like the conditions observed in humans. It was obtained by a less-aggressive mechanism, which allows for adequate study of the pathology over longer periods.
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44
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You M, Rong R, Zeng Z, Xia X, Ji D. Transneuronal Degeneration in the Brain During Glaucoma. Front Aging Neurosci 2021; 13:643685. [PMID: 33889083 PMCID: PMC8055862 DOI: 10.3389/fnagi.2021.643685] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/11/2021] [Indexed: 12/18/2022] Open
Abstract
The death of retinal ganglion cells (RGCs) is a key factor in the pathophysiology of all types of glaucoma, but the mechanism of pathogenesis of glaucoma remains unclear. RGCs are a group of central nervous system (CNS) neurons whose soma are in the inner retina. The axons of RGCs form the optic nerve and converge at the optic chiasma; from there, they project to the visual cortex via the lateral geniculate nucleus (LGN). In recent years, there has been increasing interest in the dysfunction and death of CNS and retinal neurons caused by transneuronal degeneration of RGCs, and the view that glaucoma is a widespread neurodegenerative disease involving CNS damage appears more and more frequently in the literature. In this review, we summarize the current knowledge of LGN and visual cortex neuron damage in glaucoma and possible mechanisms behind the damage. This review presents an updated and expanded view of neuronal damage in glaucoma, and reveals new and potential targets for neuroprotection and treatment.
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Affiliation(s)
- Mengling You
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China
| | - Rong Rong
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China
| | - Zhou Zeng
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China
| | - Xiaobo Xia
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China
| | - Dan Ji
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China
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45
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Takahashi N, Matsunaga N, Natsume T, Kitazawa C, Itani Y, Hama A, Hayashi I, Shimazawa M, Hara H, Takamatsu H. A longitudinal comparison in cynomolgus macaques of the effect of brimonidine on optic nerve neuropathy using diffusion tensor imaging magnetic resonance imaging and spectral domain optical coherence tomography. Heliyon 2021; 7:e06701. [PMID: 33898826 PMCID: PMC8056221 DOI: 10.1016/j.heliyon.2021.e06701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 01/04/2021] [Accepted: 03/31/2021] [Indexed: 10/26/2022] Open
Abstract
Early detection of optic neuropathy is crucial for initiating treatment that could delay or prevent visual field loss. Preclinical studies have advanced a number of potential neuroprotective strategies to prevent retinal ganglion cell (RGC) degeneration, but none have successfully completed clinical trials. One issue related to the lack of preclinical to clinical translation is the lack of preclinical morphometric assessments that could be used to track neuroprotection, as well as neurodegeneration, over time within the same animal. Thus, to assess whether clinically used morphometric assessments can identify neuroprotection of RGC, the current study compared optic nerve fractional anisotropy (FA) obtained with diffusion tensor imaging (DTI) and retinal nerve fiber layer (RNFL) thickness measured with spectral domain optical coherence tomography (SD-OCT) to observe not only the early progression of RGC axonal degeneration but to also discern which imaging modality identifies signs of neuroprotection during treatment with the alpha-adrenoceptor agonist brimonidine. Elevated and sustained intraocular pressure (IOP) was observed following laser photocoagulation of the trabecular meshwork in one eye of nonhuman primates (NHP). Either brimonidine (0.1%) or control treatment was instilled twice daily for two months. In control-treated eyes, increased IOP, increased vertical cup-to-disc (C/D), reduced rim-to-disc (R/D) ratio, decreased RNFL thickness and decreased FA were observed. While IOP remained elevated during the course of the study, brimonidine tended to delay the progression of RNFL thinning. However, in the same animal, optic nerve FA did not appear to decline. Brimonidine treatment did not affect other measures of RGC axonal degeneration. The current findings demonstrate that early progression of optic neuropathy can be tracked over time in a nonhuman primate model of ocular hypertension using either DTI or SD-OCT. Furthermore, the delayed changes to RNFL thickness and FA appear to be a neuroprotective effect of brimonidine independent of its effect on IOP.
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Affiliation(s)
- Nobuyuki Takahashi
- Pharmacology, Hamamatsu Pharma Research, Inc., 1-3-7, Shinmiyakoda, Kita-ku, Hamamatsu, Shizuoka, 431-2103, Japan
| | - Naoko Matsunaga
- Pharmacology, Hamamatsu Pharma Research, Inc., 1-3-7, Shinmiyakoda, Kita-ku, Hamamatsu, Shizuoka, 431-2103, Japan
| | - Takahiro Natsume
- Pharmacology, Hamamatsu Pharma Research, Inc., 1-3-7, Shinmiyakoda, Kita-ku, Hamamatsu, Shizuoka, 431-2103, Japan
| | - Chinatsu Kitazawa
- Pharmacology, Hamamatsu Pharma Research, Inc., 1-3-7, Shinmiyakoda, Kita-ku, Hamamatsu, Shizuoka, 431-2103, Japan
| | - Yoshitaka Itani
- Pharmacology, Hamamatsu Pharma Research, Inc., 1-3-7, Shinmiyakoda, Kita-ku, Hamamatsu, Shizuoka, 431-2103, Japan
| | - Aldric Hama
- Pharmacology, Hamamatsu Pharma Research, Inc., 1-3-7, Shinmiyakoda, Kita-ku, Hamamatsu, Shizuoka, 431-2103, Japan
| | - Ikuo Hayashi
- Hamamatsu Pharma Research USA, Inc., 4660 La Jolla Village Drive, San Diego, CA, 92122 USA
| | - Masamitsu Shimazawa
- Molecular Pharmacology, Department of Biofunctional Evaluation, Gifu Pharmaceutical University, 1-25-4 Daigaku-nishi, Gifu 501-1196, Japan
| | - Hideaki Hara
- Molecular Pharmacology, Department of Biofunctional Evaluation, Gifu Pharmaceutical University, 1-25-4 Daigaku-nishi, Gifu 501-1196, Japan
| | - Hiroyuki Takamatsu
- Pharmacology, Hamamatsu Pharma Research, Inc., 1-3-7, Shinmiyakoda, Kita-ku, Hamamatsu, Shizuoka, 431-2103, Japan
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46
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Wang Q, Qu X, Chen W, Wang H, Huang C, Li T, Wang N, Xian J. Altered coupling of cerebral blood flow and functional connectivity strength in visual and higher order cognitive cortices in primary open angle glaucoma. J Cereb Blood Flow Metab 2021; 41:901-913. [PMID: 32580669 PMCID: PMC7983497 DOI: 10.1177/0271678x20935274] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/08/2020] [Accepted: 05/26/2020] [Indexed: 01/30/2023]
Abstract
Primary open-angle glaucoma (POAG) has been suggested to be a neurodegenerative disease associated with altered cerebral vascular hemodynamics and widespread disruption of neuronal activity within the visual, working memory, attention and executive networks. We hypothesized that disturbed neurovascular coupling in visual and higher order cognitive cortices exists in POAG patients and correlates with glaucoma stage and visual field defects. Through multimodal magnetic resonance imaging, we evaluated the cerebral blood flow (CBF)-functional connectivity strength (FCS) correlations of the whole gray matter and CBF/FCS ratio per voxel for all subjects. Compared with normal controls, POAG patients showed reduced global CBF-FCS coupling and altered CBF/FCS ratios, predominantly in regions in the visual cortex, salience network, default mode network, and dorsal attentional network. The CBF/FCS ratio was negatively correlated with glaucoma stage, and positively correlated with visual field defects in the lingual gyrus in POAG patients. Moreover, early brain changes were detected in early POAG. These findings indicate neurovascular coupling dysfunction might exist in the visual and higher order cognitive cortices in POAG patients and its clinical relevance. The results may contribute to the monitoring of POAG progression and provide insight into the pathophysiology of the neurodegenerative process in POAG.
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Affiliation(s)
- Qian Wang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiaoxia Qu
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Weiwei Chen
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University
| | - Huaizhou Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University
| | - Caiyun Huang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ting Li
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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47
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van der Merwe Y, Murphy MC, Sims JR, Faiq MA, Yang XL, Ho LC, Conner IP, Yu Y, Leung CK, Wollstein G, Schuman JS, Chan KC. Citicoline Modulates Glaucomatous Neurodegeneration Through Intraocular Pressure-Independent Control. Neurotherapeutics 2021; 18:1339-1359. [PMID: 33846961 PMCID: PMC8423893 DOI: 10.1007/s13311-021-01033-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2021] [Indexed: 02/08/2023] Open
Abstract
Glaucoma is a neurodegenerative disease that causes progressive, irreversible vision loss. Currently, intraocular pressure (IOP) is the only modifiable risk factor for glaucoma. However, glaucomatous degeneration may continue despite adequate IOP control. Therefore, there exists a need for treatment that protects the visual system, independent of IOP. This study sought, first, to longitudinally examine the neurobehavioral effects of different magnitudes and durations of IOP elevation using multi-parametric magnetic resonance imaging (MRI), optokinetics and histology; and, second, to evaluate the effects of oral citicoline treatment as a neurotherapeutic in experimental glaucoma. Eighty-two adult Long Evans rats were divided into six groups: acute (mild or severe) IOP elevation, chronic (citicoline-treated or untreated) IOP elevation, and sham (acute or chronic) controls. We found that increasing magnitudes and durations of IOP elevation differentially altered structural and functional brain connectivity and visuomotor behavior, as indicated by decreases in fractional anisotropy in diffusion tensor MRI, magnetization transfer ratios in magnetization transfer MRI, T1-weighted MRI enhancement of anterograde manganese transport, resting-state functional connectivity, visual acuity, and neurofilament and myelin staining along the visual pathway. Furthermore, 3 weeks of oral citicoline treatment in the setting of chronic IOP elevation significantly reduced visual brain integrity loss and visual acuity decline without altering IOP. Such effects sustained after treatment was discontinued for another 3 weeks. These results not only illuminate the close interplay between eye, brain, and behavior in glaucomatous neurodegeneration, but also support a role for citicoline in protecting neural tissues and visual function in glaucoma beyond IOP control.
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Affiliation(s)
- Yolandi van der Merwe
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matthew C Murphy
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Jeffrey R Sims
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA
| | - Muneeb A Faiq
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA
| | - Xiao-Ling Yang
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Leon C Ho
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ian P Conner
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yu Yu
- Pleryon Therapeutics Limited, Shenzhen, China
| | - Christopher K Leung
- University Eye Center, Hong Kong Eye Hospital, Hong Kong, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA
- Center for Neural Science, College of Arts and Science, New York University, New York, NY, USA
| | - Joel S Schuman
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA
- Center for Neural Science, College of Arts and Science, New York University, New York, NY, USA
- Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA
| | - Kevin C Chan
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA.
- Center for Neural Science, College of Arts and Science, New York University, New York, NY, USA.
- Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA.
- Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA.
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48
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Haykal S, Jansonius NM, Cornelissen FW. Progression of Visual Pathway Degeneration in Primary Open-Angle Glaucoma: A Longitudinal Study. Front Hum Neurosci 2021; 15:630898. [PMID: 33854423 PMCID: PMC8039117 DOI: 10.3389/fnhum.2021.630898] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/05/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Primary open-angle glaucoma (POAG) patients exhibit widespread white matter (WM) degeneration throughout their visual pathways. Whether this degeneration starts at the pre- or post-geniculate pathways remains unclear. In this longitudinal study, we assess the progression of WM degeneration exhibited by the pre-geniculate optic tracts (OTs) and the post-geniculate optic radiations (ORs) of POAG patients over time, aiming to determine the source and pattern of spread of this degeneration. Methods: Diffusion-weighted MRI scans were acquired for 12 POAG patients and 14 controls at two time-points 5.4 ± 2.1 years apart. Fiber density (FD), an estimate of WM axonal density, was computed for the OTs and ORs of all participants in an unbiased longitudinal population template space. First, FD was compared between POAG patients and the controls at time-point 1 (TP1) and time-point 2 (TP2) independently. Secondly, repeated measures analysis was performed for FD change in POAG patients between the two time-points. Finally, we compared the rate of FD change over time between the two groups. Results: Compared to the controls, POAG patients exhibited significantly lower FD in the left OT at TP1 and in both OTs and the left OR at TP2. POAG patients showed a significant loss of FD between the time-points in the right OT and both ORs, while the left OR showed a significantly higher rate of FD loss in POAG patients compared to the controls. Conclusions: We find longitudinal progression of neurodegenerative WM changes in both the pre- and post-geniculate visual pathways of POAG patients. The pattern of changes suggests that glaucomatous WM degeneration starts at the pre-geniculate pathways and then spreads to the post-geniculate pathways. Furthermore, we find evidence that the trans-synaptic spread of glaucomatous degeneration to the post-geniculate pathways is a prolonged process which continues in the absence of detectable pre-geniculate degenerative progression. This suggests the presence of a time window for salvaging intact post-geniculate pathways, which could prove to be a viable therapeutic target in the future.
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Affiliation(s)
- Shereif Haykal
- Laboratory for Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Frans W Cornelissen
- Laboratory for Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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49
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Fiedorowicz M, Choragiewicz T, Turski WA, Kocki T, Nowakowska D, Wertejuk K, Kamińska A, Avitabile T, Wełniak-Kaminska M, Grieb P, Zweifel S, Rejdak R, Toro MD. Tryptophan Pathway Abnormalities in a Murine Model of Hereditary Glaucoma. Int J Mol Sci 2021; 22:1039. [PMID: 33494373 PMCID: PMC7865582 DOI: 10.3390/ijms22031039] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND It has been shown that a possible pathogenetic mechanism of neurodegeneration in the mouse model of glaucoma (DBA/2J) may be an alteration of kynurenic acid (KYNA) in the retina. This study aimed to verify the hypothesis that alterations of tryptophan (TRP) metabolism in DBA/2J mice is not limited to the retina. METHODS Samples of the retinal tissue and serum were collected from DBA/2J mice (6 and 10 months old) and control C57Bl/6 mice of the same age. The concentration of TRP, KYNA, kynurenine (KYN), and 3-hydroxykynurenine (3OH-K) was measured by HPLC. The activity of indoleamine 2,3-dioxygenase (IDO) was also determined as a KYN/TRP ratio. RESULTS TRP, KYNA, L-KYN, and 3OH-K concentration were significantly lower in the retinas of DBA/2J mice than in C57Bl/6 mice. 3OH-K concentration was higher in older mice in both strains. Serum TRP, L-KYN, and KYNA concentrations were lower in DBA/2J than in age-matched controls. However, serum IDO activity did not differ significantly between compared groups and strains. CONCLUSIONS Alterations of the TRP pathway seem not to be limited to the retina in the murine model of hereditary glaucoma.
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Affiliation(s)
- Michal Fiedorowicz
- Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland; (M.F.); (M.W.-K.); (P.G.)
| | - Tomasz Choragiewicz
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland; (T.C.); (D.N.); (K.W.); (R.R.)
| | - Waldemar A. Turski
- Department of Experimental and Clinical Pharmacology, Medical University of Lublin, 20-079 Lublin, Poland; (W.A.T.); (T.K.)
| | - Tomasz Kocki
- Department of Experimental and Clinical Pharmacology, Medical University of Lublin, 20-079 Lublin, Poland; (W.A.T.); (T.K.)
| | - Dominika Nowakowska
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland; (T.C.); (D.N.); (K.W.); (R.R.)
| | - Kamila Wertejuk
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland; (T.C.); (D.N.); (K.W.); (R.R.)
| | - Agnieszka Kamińska
- Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland;
| | - Teresio Avitabile
- Department of Ophthalmology, University of Catania, 95123 Catania, Italy;
| | - Marlena Wełniak-Kaminska
- Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland; (M.F.); (M.W.-K.); (P.G.)
| | - Pawel Grieb
- Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland; (M.F.); (M.W.-K.); (P.G.)
| | - Sandrine Zweifel
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland;
| | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland; (T.C.); (D.N.); (K.W.); (R.R.)
| | - Mario Damiano Toro
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland; (T.C.); (D.N.); (K.W.); (R.R.)
- Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland;
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland;
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Abstract
Safe driving demands the coordination of multiple sensory and cognitive functions, such as vision and attention. Patients with neurologic or ophthalmic disease are exposed to selective pathophysiologic insults to driving-critical systems, placing them at a higher risk for unsafe driving and restricted driving privileges. Here, we evaluate how vision and attention contribute to unsafe driving across different patient populations. In ophthalmic disease, we focus on macular degeneration, glaucoma, diabetic retinopathy, and cataract; in neurologic disease, we focus on Alzheimer's disease, Parkinson's disease, and multiple sclerosis. Unsafe driving is generally associated with impaired vision and attention in ophthalmic and neurologic patients, respectively. Furthermore, patients with ophthalmic disease experience some degree of impairment in attention. Similarly, patients with neurologic disease experience some degree of impairment in vision. While numerous studies have demonstrated a relationship between impaired vision and unsafe driving in neurologic disease, there remains a dearth of knowledge regarding the relationship between impaired attention and unsafe driving in ophthalmic disease. In summary, this chapter confirms-and offers opportunities for future research into-the contribution of vision and attention to safe driving.
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Affiliation(s)
- David E Anderson
- Department of Ophthalmology & Visual Sciences, University of Nebraska Medical Center, Omaha, NE, United States
| | - Deepta A Ghate
- Department of Ophthalmology & Visual Sciences, University of Nebraska Medical Center, Omaha, NE, United States
| | - Matthew Rizzo
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States.
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