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Umeya N, Yoshizawa Y, Fukuda K, Ikeda K, Kamada M, Inada H, Usui T, Miyawaki I. Detection of retinal dysfunction induced by HCN channel inhibitors using multistep light stimulus and long-duration light stimulus ERG in rats. Exp Eye Res 2024; 241:109847. [PMID: 38401854 DOI: 10.1016/j.exer.2024.109847] [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: 11/17/2023] [Revised: 02/01/2024] [Accepted: 02/21/2024] [Indexed: 02/26/2024]
Abstract
Ivabradine, a hyperpolarization-activated cyclic nucleotide-gated (HCN) channel inhibitor, has been reported to induce photosensitivity-related visual disturbances such as phosphene in humans. Ivabradine-induced visual disturbances are caused by inhibition of HCN channels in the retina, and the mechanisms have been verified using HCN channel knockout mice and electroretinography (ERG). However, in rats, classical ERG using single flash light stimulus with standard analyses of waveform amplitude and latency has not revealed abnormal retinal function after administration of ivabradine. To verify whether retinal dysfunction after ivabradine administration was detectable in rats, we performed ERG using multistep flash light stimulation at the time when plasma concentration of ivabradine was high. Furthermore, the mechanism of the change in the waveform that appeared after the b-wave was investigated. Ivabradine and cilobradine, a selective HCN channel inhibitor, were administered subcutaneously to rats at 4-40 mg/kg as a single dose, and flash or long-duration ERG recordings at each light stimulus luminance were conducted 1.5 h after administration. Plasma and retinal concentrations of both compounds were measured immediately after the ERG recordings. In the flash ERG, prolongation of a- and/or b-wave latencies were detected at each light stimulus, and dose-dependent waveform changes after the b-wave were recorded at the specific light stimulus luminance for both compounds. These ERG changes increased in response to increasing plasma and retinal concentrations for both ivabradine and cilobradine. In the long-duration light stimulus ERG, a change in the waveform of the b-wave trough and attenuation of the c-wave were recorded, suggesting that the feedback control in the photoreceptor cells may be inhibited. This study revealed that the retinal dysfunction by HCN channel inhibitors in rats can be detected by multistep light stimulus ERG. Additionally, we identified that the inhibition of feedback current and the sustained responses in the photoreceptor cells cause the retinal dysfunction of HCN channel inhibitors in rats.
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Affiliation(s)
- Naohisa Umeya
- Preclinical Research Unit, Drug Research Division, Sumitomo Pharma Co. Ltd., 3-1-98 Kasugade-naka, Konohana-ku, Osaka, 554-0022, Japan.
| | - Yuki Yoshizawa
- Preclinical Research Unit, Drug Research Division, Sumitomo Pharma Co. Ltd., 3-1-98 Kasugade-naka, Konohana-ku, Osaka, 554-0022, Japan
| | - Kosuke Fukuda
- Preclinical Research Unit, Drug Research Division, Sumitomo Pharma Co. Ltd., 3-1-98 Kasugade-naka, Konohana-ku, Osaka, 554-0022, Japan
| | - Keigo Ikeda
- Preclinical Research Unit, Drug Research Division, Sumitomo Pharma Co. Ltd., 3-1-98 Kasugade-naka, Konohana-ku, Osaka, 554-0022, Japan
| | - Mami Kamada
- Preclinical Research Unit, Drug Research Division, Sumitomo Pharma Co. Ltd., 3-1-98 Kasugade-naka, Konohana-ku, Osaka, 554-0022, Japan
| | - Hiroshi Inada
- Preclinical Research Unit, Drug Research Division, Sumitomo Pharma Co. Ltd., 3-1-98 Kasugade-naka, Konohana-ku, Osaka, 554-0022, Japan
| | - Toru Usui
- Preclinical Research Unit, Drug Research Division, Sumitomo Pharma Co. Ltd., 3-1-98 Kasugade-naka, Konohana-ku, Osaka, 554-0022, Japan
| | - Izuru Miyawaki
- Preclinical Research Unit, Drug Research Division, Sumitomo Pharma Co. Ltd., 3-1-98 Kasugade-naka, Konohana-ku, Osaka, 554-0022, Japan
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Rodrigo MJ, Bravo-Osuna I, Subias M, Montolío A, Cegoñino J, Martinez-Rincón T, Mendez-Martinez S, Aragón-Navas A, Garcia-Herranz D, Pablo LE, Herrero-Vanrell R, del Palomar AP, Garcia-Martin E. Tunable degrees of neurodegeneration in rats based on microsphere-induced models of chronic glaucoma. Sci Rep 2022; 12:20622. [PMID: 36450772 PMCID: PMC9712621 DOI: 10.1038/s41598-022-24954-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
This study compares four different animal models of chronic glaucoma against normal aging over 6 months. Chronic glaucoma was induced in 138 Long-Evans rats and compared against 43 aged-matched healthy rats. Twenty-five rats received episcleral vein sclerosis injections (EPIm cohort) while the rest were injected in the eye anterior chamber with a suspension of biodegradable microspheres: 25 rats received non-loaded microspheres (N-L Ms cohort), 45 rats received microspheres loaded with dexamethasone (MsDexa cohort), and 43 rats received microspheres co-loaded with dexamethasone and fibronectin (MsDexaFibro cohort). Intraocular pressure, neuroretinal function, structure and vitreous interface were evaluated. Each model caused different trends in intraocular pressure, produced specific retinal damage and vitreous signals. The steepest and strongest increase in intraocular pressure was seen in the EPIm cohort and microspheres models were more progressive. The EPIm cohort presented the highest vitreous intensity and percentage loss in the ganglion cell layer, the MsDexa cohort presented the greatest loss in the retinal nerve fiber layer, and the MsDexaFibro cohort presented the greatest loss in total retinal thickness. Function decreased differently among cohorts. Using biodegradable microspheres models it is possible to generate tuned neurodegeneration. These results support the multifactorial nature of glaucoma based on several noxa.
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Affiliation(s)
- María Jesús Rodrigo
- grid.411106.30000 0000 9854 2756Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain ,grid.417198.20000 0000 8497 6529Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, Madrid, Spain ,grid.11205.370000 0001 2152 8769Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - Irene Bravo-Osuna
- grid.4795.f0000 0001 2157 7667Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain ,grid.417198.20000 0000 8497 6529Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, Madrid, Spain ,Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - Manuel Subias
- grid.411106.30000 0000 9854 2756Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain ,grid.11205.370000 0001 2152 8769Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - Alberto Montolío
- grid.11205.370000 0001 2152 8769Biomaterials Group, Aragon Engineering Research Institute (I3a), University of Zaragoza, Zaragoza, Spain ,grid.11205.370000 0001 2152 8769Department of Mechanical Engineering, University of Zaragoza, Zaragoza, Spain
| | - José Cegoñino
- grid.11205.370000 0001 2152 8769Biomaterials Group, Aragon Engineering Research Institute (I3a), University of Zaragoza, Zaragoza, Spain ,grid.11205.370000 0001 2152 8769Department of Mechanical Engineering, University of Zaragoza, Zaragoza, Spain
| | - Teresa Martinez-Rincón
- grid.411106.30000 0000 9854 2756Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain ,grid.11205.370000 0001 2152 8769Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - Silvia Mendez-Martinez
- grid.411106.30000 0000 9854 2756Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain ,grid.11205.370000 0001 2152 8769Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - Alba Aragón-Navas
- grid.4795.f0000 0001 2157 7667Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain ,grid.417198.20000 0000 8497 6529Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, Madrid, Spain ,Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - David Garcia-Herranz
- grid.4795.f0000 0001 2157 7667Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain ,grid.417198.20000 0000 8497 6529Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, Madrid, Spain ,Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - Luis Emilio Pablo
- grid.411106.30000 0000 9854 2756Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain ,grid.417198.20000 0000 8497 6529Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, Madrid, Spain ,grid.11205.370000 0001 2152 8769Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - Rocío Herrero-Vanrell
- grid.4795.f0000 0001 2157 7667Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain ,grid.417198.20000 0000 8497 6529Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, Madrid, Spain ,Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - Amaya Pérez del Palomar
- grid.11205.370000 0001 2152 8769Biomaterials Group, Aragon Engineering Research Institute (I3a), University of Zaragoza, Zaragoza, Spain ,grid.11205.370000 0001 2152 8769Department of Mechanical Engineering, University of Zaragoza, Zaragoza, Spain
| | - Elena Garcia-Martin
- grid.411106.30000 0000 9854 2756Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain ,grid.417198.20000 0000 8497 6529Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, Madrid, Spain ,grid.11205.370000 0001 2152 8769Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Zaragoza, Spain ,C/Padre Arrupe, Servicio de Oftalmología, Edificio de Consultas Externas, Planta 1, 50009 Zaragoza, Spain
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Gao S, Zeng Y, Li Y, Cohen ED, Berkowitz BA, Qian H. Fast and slow light-induced changes in murine outer retina optical coherence tomography: complementary high spatial resolution functional biomarkers. PNAS NEXUS 2022; 1:pgac208. [PMID: 36338188 PMCID: PMC9615127 DOI: 10.1093/pnasnexus/pgac208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/21/2022] [Indexed: 11/18/2022]
Abstract
Fast (seconds) and slow (minutes to hours) optical coherence tomography (OCT) responses to light stimulation have been developed to probe outer retinal function with higher spatial resolution than the classical full-field electroretinogram (ERG). However, the relationships between functional information revealed by OCT and ERG are largely unexplored. In this study, we directly compared the fast and slow OCT responses with the ERG. Fast responses [i.e. the optoretinogram (ORG)] are dominated by reflectance changes in the outer segment (OS) and the inner segment ellipsoid zone (ISez). The ORG OS response has faster kinetics and a higher light sensitivity than the ISez response, and both differ significantly with ERG parameters. Sildenafil-inhibition of phototransduction reduced the ORG light sensitivity, suggesting a complete phototransduction pathway is needed for ORG responses. Slower OCT responses were dominated by light-induced changes in the external limiting membrane to retinal pigment epithelium (ELM-RPE) thickness and photoreceptor-tip hyporeflective band (HB) magnitudes, with the biggest changes occurring after prolonged light stimulation. Mice with high (129S6/ev) vs. low (C57BL/6 J) ATP(adenosine triphosphate) synthesis efficiency show similar fast ORG, but dissimilar slow OCT responses. We propose that the ORG reflects passive physiology, such as water movement from photoreceptors, in response to the photocurrent response (measurable by ERG), whereas the slow OCT responses measure mitochondria-driven physiology in the outer retina, such as dark-provoked water removal from the subretinal space.
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Affiliation(s)
- Shasha Gao
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, China
- Visual Function Core, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Yong Zeng
- Visual Function Core, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Yichao Li
- Visual Function Core, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ethan D Cohen
- Division of Biomedical Physics, Office of Science and Engineering Labs, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD 20993-0002, USA
| | - Bruce A Berkowitz
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI 48202, USA
| | - Haohua Qian
- Visual Function Core, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Retinal Toxicity Induced by Chemical Agents. Int J Mol Sci 2022; 23:ijms23158182. [PMID: 35897758 PMCID: PMC9331776 DOI: 10.3390/ijms23158182] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
Vision is an important sense for humans, and visual impairment/blindness has a huge impact in daily life. The retina is a nervous tissue that is essential for visual processing since it possesses light sensors (photoreceptors) and performs a pre-processing of visual information. Thus, retinal cell dysfunction or degeneration affects visual ability and several general aspects of the day-to-day of a person's lives. The retina has a blood-retinal barrier, which protects the tissue from a wide range of molecules or microorganisms. However, several agents, coming from systemic pathways, reach the retina and influence its function and survival. Pesticides are still used worldwide for agriculture, contaminating food with substances that could reach the retina. Natural products have also been used for therapeutic purposes and are another group of substances that can get to the retina. Finally, a wide number of medicines administered for different diseases can also affect the retina. The present review aimed to gather recent information about the hazard of these products to the retina, which could be used to encourage the search for more healthy, suitable, or less risky agents.
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Sildenafil-evoked photoreceptor oxidative stress in vivo is unrelated to impaired visual performance in mice. PLoS One 2021; 16:e0245161. [PMID: 33661941 PMCID: PMC7932139 DOI: 10.1371/journal.pone.0245161] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 12/22/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose The phosphodiesterase inhibitor sildenafil is a promising treatment for neurodegenerative disease, but it can cause oxidative stress in photoreceptors ex vivo and degrade visual performance in humans. Here, we test the hypotheses that in wildtype mice sildenafil causes i) wide-spread photoreceptor oxidative stress in vivo that is linked with ii) impaired vision. Methods In dark or light-adapted C57BL/6 mice ± sildenafil treatment, the presence of oxidative stress was evaluated in retina laminae in vivo by QUEnch-assiSTed (QUEST) magnetic resonance imaging, in the subretinal space in vivo by QUEST optical coherence tomography, and in freshly excised retina by a dichlorofluorescein assay. Visual performance indices were also evaluated by QUEST optokinetic tracking. Results In light-adapted mice, 1 hr post-sildenafil administration, oxidative stress was most evident in the superior peripheral outer retina on both in vivo and ex vivo examinations; little evidence was noted for central retina oxidative stress in vivo and ex vivo. In dark-adapted mice 1 hr after sildenafil, no evidence for outer retina oxidative stress was found in vivo. Evidence for sildenafil-induced central retina rod cGMP accumulation was suggested as a panretinally thinner, dark-like subretinal space thickness in light-adapted mice at 1 hr but not 5 hr post-sildenafil. Cone-based visual performance was impaired by 5 hr post-sildenafil and not corrected with anti-oxidants; vision was normal at 1 hr and 24 hr post-sildenafil. Conclusions The sildenafil-induced spatiotemporal pattern of oxidative stress in photoreceptors dominated by rods was unrelated to impairment of cone-based visual performance in wildtype mice.
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Rodrigo MJ, Cardiel MJ, Fraile JM, Mendez-Martinez S, Martinez-Rincon T, Subias M, Polo V, Ruberte J, Ramirez T, Vispe E, Luna C, Mayoral JA, Garcia-Martin E. Brimonidine-LAPONITE® intravitreal formulation has an ocular hypotensive and neuroprotective effect throughout 6 months of follow-up in a glaucoma animal model. Biomater Sci 2020; 8:6246-6260. [PMID: 33016285 DOI: 10.1039/d0bm01013h] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Intravitreal administration is widely used in ophthalmological practice to maintain therapeutic drug levels near the neuroretina and because drug delivery systems are necessary to avoid reinjections and sight-threatening side effects. However, currently there is no intravitreal treatment for glaucoma. The brimonidine-LAPONITE® formulation was created with the aim of treating glaucoma for extended periods with a single intravitreal injection. Glaucoma was induced by producing ocular hypertension in two rat cohorts: [BRI-LAP] and [non-bri], with and without treatment, respectively. Eyes treated with brimonidine-LAPONITE® showed lower ocular pressure levels up to week 8 (p < 0.001), functional neuroprotection explored by scotopic and photopic negative response electroretinography (p = 0.042), and structural protection of the retina, retinal nerve fibre layer and ganglion cell layer (p = 0.038), especially on the superior-inferior axis explored by optical coherence tomography, which was corroborated by a higher retinal ganglion cell count (p = 0.040) using immunohistochemistry (Brn3a antibody) up to the end of the study (week 24). Furthermore, delayed neuroprotection was detected in the contralateral eye. Brimonidine was detected in treated rat eyes for up to 6 months. Brimonidine-LAPONITE® seems to be a potential sustained-delivery intravitreal drug for glaucoma treatment.
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Affiliation(s)
- M J Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.
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Rodrigo MJ, Martinez-Rincon T, Subias M, Mendez-Martinez S, Luna C, Pablo LE, Polo V, Garcia-Martin E. Effect of age and sex on neurodevelopment and neurodegeneration in the healthy eye: Longitudinal functional and structural study in the Long-Evans rat. Exp Eye Res 2020; 200:108208. [PMID: 32882213 DOI: 10.1016/j.exer.2020.108208] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/05/2020] [Accepted: 08/26/2020] [Indexed: 01/03/2023]
Abstract
The processes involved in neurodevelopment and aging have not yet been fully discovered. This is especially challenging in premorbid or borderline situations of neurodegenerative diseases such as Alzheimer's or glaucoma. The retina, as part of the central nervous system, can be considered the easiest and most accessible neural structure that can be analyzed using non-invasive methods. Animal studies of neuroretinal tissue in situations of health and under controlled conditions allow the earliest sex- and aging-induced changes to be analyzed so as to differentiate them from the first signs occurring in manifested disease. This study evaluates differences by age and sex based on intraocular pressure (IOP) and neuroretinal function and structure in healthy young and adult rats before decline due to senescence. For this purpose, eighty-five healthy Long-Evans rats (31 males and 54 females) were analyzed in this 6-month longitudinal study running from childhood to adulthood. IOP was measured by tonometer (Tonolab; Tiolat Oy Helsinki, Finland), neuroretinal function was recorded by flash scotopic and light-adapted photopic negative response electroretinography (ERG) (Roland consult® RETIanimal ERG, Germany) at 4, 16 and 28 weeks of age; and structure was evaluated by in vivo optical coherence tomography (OCT) (Spectralis, Heidelberg® Engineering, Germany). Analyzing both sexes together, IOP was below 20 mmHg throughout the study; retina (R), retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thicknesses measured by OCT decreased over time; an increase in ERG signal was recorded at week 16; and no differences were found between right and left eyes. However, analyzing differences by sex revealed that males had higher IOP (even reaching ocular hypertension [>20 mmHg] by the end of the study [7 months of age]), exhibited greater neuroretinal thickness but higher structural percentage loss, and had worse dark- and light-adapted function as measured by ERG than females. This study concludes that age and sex influenced neurodevelopment and neurodegeneration. Different structural and functional degenerative patterns were observed by sex; these occurred earlier and more intensely in males than in age-matched females.
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Affiliation(s)
- Maria Jesus Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, Spain; RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain.
| | - Teresa Martinez-Rincon
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, Spain
| | - Manuel Subias
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, Spain
| | - Silvia Mendez-Martinez
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, Spain
| | - Coral Luna
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, Spain
| | - Luis Emilio Pablo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, Spain; RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain
| | - Vicente Polo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, Spain
| | - Elena Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, Spain; RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain
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