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Goto H, Arima T, Takahashi A, Tobita Y, Nakano Y, Toda E, Shimizu A, Okamoto F. Trimebutine prevents corneal inflammation in a rat alkali burn model. Sci Rep 2024; 14:12111. [PMID: 38802470 PMCID: PMC11130283 DOI: 10.1038/s41598-024-61112-4] [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: 02/14/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024] Open
Abstract
Alkaline burns to the cornea lead to loss of corneal transparency, which is essential for normal vision. We used a rat corneal alkaline burn model to investigate the effect of ophthalmic trimebutine solution on healing wounds caused by alkaline burns. Trimebutine, an inhibitor of the high-mobility group box 1-receptor for advanced glycation end products, when topically applied to the burned cornea, suppressed macrophage infiltration in the early phase and neutrophil infiltration in the late phase at the wound site. It also inhibited neovascularization and myofibroblast development in the late phase. Furthermore, trimebutine effectively inhibited interleukin-1β expression in the injured cornea. It reduced scar formation by decreasing the expression of type III collagen. These findings suggest that trimebutine may represent a novel therapeutic strategy for corneal wounds, not only through its anti-inflammatory effects but also by preventing neovascularization.
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Affiliation(s)
- Hitoshi Goto
- Department of Ophthalmology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan
- Department of Analytic Human Pathology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Takeshi Arima
- Department of Ophthalmology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan
- Department of Analytic Human Pathology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Akira Takahashi
- Department of Ophthalmology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan
- Department of Analytic Human Pathology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Yutaro Tobita
- Department of Ophthalmology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan
- Department of Analytic Human Pathology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Yuji Nakano
- Department of Ophthalmology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan
- Department of Analytic Human Pathology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Etsuko Toda
- Department of Analytic Human Pathology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Akira Shimizu
- Department of Analytic Human Pathology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan.
| | - Fumiki Okamoto
- Department of Ophthalmology, Nippon Medical School, Bunkyo-Ku, Tokyo, 113-8603, Japan.
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Allen NE, Crawford AZ, McGhee CNJ, Meyer JJ. Chemical eye injuries: a 10 year retrospective review of acute presentations and clinical outcomes in Auckland, New Zealand. Sci Rep 2024; 14:8264. [PMID: 38594410 PMCID: PMC11004117 DOI: 10.1038/s41598-024-58670-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 04/02/2024] [Indexed: 04/11/2024] Open
Abstract
To assess the aetiologies, clinical characteristics, treatment regimens, and outcomes of acute chemical injuries treated at an emergency eye clinic. Retrospective, observational study of all cases of chemical eye injury that presented acutely to the Greenlane Clinical Centre in Auckland, New Zealand from 1 January 2012 through 31 December 2021. Patient demographics, activity at the time of injury, causative chemical, clinical characteristics of injury at presentation, severity (Dua) classification, admission and discharge best corrected visual acuity (BCVA), treatment regimen, time to epithelisation and number of follow-up appointments were recorded. In total, 1522 cases involving 1919 eyes were studied. The mean age was 40.6 ± 18.8 years and 65% were male. The majority of cases occurred at home (62%) and cleaning was the most common activity (38%). There were 1490 Grade I (98%), 22 Grade II (1.5%), 5 Grade III (0.3%), 1 Grade IV (0.07%), 0 Grade V, and 4 Grade VI (0.3%) cases. An epithelial defect was noted in 409 cases (26.9%), of which re-epithelialisation occurred within one week for 378 cases (92%) and within 30 days for 384 cases (94%). Moderate vision loss (BCVA ≤ 6/12) attributed to the injury occurred in 152 (10%), while severe vision loss (BCVA ≤ 6/60) occurred in 30 (2%). Lack of irrigation at the scene was associated with an increased risk of severe injury and longstanding visual impairment (p = 0.0001). Most acute chemical injuries are mild with good clinical outcomes. Although rare, severe injuries are associated with a lack of irrigation at the scene and worse visual outcomes.
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Affiliation(s)
- Natalie E Allen
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand.
| | | | - Charles N J McGhee
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
| | - Jay J Meyer
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
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3
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Callejas A, Faris I, Torres J, Rus G. Nonlinear fourth-order elastic characterization of the cornea using torsional wave elastography. Phys Eng Sci Med 2023; 46:1489-1501. [PMID: 37642939 DOI: 10.1007/s13246-023-01314-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 07/26/2023] [Indexed: 08/31/2023]
Abstract
Measuring the mechanical nonlinear properties of the cornea remains challenging due to the lack of consensus in the methodology and in the models that effectively predict its behaviour. This study proposed developing a procedure to reconstruct nonlinear fourth-order elastic properties of the cornea based on a mathematical model derived from the theory of Hamilton et al. and using the torsional wave elastography (TWE) technique. In order to validate its diagnostic capability of simulated pathological conditions, two different groups were studied, non-treated cornea samples (n=7), and ammonium hydroxide ([Formula: see text]) treated samples (n=7). All the samples were measured in-plane by a torsional wave device by increasing IOP from 5 to 25 mmHg with 5 mmHg steps. The results show a nonlinear variation of the shear wave speed with the IOP, with higher values for higher IOPs. Moreover, the shear wave speed values of the control group were higher than those of the treated group. The study also revealed significant differences between the control and treated groups for the Lamé parameter [Formula: see text] (25.9-6.52 kPa), third-order elastic constant A (215.09-44.85 kPa), and fourth-order elastic constant D (523.5-129.63 kPa), with p-values of 0.010, 0.024, and 0.032, respectively. These findings demonstrate that the proposed procedure can distinguish between healthy and damaged corneas, making it a promising technique for detecting diseases associated with IOP alteration, such as corneal burns, glaucoma, or ocular hypertension.
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Affiliation(s)
- Antonio Callejas
- Ultrasonics Lab (TEP-959), Department of Structural Mechanics, University of Granada, Granada, 18071, Spain.
- TEC-12 group, Instituto de Investigación Biosanitaria, ibs.Granada, 18001, Spain.
| | - Inas Faris
- Ultrasonics Lab (TEP-959), Department of Structural Mechanics, University of Granada, Granada, 18071, Spain
- TEC-12 group, Instituto de Investigación Biosanitaria, ibs.Granada, 18001, Spain
| | - Jorge Torres
- Ultrasonics Lab (TEP-959), Department of Structural Mechanics, University of Granada, Granada, 18071, Spain
- TEC-12 group, Instituto de Investigación Biosanitaria, ibs.Granada, 18001, Spain
| | - Guillermo Rus
- Ultrasonics Lab (TEP-959), Department of Structural Mechanics, University of Granada, Granada, 18071, Spain
- TEC-12 group, Instituto de Investigación Biosanitaria, ibs.Granada, 18001, Spain
- Excellence Research Unit "ModelingNature" (MNat), Universidad de Granada, Granada, 18001, Spain
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4
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Song L, Yang X, Cui H. Plasma fibrin membranes loaded with bone marrow mesenchymal stem cells and corneal epithelial cells promote corneal injury healing via attenuating inflammation and fibrosis after corneal burns. Biomater Sci 2023; 11:5970-5983. [PMID: 37486330 DOI: 10.1039/d3bm00713h] [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: 07/25/2023]
Abstract
The shortage of corneal donors has prompted the development of tissue-engineered corneal grafts as an alternative solution. Currently, amniotic membranes with good biocompatibility are widely used as scaffolds for loading stem cells in the treatment of corneal injury. However, this approach has its limitations. In this study, BMSCs were induced to differentiate into corneal epithelial cells via direct contact co-culture, and platelet-poor plasma was used to prepare fibrin gels, which were compressed to remove excess liquid and then lyophilized to obtain plasma fibrin membranes (PFMs). A tissue-engineered corneal implant with PFMs as a scaffold loaded with BMSCs and corneal epithelial cells was designed and obtained. Scanning electron microscopy showed that PFMs have a uniformly distributed microporous surface that facilitates cell attachment and nutrient transport. The rheological results showed that the freeze-dried and rehydrated PFMs were more rigid than fresh membranes, which makes it easier to use them for transplantation after cell loading. The experimental results of a rat alkali burn cornea injury model showed that PFMs effectively reduced the inflammatory reaction, inhibited fibrosis, and accelerated the healing of corneal wounds. It was also found that some of the BMSCs were successfully implanted into the corneal injury site in rats and differentiated into corneal epithelial cells. These results demonstrate the potential of tissue-engineered corneal implants using BMSCs and corneal epithelial cells and PFMs as scaffolds as a new treatment option for corneal injury.
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Affiliation(s)
- Liqun Song
- Key Laboratory of Chemical Biology, Ministry of Education, Institute of Biochemical and Biotechnological Drugs, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
| | - Xue Yang
- Key Laboratory of Chemical Biology, Ministry of Education, Institute of Biochemical and Biotechnological Drugs, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
| | - Huifei Cui
- Key Laboratory of Chemical Biology, Ministry of Education, Institute of Biochemical and Biotechnological Drugs, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
- National Glycoengineering Research Center, Cheeloo College of Medicine, Shandon University, Jinan, 250012, Shandong, China
- Shandong Provincial Key Laboratory of Carbohydrate Chemistry end Glycobiology, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
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Lata S, Bari A, Agarwal T. Tectonic Deep Anterior Lamellar Keratoplasty in Severe Ocular Chuna Particle Injury in a Child. Cureus 2023; 15:e41712. [PMID: 37575863 PMCID: PMC10415958 DOI: 10.7759/cureus.41712] [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] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
A 10-year-old child presented to eye casualty with pain, watering and photophobia of the left eye for one month. Parents gave a history of chuna (lime) falling inside the eye one month back, following which the patient consulted at a primary health centre. However, there was no relief of symptoms and the patient was referred to a higher centre. On examination under anaesthesia, the eye was full of chuna particles. Removal of all visible chuna particles and the corneal chuna plaque was planned. Intra-operatively, the stromal melt was noted around the corneal chuna plaque extending up to Descemet's membrane. Microscope-integrated optical coherence tomography (Mi-OCT) guided removal of corneal chuna particles was done. A tectonic deep anterior lamellar keratoplasty (DALK) along with amniotic membrane graft (AMG) and symblepharon ring placement was done. Two weeks post-operatively, the patient was having a persistent epithelial defect. A repeat AMG with a symblepharon ring was done. On one month follow-up, the epithelial defect had healed. This case emphasises the fact that ocular chemical injuries are an emergency requiring urgent and apt management. In cases of severe ocular chuna injury with delayed presentation, removal of all particles, maintenance of globe integrity and ocular surface restoration is a challenging goal. Healing is slow and visual prognosis is generally guarded in such cases.
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Affiliation(s)
- Suman Lata
- Ophthalmology, All India Institute of Medical Sciences, New Delhi, IND
| | - Aafreen Bari
- Ophthalmology, All India Institute of Medical Sciences, New Delhi, IND
| | - Tushar Agarwal
- Ophthalmology, All India Institute of Medical Sciences, New Delhi, IND
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Liu J, Xu Y, Huang Y, Sun X, Peng Y, Song W, Yuan J, Ren L. Collagen membrane loaded with doxycycline through hydroxypropyl chitosan microspheres for the early reconstruction of alkali-burned cornea. Int J Biol Macromol 2023:125188. [PMID: 37270120 DOI: 10.1016/j.ijbiomac.2023.125188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/03/2023] [Accepted: 05/30/2023] [Indexed: 06/05/2023]
Abstract
Corneal alkali burn is one of the most devastating ophthalmic emergencies correlated with remarkable morbidity resulting in severe visual impairment. Appropriate intervention in the acute phase determines the eventual outcome for later corneal restoration treatment. Since the epithelium plays an essential role in inhibiting inflammation and promoting tissue repair, sustained anti-matrix metalloproteinases (MMPs) and pro-epithelialization are the prior remedies during the first week. In this study, a drug-loaded collagen membrane (Dox-HCM/Col) that could be sutured to overlay the burned cornea was developed to accelerate the early reconstruction. Doxycycline (Dox), a specific inhibitor of MMPs, was encapsulated in collagen membrane (Col) through hydroxypropyl chitosan microspheres (HCM) to develop Dox-HCM/Col, affording a preferable pro-epithelialization microenvironment and an in-situ controlled release. Results showed that loading HCM into Col prolonged the release time to 7 days, and Dox-HCM/Col could significantly suppress the expression of MMP-9 and -13 in vitro and in vivo. Furthermore, the membrane accelerated the corneal complete re-epithelialization and promoted early reconstruction within the first week. Overall, Dox-HCM/Col was a promising biomaterial membrane for treating alkali-burned cornea in the early stage, and our attempt may provide a clinically feasible method for the ocular surface reconstruction.
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Affiliation(s)
- Jia Liu
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, China; National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou 510006, China; Key Laboratory of Biomedical Engineering of Guangdong Province, South China University of Technology, Guangzhou 510006, China; Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, China; Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, China
| | - Yingni Xu
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, China; National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou 510006, China; Key Laboratory of Biomedical Engineering of Guangdong Province, South China University of Technology, Guangzhou 510006, China; Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, China; Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, China
| | - Yongrui Huang
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, China; National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou 510006, China; Key Laboratory of Biomedical Engineering of Guangdong Province, South China University of Technology, Guangzhou 510006, China; Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, China; Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, China
| | - Xiaomin Sun
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, China; National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou 510006, China; Key Laboratory of Biomedical Engineering of Guangdong Province, South China University of Technology, Guangzhou 510006, China; Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, China; Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, China
| | - Yuehai Peng
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou 510006, China; Key Laboratory of Biomedical Engineering of Guangdong Province, South China University of Technology, Guangzhou 510006, China; Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, China; Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, China; School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, China; Guangzhou Proud Seeing Biotechnology Co., Ltd, Guangzhou 510623, China
| | - Wenjing Song
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, China; National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou 510006, China; Key Laboratory of Biomedical Engineering of Guangdong Province, South China University of Technology, Guangzhou 510006, China; Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, China; Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, China.
| | - Jin Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510623, China.
| | - Li Ren
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, China; National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou 510006, China; Key Laboratory of Biomedical Engineering of Guangdong Province, South China University of Technology, Guangzhou 510006, China; Key Laboratory of Biomedical Materials and Engineering of the Ministry of Education, South China University of Technology, Guangzhou 510006, China; Innovation Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, China; Bioland Laboratory (Guangzhou Regenerative Medicine and Health Guangdong Laboratory), Guangzhou 510005, China.
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7
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Effect of liposomal formulation of ascorbic acid on corneal permeability. Sci Rep 2023; 13:3448. [PMID: 36859418 PMCID: PMC9977777 DOI: 10.1038/s41598-023-29290-9] [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: 08/19/2022] [Accepted: 02/02/2023] [Indexed: 03/03/2023] Open
Abstract
Ascorbic acid (AA) has a pivotal role in corneal wound healing via stimulating the biosynthesis of highly organized extracellular matrix components, but its rapid degradation and low corneal permeability limits its therapeutic effects. In this paper, we present the pharmacokinetic properties of a liposomal-based formulation of AA in terms of corneal permeation. Chemical stability, shelf-life, and drug release rate of lyophilized liposome (AA-LLipo) formulation was determined in comparison to free-form of AA solution using high-performance liquid chromatography (HPLC) and rapid equilibrium dialysis. In vitro transcorneal permeability was studied using a parallel artificial membrane permeability assay (PAMPA). Ex vivo permeation was examined on AA-LLipo-treated porcine cornea by determining the AA content on the ocular surface, in the cornea as well as in the aqueous humor using HPLC, and by Raman-mapping visualizing the AA-distribution. Our results showed that the liposomal formulation improved the chemical stability of AA, while drug release was observed with the same kinetic efficiency as from the free-form of AA solution. Both corneal-PAMPA and porcine corneal permeability studies showed that AA-LLipo markedly improved the corneal absorption kinetics of AA, thus, increasing the AA content in the cornea and aqueous humor. AA-LLipo formulation could potentially increase the bioavailability of AA in corneal tissues.
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Chen HC, Lee CY, Cheng CM, Hsueh YJ, Chang CK, Wu WC. Successful Phakic Intraocular Lens Implantation with the Usage of Topical Ascorbic Acid in Patient with Reduced Corneal Endothelial Cell Density. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101367. [PMID: 36295528 PMCID: PMC9610942 DOI: 10.3390/medicina58101367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 12/02/2022]
Abstract
We aimed to describe the use of topical ascorbic acid (AA) in a patient with reduced endothelial cells density (ECD) who was scheduled for phakic intraocular lens (pIOL) implantation. A 28-year-old woman presenting with dry eye and reduced ECD would like to have her high myopia (spherical equivalence >−15.0 D) corrected. The procedure of laser refractive surgery or even pIOL was not indicated for the reduced ECD of 1865/mm2 in the right eye and 2188/mm2 in the left eye, as well as level 3 dry eye. Fortunately, the ECD increased to 3144/mm2 in the right eye and 2538/mm2 in the left eye after topical AA was prescribed for one year preoperatively and one month postoperatively, with concomitant improvement of dry eye to level 1. Finally, bilateral pIOL implantation was performed smoothly and no sign of corneal decompensation was found postoperatively. Three months postoperatively, the ECD showed a satisfactory level of 2983/mm2 in the right eye and 3003/mm2 in the left eye. In conclusion, topical AA instillation might increase and maintain the density of central human corneal endothelial cells (HCECs) even after pIOL implantation.
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Affiliation(s)
- Hung-Chi Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 333423, Taiwan
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou 333423, Taiwan
- Correspondence: ; Tel.: +886-3-3281200 (ext. 8666)
| | - Chia-Yi Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Nobel Eye Institute, Taipei 100008, Taiwan
- Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung 41265, Taiwan
| | - Chao-Min Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 300044, Taiwan
| | - Yi-Jen Hsueh
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 333423, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou 333423, Taiwan
| | - Chao-Kai Chang
- Nobel Eye Institute, Taipei 100008, Taiwan
- Department of Optometry, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
- Department of Optometry, Da-Yeh University, Chunghua 51500, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 333423, Taiwan
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan
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Luo Y, Shen M, Feng P, Qiu H, Wu X, Yang L, Zhu Y. Various administration forms of decellularized amniotic membrane extract towards improving corneal repair. J Mater Chem B 2021; 9:9347-9357. [PMID: 34724021 DOI: 10.1039/d1tb01848e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Amniotic membrane (AM) transplantation is often used as a treatment for corneal repair, but AM is prone to dissolving and shedding after surgery; multiple transplants will cause pain and financial burden. In this work, human amniotic membrane was firstly decellularized to obtain an AM extracellular matrix (dAM). This dAM was homogenized and extracted to obtain the dAM extract (simplified as dAME). Different forms of administration for corneal injury were performed as liquid drops (diluted dAME), in situ gels (using temperature-dependent Poloxamer 407 as the matrix), and tablets (poly(vinyl alcohol) as the matrix). The cytocompatibility of dAME was evaluated using corneal epithelial cells, corneal stromal cells and fibroblasts as cell models. The results showed that dAME is biocompatible to all these cells. Cells exhibited normal morphology and growth state at a dAME concentration of up to 160 μg mL-1. In vivo, dAME exhibited increased wound healing efficiency in severe corneal injury, being characterized with a shorter healing time for epithelium and a faster recovery for stromal opacity and thickness, compared with those of the control eyes. Different forms of administration have different effects on corneal repair; among them, in situ gels achieved the best therapeutic efficiency. Their biological mechanism was detected via quantitative real-time polymerase chain reaction (qRT-PCR) technology. It was confirmed that dAME plays important roles in promoting the mRNA expression of leucine-rich and immunoglobulin-like domains 1 (LRIG1) and in inhibiting the mRNA of transforming growth factor-β1 (TGF-β1).
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Affiliation(s)
- Yang Luo
- School of Medicine, Ningbo University, Ningbo 315211, China.
| | - Meiting Shen
- School of Medicine, Ningbo University, Ningbo 315211, China.
| | - Peipei Feng
- School of Medicine, Ningbo University, Ningbo 315211, China.
| | - Haofeng Qiu
- School of Medicine, Ningbo University, Ningbo 315211, China.
| | - Xujin Wu
- School of Medicine, Ningbo University, Ningbo 315211, China.
| | - Lu Yang
- The Affiliated Hospital of Medical School, Ningbo University, Ningbo, 315000, China.
| | - Yabin Zhu
- School of Medicine, Ningbo University, Ningbo 315211, China.
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Begum G, Leigh T, Stanley D, Logan A, Blanch RJ. Determining the effect of ocular chemical injuries on topical drug delivery. Drug Deliv 2021; 28:2044-2050. [PMID: 34595979 PMCID: PMC8491719 DOI: 10.1080/10717544.2021.1979124] [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: 11/08/2022] Open
Abstract
Ocular chemical injuries (OCIs) commonly cause ocular damage and visual loss and treatment uses topical therapies to facilitate healing and limit complications. However, the impact of chemical injury on corneal barrier function and treatment penetration is unknown. Therefore, the aim of this study was to determine the effect of OCI on drug penetration and absorption. Porcine corneal explants were used to assess histological damage, electrical resistance, and the trans-corneal penetration/corneal adsorption of reference compounds (sodium fluorescein and rhodamine B) and dexamethasone. Corneal explants were injured with either 1 M sulfuric acid, or 1 M sodium hydroxide. Dexamethasone penetration was measured using high-performance liquid chromatography (HPLC) and that of fluorescein and rhodamine using fluorescence. Dexamethasone corneal adsorption was measured using enzyme-linked immunoabsorbant assay (ELISA). Both acid and alkaline injuries reduced trans-corneal electrical resistance. NaOH injury increased hydrophilic fluorescein penetration (NaOH 8.59 ± 1.50E–05 cm.min−1 vs. Hanks' Balanced Salt Solution (HBSS) 1.64 ± 1.01E–06 cm.min−1) with little impact on hydrophobic rhodamine B (1 M NaOH 6.55 ± 2.45E–04 cm.min−1 vs. HBSS 4.60 ± 0.972E–04 cm.min−1) and dexamethasone penetration (1 M NaOH 3.00 ± 0.853E–04 cm.min−1 vs. HBSS 2.69 ± 0.439E–04 cm.min−1). By contrast, H2SO4 decreased trans-corneal penetration of hydrophilic fluorescein (H2SO4 1.16 ± 14.2E–07 cm.min−1) and of hydrophobic dexamethasone (H2SO4 1.88 ± 0.646E–04 cm.min−1) and rhodamine B (H2SO4 4.60 ± 1.42E–05 cm.min−1). Acid and alkaline OCI differentially disrupted the corneal epithelial barrier function. Acid injury reduced penetration of hydrophobic dexamethasone and rhodamine B as well as hydrophilic fluorescein, which may translate clinically into reduced drug penetration after OCI, while alkaline injury increased fluorescein penetration, with minimal effect on dexamethasone and rhodamine B penetration.
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Affiliation(s)
- Ghazala Begum
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK
| | - Thomas Leigh
- School of Chemistry, University of Birmingham, Birmingham, UK
| | - David Stanley
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Ann Logan
- Axolotl Consulting Ltd, Droitwich, UK.,Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Richard James Blanch
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK.,Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK.,Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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11
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Tey KY, Gan J, Foo V, Tan B, Ke MY, Schmetterer L, Mehta JS, Ang M. Role of anterior segment optical coherence tomography angiography in the assessment of acute chemical ocular injury: a pilot animal model study. Sci Rep 2021; 11:16625. [PMID: 34404833 PMCID: PMC8371111 DOI: 10.1038/s41598-021-96086-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022] Open
Abstract
To examine the use of anterior segment-optical coherence tomography angiography (AS-OCTA) in the assessment of limbal ischemia in an animal model chemical ocular injury. We conducted a prospective study using an established chemical ocular injury model in 6 rabbits (12 eyes), dividing the cornea limbus into 4 quadrants. Chemical injury grade was induced based on extent of limbal injury (0 to 360 degrees) and all eyes underwent serial slit-lamp with AS-OCTA imaging up to one month. Main outcome measure was changes in AS-OCTA vessel density (VD) comparing injured and control cornea limbal quadrants within 24 h and at one month. AS-OCTA was able to detect differences in limbal VD reduction comparing injured (3.3 ± 2.4%) and control quadrants (7.6 ± 2.3%; p < 0.001) within 24 h of ocular chemical injury. We also observed that AS-OCTA VD reduction was highly correlated with the number of quadrants injured (r = − 0.89; p < 0.001; 95% CI − 5.65 to − 1.87). Corneal vascularization was detected by AS-OCTA in injured compared to control quadrants (10.1 ± 4.3% vs 7.0 ± 1.2%; p = 0.025) at 1 month. Our animal pilot study suggests that AS-OCTA was able to detect limbal vessel disruption from various severities of acute chemical insult, and in the future, could potentially serve as an adjunct in providing objective grading of acute ocular chemical injury once validated in a clinical trial.
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Affiliation(s)
- Kai Yuan Tey
- Singapore Eye Research Institute, Singapore, Singapore
| | - Jinyuan Gan
- Duke-NUS Medical School, Singapore, Singapore
| | - Valencia Foo
- Singapore National Eye Centre, 20 College Rd, Singapore, 169856, Singapore
| | - Bingyao Tan
- Singapore Eye Research Institute, Singapore, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE) Program, Nanyang Technological University, Singapore, Singapore
| | - Meng Yuan Ke
- Singapore Eye Research Institute, Singapore, Singapore
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE) Program, Nanyang Technological University, Singapore, Singapore.,School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore.,Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.,Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Jodhbir S Mehta
- Singapore Eye Research Institute, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Singapore National Eye Centre, 20 College Rd, Singapore, 169856, Singapore
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore, Singapore. .,Duke-NUS Medical School, Singapore, Singapore. .,Singapore National Eye Centre, 20 College Rd, Singapore, 169856, Singapore.
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12
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Liang L, Luo X, Zhang J, Su W, Zhu W, Xie Y, Zhang N, Peng Y, Chen X, Xiang AP, Liu Y, Liang D. Safety and feasibility of subconjunctival injection of mesenchymal stem cells for acute severe ocular burns: A single-arm study. Ocul Surf 2021; 22:103-109. [PMID: 34333155 DOI: 10.1016/j.jtos.2021.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 06/06/2021] [Accepted: 07/28/2021] [Indexed: 01/27/2023]
Abstract
PURPOSE To investigate the safety and feasibility of topical injection of bone marrow derived mesenchymal stem cells (BM-MSCs) in acute severe ocular burns. METHODS In this open-label,single-arm study, subconjunctival injection of allogenic BM-MSCs combined with standard treatment was given to 16 patients with acute severe ocular burns (Dua's grade IV to VI) within 2 weeks after injury. The primary outcome was efficacy rate which referred to the proportion of complete corneal epithelialization patients without perforation. The secondary outcome was safety, visual acuity, the number of symblephara, and elevated intraocular pressure. RESULTS One patient was lost to follow-up. During the follow-up period, no corneal perforation was developed. Complete corneal epithelialization was noted 8 (ranged 4-10 weeks) weeks after treatment in 13 eyes (81.3%). The efficacy rate was 87.5% (95% confidence interval, CI: 61.7-98.4). Hypopyon was detected and later well controlled in 1 eye. Partial or total limbal stem cell deficiency (LSCD) was noted in all eyes. Improvement of visual acuity was achieved in 5 out of 16 eyes (31.3%). Seven eyes' visual acuity was reached 0.1. Symblepharon with varied severity was noted in 5 eyes. Two eyes had elevated intraocular pressure. CONCLUSIONS This study confirms the safety of subconjunctival injection of BM-MSCs as an innovative and convenient procedure in ocular burns. The overall result is promising considering the absence of perforation, the low severity of symblepharon and visual acuity improvement.
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Affiliation(s)
- Lingyi Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Ocular Surface Center, Sun Yat-sen University, 54S Xianlie Road, Guangzhou, 510060, China
| | - Xiaohui Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Ocular Surface Center, Sun Yat-sen University, 54S Xianlie Road, Guangzhou, 510060, China
| | - Jian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Ocular Surface Center, Sun Yat-sen University, 54S Xianlie Road, Guangzhou, 510060, China
| | - Wenru Su
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Ocular Surface Center, Sun Yat-sen University, 54S Xianlie Road, Guangzhou, 510060, China
| | - Wenjie Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Ocular Surface Center, Sun Yat-sen University, 54S Xianlie Road, Guangzhou, 510060, China
| | - Yanyan Xie
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Ocular Surface Center, Sun Yat-sen University, 54S Xianlie Road, Guangzhou, 510060, China
| | - Nuan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Ocular Surface Center, Sun Yat-sen University, 54S Xianlie Road, Guangzhou, 510060, China
| | - Yanwen Peng
- Center for Stem Cell Biology and Tissue Engineering, Key Laboratory for Stem Cells and Tissue Engineering, Ministry of Education, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Xiaoyong Chen
- Center for Stem Cell Biology and Tissue Engineering, Key Laboratory for Stem Cells and Tissue Engineering, Ministry of Education, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Andy Peng Xiang
- Center for Stem Cell Biology and Tissue Engineering, Key Laboratory for Stem Cells and Tissue Engineering, Ministry of Education, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Ocular Surface Center, Sun Yat-sen University, 54S Xianlie Road, Guangzhou, 510060, China.
| | - Dan Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Ocular Surface Center, Sun Yat-sen University, 54S Xianlie Road, Guangzhou, 510060, China.
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13
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Sumioka T, Iwanishi H, Okada Y, Miyajima M, Ichikawa K, Reinach PS, Matsumoto KI, Saika S. Impairment of corneal epithelial wound healing is association with increased neutrophil infiltration and reactive oxygen species activation in tenascin X-deficient mice. J Transl Med 2021; 101:690-700. [PMID: 33782532 PMCID: PMC8137452 DOI: 10.1038/s41374-021-00576-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 01/14/2023] Open
Abstract
The purpose of the study was to uncover the role of tenascin X in modulation of healing in mouse corneas subjected to epithelium debridement. Healing in corneas with an epithelial defect was evaluated at the levels of gene and protein expression. Wound healing-related mediators and inflammatory cell infiltration were detected by histology, immunohistochemistry and real-time RT-PCR. Tenascin X protein was upregulated in the wounded wild-type (WT) corneal epithelium. The lack of tenascin X impaired closure of an epithelial defect and accelerated infiltration of neutrophils into the wound periphery as compared to the response in WT tissue. Expression of wound healing-related proinflammatory and reparative components, i.e., interleukin-6, transforming growth factor β, matrix metalloproteinases, were unaffected by the loss of tenascin X expression. Marked accumulation of malondialdehyde (a lipid peroxidation-derived product) was observed in KO healing epithelia as compared with its WT counterpart. Neutropenia induced by systemic administration of a specific antibody rescued the impairment of epithelial healing in KO corneas, with reduction of malondialdehyde levels in the epithelial cells. Finally, we showed that a chemical scavenging reactive oxygen species reversed the impairment of attenuation of epithelial repair with a reduction of tissue levels of malondialdehyde. In conclusion, loss of tenascin X prolonged corneal epithelial wound healing and increased neutrophilic inflammatory response to debridement in mice. Tenascin X contributes to the control of neutrophil infiltration needed to support the regenerative response to injury and prevent the oxidative stress mediators from rising to cytotoxic levels.
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Affiliation(s)
- Takayoshi Sumioka
- Department of Ophthalmology, Wakayama Medical University School of Medicine, Wakayama, Japan.
| | - Hiroki Iwanishi
- Department of Ophthalmology, Wakayama Medical University School of Medicine, Wakayama, Japan
| | - Yuka Okada
- Department of Ophthalmology, Wakayama Medical University School of Medicine, Wakayama, Japan
| | - Masayasu Miyajima
- Department of Ophthalmology, Wakayama Medical University School of Medicine, Wakayama, Japan
| | - Kana Ichikawa
- Department of Ophthalmology, Wakayama Medical University School of Medicine, Wakayama, Japan
| | - Peter S Reinach
- Department of Ophthalmology, Wenzhou Medical University, Wenzhou, P. R. China
| | - Ken-Ichi Matsumoto
- Department of Biosignaling and Radioisotope Experiment, Interdisciplinary Center for Science Research, Organization for Research and Academic Information, Shimane University, Izumo, Enya-cho, Japan
| | - Shizuya Saika
- Department of Ophthalmology, Wakayama Medical University School of Medicine, Wakayama, Japan
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14
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Hakami NY, Dusting GJ, Chan EC, Shah MH, Peshavariya HM. Wound Healing After Alkali Burn Injury of the Cornea Involves Nox4-Type NADPH Oxidase. Invest Ophthalmol Vis Sci 2021; 61:20. [PMID: 33079994 PMCID: PMC7585390 DOI: 10.1167/iovs.61.12.20] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose Corneal injury that occurs after burning with alkali initiates wound-healing processes, including inflammation, neovascularization, and fibrosis. Excessive reactions to injury can reduce corneal transparency and thereby compromise vision. The NADPH oxidase (Nox) enzyme complex is known to be involved in cell signaling for wound-healing angiogenesis, but its role in corneal neovascularization has been little studied. Methods The center corneas of wild-type and Nox4 knockout (KO) mice were injured with 3 µL 1 M NaOH, while the contralateral corneas remained untouched. On day 7, mRNA expression levels of NADPH oxidase isoforms, the proangiogenic factors VEGF-A and TGFβ1, and proinflammatory genes ICAM-1 and VCAM-1 were determined. Corneal neovascularization and fibrosis were visualized using PECAM-1 antibody and picrosirius red staining, respectively, on the same day. Results Expressions of both Nox2 and Nox4 gene isoforms as well as the above genes were markedly increased in the injured corneas at 7 days. Injured corneas showed neovascularization and fibrosis as well as an increase in clinical opacity score. All responses stimulated by alkali burn were abrogated in Nox4 KO mice. Conclusions Nox4 could be a new target to treat pathologic corneal wound-healing responses and such targeting might prevent blindness caused by burn injuries.
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Affiliation(s)
- Nora Y Hakami
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia.,Department of Pharmacology and Therapeutics, University of Melbourne, Melbourne, Victoria, Australia.,Faculty of Applied Medical Sciences, King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Gregory J Dusting
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
| | - Elsa C Chan
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
| | - Manisha H Shah
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
| | - Hitesh M Peshavariya
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
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15
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Shahriary A, Sabzevari M, Jadidi K, Yazdani F, Aghamollaei H. The Role of Inflammatory Cytokines in Neovascularization of Chemical Ocular Injury. Ocul Immunol Inflamm 2021; 30:1149-1161. [PMID: 33734925 DOI: 10.1080/09273948.2020.1870148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Aim: Chemical injuries can potentially lead to the necrosis anterior segment of the eye, and cornea in particular. Inflammatory cytokines are the first factors produced after chemical ocular injuries. Inflammation via promoting the angiogenesis factor tries to implement the wound healing mechanism in the epithelial and stromal layer of the cornea. Methods: Narrative review.Results: In our review, we described the patterns of chemical injuries in the cornea and their molecular mechanisms associated with the expression of inflammatory cytokines. Moreover, the effects of inflammation signals on angiogenesis factors and CNV were explained. Conclusion: The contribution of inflammation and angiogenesis causes de novo formation of blood vessels that is known as the corneal neovascularization (CNV). The new vascularity interrupts cornea clarity and visual acuity. Inflammation also depleted the Limbal stem cells (LSCs) in the limbus causing the failure of normal corneal epithelial healing and conjunctivalization of the cornea.
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Affiliation(s)
- Alireza Shahriary
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Milad Sabzevari
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Khosrow Jadidi
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Farshad Yazdani
- Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hossein Aghamollaei
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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16
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Little A, Dietze-Fiedler M, Fernstrum C, Mancera N, Wilcox R, Do V. Magnesium ocular injury – A case report. BURNS OPEN 2021. [DOI: 10.1016/j.burnso.2020.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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17
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Dinç E, Dursun Ö, Yilmaz G, Kurt AH, Ayaz L, Vatansever M, Özer Ö, Yilmaz ŞN. Evaluation of Anti-Inflammatory and Antiapoptotic Effects of Bone Marrow and Adipose-Derived Mesenchymal Stem Cells in Acute Alkaline Corneal Burn. J Ocul Pharmacol Ther 2020; 37:24-34. [PMID: 33275515 DOI: 10.1089/jop.2020.0103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The aim of the present study is to comparatively evaluate the anti-inflammatory and antiapoptotic effects of bone marrow and adipose-derived mesenchymal stem cells (MSCs) applied subconjunctivally after alkaline corneal burn. Methods: Thirty-two rats were divided into 4 groups and included in the study (n = 8). While no intervention was made in the control group, a chemical burn was created by applying 4 μL of NaOH soaked in 6 mm filter paper to the right eye of each subject in the other groups under general anesthesia. While only subconjunctival 0.1 mL phosphate-buffered saline (PBS) was injected to in the group 1, 2 × 106 adipose or bone marrow-derived MSC in 0.1 mL PBS was applied subconjunctivally to the subjects in the remaining groups (Group 2 and 3, respectively). Tissue samples were collected for histological analysis on the third day after the burn. Tissue samples were evaluated light microscopically and immunohistochemically stained for interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α), caspase-3 (Cas-3), and CD68. Results: The IL-1β and TNF-α staining scores and the number of CD68- and Cas-3-positive stained cells were significantly lower in the groups given bone marrow and adipose-derived MSC compared to the alkaline burn group (P < 0.0001, for all parameters). Epithelial IL-1β and TNF-α staining scores were significantly lower in the bone marrow-derived MSC group compared to the adipose-derived MSC group (P < 0.0001, for all parameters). Conclusions: The presented study shows that both bone-marrow and adipose-derived MSCs support wound healing in the corneal tissue and strongly suppress the inflammation occured in the tissue.
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Affiliation(s)
- Erdem Dinç
- Department of Ophthalmology and Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Özer Dursun
- Department of Ophthalmology and Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Gülsen Yilmaz
- Department of Histology & Embryology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - A Hakan Kurt
- Department of Pharmacology, Bolu İzzet Baysal University, Bolu, Turkey
| | - Lokman Ayaz
- Department of Biochemistry, Faculty of Pharmacy, Trakya University, Edirne, Turkey
| | - Mustafa Vatansever
- Department of Ophthalmology and Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Ömer Özer
- Department of Ophthalmology and Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Şakir Necat Yilmaz
- Department of Histology & Embryology, Faculty of Medicine, Mersin University, Mersin, Turkey
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18
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Zhao X, Zuo X, Zhong J, Wang B, Li S, Xiao Y, Yuan J. Heparin-Modified Amniotic Membrane Combined With Growth Factors for Promoting Corneal Wound Healing After Alkali Burn. Front Bioeng Biotechnol 2020; 8:599800. [PMID: 33330430 PMCID: PMC7719686 DOI: 10.3389/fbioe.2020.599800] [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: 08/28/2020] [Accepted: 10/27/2020] [Indexed: 12/13/2022] Open
Abstract
Ocular chemical burns are potentially blinding ocular injuries and require urgent management. Amniotic membrane (AM) transplantation is an effective surgical treatment, one of the reasons is because AM is a rich source of growth factors that can promote epithelialization and wound healing. However, growth factors will be gradually lost and insufficient after preparation process and long-time storage, leading to unsatisfactory therapeutic effects. Herein, we present a modified AM (AM-HEP) for the supplement and sustained release of growth factor by surface grafting heparin for treatment of ocular chemical burns. Heparin grafting rate and stability, microstructure, physical property, and sustained release of epithelial growth factor (EGF) of AM-HEP were characterized. Biocompatibility and ability to promote corneal epithelial cell growth and migration were evaluated and compared with a biological amnion, which is available on the market in vitro. The therapeutic effects of AM-HEP combined with EGF (AM-HEP@EGF) in vivo had been evaluated in a model of mouse corneal alkali burn. The results indicated that heparin was introduced into AM and maintain stability over 3 weeks at 37°C. The modification process of AM-HEP did not affect microstructure and physical property after comparing with non-modified AM. EGF could be combined quickly and effectively with AM-HEP; the sustained release could last for more than 14 days. AM-HEP@EGF could significantly promote corneal epithelial cell growth and migration, compared with non-modified AM and control group. Faster corneal epithelialization was observed with the transplantation of AM-HEP@EGF in vivo, compared with the untreated control group. The corneas in the AM-HEP@EGF group have less inflammation and were more transparent than those in the control group. The results from in vitro and in vivo experiments demonstrated that AM-HEP@EGF could significantly enhance the therapeutic effects. Taken together, AM-HEP@EGF is exhibited to be a potent clinical application in corneal alkali burns through accelerating corneal epithelial wound healing.
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Affiliation(s)
| | | | | | | | | | | | - Jin Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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19
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Dua HS, Ting DSJ, Al Saadi A, Said DG. Chemical eye injury: pathophysiology, assessment and management. Eye (Lond) 2020; 34:2001-2019. [PMID: 32572184 PMCID: PMC7784957 DOI: 10.1038/s41433-020-1026-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/27/2020] [Accepted: 06/04/2020] [Indexed: 11/09/2022] Open
Abstract
Chemical eye injury (CEI) is an acute emergency which can threaten sight and life. These commonly occur at home or the workplace with the former being generally mild and the latter more severe and bilateral. Major workplace accidents involve other parts of the body and can be associated with inhalation or ingestion of the chemical. Alkali injuries cause damage by saponification of tissue and deeper penetration as a consequence. Acid injuries cause rapid coagulation of tissue, which impedes penetration and limits damage. Irritants such as alcohols, cause superficial epithelial denudation. Severe chemical insult can affect all anterior segment structures causing iris, pupil and lens abnormalities. Eye pressure is variably affected and can be low or high or start as one and rapidly change to the other. Chorioretinal changes in the form of vasculopathy are seen and ascribed to be secondary to anterior segment inflammation rather than due to the direct effect of CEI. Final outcome related to structure and function is determined by the injurious agent, duration of exposure, nature of treatment and the rapidity with which it is instituted. Prevention of further damage by profuse and prolonged eye wash, after ascertaining pH of both eyes, together with exploration and removal of all particulate matter, is the key. Other management principles include a complete and thorough assessment, control of inflammation, facilitation of healing and prevention and management of sequelae and complications. Intraocular pressure is often forgotten and must be assessed and managed. Management often requires a multidisciplinary approach.
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Affiliation(s)
- Harminder S Dua
- Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.
- Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK.
| | - Darren Shu Jeng Ting
- Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK
| | - Ahmed Al Saadi
- Department of Ophthalmology, Zayed Military Hospital, Abu Dhabi, UAE
| | - Dalia G Said
- Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK
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20
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Hoffman JJ, Casswell EJ, Shortt AJ. Assault-related severe ocular chemical injury at a London ophthalmic referral hospital: a 3-year retrospective observational study. BMJ Open 2020; 10:e038109. [PMID: 33077563 PMCID: PMC7574930 DOI: 10.1136/bmjopen-2020-038109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES To understand the incidence, causes, management and outcomes of intentional (assault) and unintentional severe ocular chemical injuries (SOCI) at an urban tertiary referral centre in the UK. DESIGN Retrospective observational study. SETTING A London tertiary referral ophthalmic centre, Moorfields Eye Hospital. PARTICIPANTS All cases of SOCI presenting between 1 September 2011 and 31 August 2014 were identified. The definition of SOCI was grade 3 or 4 on the Hughes-Roper-Hall classification system. We identified 25 cases (6 in 2011-2012, 8 in 2012-2013, 11 in 2013-2014). Median age was 31.1 years. 23 cases (92%) were male. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the proportion of cases of SOCI caused by assault, per year. Secondary outcome measures included the number of cases of SOCI, injury characteristics and mechanism, initial and long-term management, visual outcome and the need for surgical intervention. RESULTS Between 2011 and 2012, 3/6 cases were due to assault (50%); between 2012 and 2013, 7/8 were due to assault (87.5%); and between 2013 and 2014, 6/11 were due to assault (54.4%). Assault was responsible for 16/25 (64%) cases overall, while 8/25 (32%) cases were work related. The causative agent was known to be alkali in 16/25 (64%), while 10/25 (40%) did not complete the follow-up. The mean number of clock hours of limbal ischaemia was 5.24 (SD 2.97). 17/25 (68%) were Hughes-Roper-Hall grade 3. Surgical intervention occurred in 1/25. The final best-corrected visual acuity was 6/12 or worse in 11/25 (44%) and was counting fingers or worse in 4/25 (16%). CONCLUSIONS Previous studies found that SOCI had a low incidence and that work-related injuries were the most common cause. Our study demonstrates an increasing incidence of SOCI, which may be accounted for by a rise in assault using corrosive substances. A high number of patients did not attend regularly for follow-up and visual outcomes from these injuries are poor.
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Affiliation(s)
- Jeremy John Hoffman
- Accident and Emergency Department, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- National Institute of Health Research (NIHR) Biomedical Research Centre, University College London Institute of Ophthalmology, London, UK
| | - Edward Joshua Casswell
- Accident and Emergency Department, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- National Institute of Health Research (NIHR) Biomedical Research Centre, University College London Institute of Ophthalmology, London, UK
| | - Alex John Shortt
- National Institute of Health Research (NIHR) Biomedical Research Centre, University College London Institute of Ophthalmology, London, UK
- Department of External Eye Diseases, Moorfields Eye Hospital NHS Foundation Trust, London, UK
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21
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Soleimani M, Naderan M. Management Strategies of Ocular Chemical Burns: Current Perspectives. Clin Ophthalmol 2020; 14:2687-2699. [PMID: 32982161 PMCID: PMC7501954 DOI: 10.2147/opth.s235873] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/20/2020] [Indexed: 11/25/2022] Open
Abstract
Ocular chemical burns are absolute ophthalmic emergencies and require immediate management to minimize devastating sequelae. Management of alkali and acid burns is started at the scene of the accident by copious irrigation. Treatment is directed at improving epithelial integrity and stromal stability, reduction of undue inflammation, and prevention or timely management of complications. To ascertain the best possible outcome, numerous biological medications and surgical interventions have been merged into conventional therapeutic regimens. These include autologous and umbilical cord serum preparations, platelet-rich plasma, amniotic membrane transplantation, limbal stem-cell transplantation, and anti-angiogenic agents.
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Affiliation(s)
- Mohammad Soleimani
- Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Naderan
- Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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22
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Topical cell-free conditioned media harvested from adipose tissue-derived stem cells promote recovery from corneal epithelial defects caused by chemical burns. Sci Rep 2020; 10:12448. [PMID: 32709896 PMCID: PMC7381646 DOI: 10.1038/s41598-020-69020-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 06/29/2020] [Indexed: 02/07/2023] Open
Abstract
Corneal chemical burns can lead to blindness following serious complications. As most of these complications are caused by failure of reepithelization during the acute phase, treatment at this stage is critical. Although there have been some studies on corneal injury recovery using adipose tissue-derived stem cells (ADSCs), none has reported the effect of topical cell-free conditioned culture media (CM) derived from ADSCs on corneal epithelial regeneration. Here, the best conditions for CM were selected and used for in vitro and in vivo experiments. Corneal burn in rats was induced using 100% alcohol. The chosen CM was administered to corneal burn rats (CM-treated [CT] group) four times a day for three days and this group was compared with the normal control and corneal burn (CB) groups. Biomicroscopic fluorescence images and the actual physical corneas were taken over time and used for analysis. mRNA levels of hepatocyte growth factor and epidermal growth factor (EGF) were significantly increased, whereas those of vascular endothelial growth factor, interleukin (IL)-1β, IL-6, IL-10, and matrix metalloproteinase-9 were significantly decreased in the CT group compared with those in the CB group. The numbers of proliferating cell nuclear antigen- and zonular occludens-1-positive cells in the CT group were significantly higher than those in the CB group. The macrophage-infiltrating corneas in the CT group expressed significantly more of the M2 marker arginase than corneas in the CB group. Optimal CM (× 0.5 concentration) treatment significantly accelerated the migration of corneal epithelial cells and induced upregulation of the expression of IL-6, EGF, and C-X-C chemokine receptor type 4 mRNAs. Overall, in this study, topical administration of cell-free CM promoted regeneration of the corneal epithelium after induction of chemical burns.
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Kulikov AN, Chernysh VF, Churashov SV. [On the new classification of eye burns]. Vestn Oftalmol 2020; 136:134-142. [PMID: 32366081 DOI: 10.17116/oftalma2020136021134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The currently used classification of eye burns was proposed in 1973 by N.A. Puchkovskaya and V.M. Nepomnyashaya. Recent emergence of the concept of limbal stem cells of the corneal epithelium and its application in clinical practice has significantly expanded the possibilities for diagnosis, treatment, and visual rehabilitation of patients with eye burns. In 1997, Dr. Michael Wagoner proposed a classification of eye burns in which the grade of burn severity is determined by the degree of damage to the limbal stem cells. Considering this approach, the authors conducted a comparative analysis of the classifications of eye burns used in Russia (in different years) and those that have appeared in the Western countries in recent years. In this regard, a new classification of eye burns is being proposed.
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Affiliation(s)
- A N Kulikov
- S.M. Kirov Military Medical Academy, St. Petersburg, Russia
| | - V F Chernysh
- S.M. Kirov Military Medical Academy, St. Petersburg, Russia
| | - S V Churashov
- S.M. Kirov Military Medical Academy, St. Petersburg, Russia
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Topical Ascorbic Acid Ameliorates Oxidative Stress-Induced Corneal Endothelial Damage via Suppression of Apoptosis and Autophagic Flux Blockage. Cells 2020; 9:cells9040943. [PMID: 32290365 PMCID: PMC7227019 DOI: 10.3390/cells9040943] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 12/16/2022] Open
Abstract
Compromised pumping function of the corneal endothelium, due to loss of endothelial cells, results in corneal edema and subsequent visual problems. Clinically and experimentally, oxidative stress may cause corneal endothelial decompensation after phacoemulsification. Additionally, in vitro and animal studies have demonstrated the protective effects of intraoperative infusion of ascorbic acid (AA). Here, we established a paraquat-induced cell damage model, in which paraquat induced reactive oxygen species (ROS) production and apoptosis in the B4G12 and ARPE-19 cell lines. We demonstrate that oxidative stress triggered autophagic flux blockage in corneal endothelial cells and that addition of AA ameliorated such oxidative damage. We also demonstrate the downregulation of Akt phosphorylation in response to oxidative stress. Pretreatment with ascorbic acid reduced the downregulation of Akt phosphorylation, while inhibition of the PI3K/Akt pathway attenuated the protective effects of AA. Further, we establish an in vivo rabbit model of corneal endothelial damage, in which an intracameral infusion of paraquat caused corneal opacity. Administration of AA via topical application increased its concentration in the corneal stroma and reduced oxidative stress in the corneal endothelium, thereby promoting corneal clarity. Our findings indicate a perioperative strategy of topical AA administration to prevent oxidative stress-induced damage, particularly for those with vulnerable corneal endothelia.
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Fung AT, Tran T, Lim LL, Samarawickrama C, Arnold J, Gillies M, Catt C, Mitchell L, Symons A, Buttery R, Cottee L, Tumuluri K, Beaumont P. Local delivery of corticosteroids in clinical ophthalmology: A review. Clin Exp Ophthalmol 2020; 48:366-401. [PMID: 31860766 PMCID: PMC7187156 DOI: 10.1111/ceo.13702] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 11/21/2019] [Accepted: 12/09/2019] [Indexed: 12/22/2022]
Abstract
Locally administered steroids have a long history in ophthalmology for the treatment of inflammatory conditions. Anterior segment conditions tend to be treated with topical steroids whilst posterior segment conditions generally require periocular, intravitreal or systemic administration for penetration. Over recent decades, the clinical applications of periocular steroid delivery have expanded to a wide range of conditions including macular oedema from retino-vascular conditions. Formulations have been developed with the aim to provide practical, targeted, longer-term and more efficacious therapy whilst minimizing side effects. Herein, we provide a comprehensive overview of the types of periocular steroid delivery, their clinical applications in ophthalmology and their side effects.
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Affiliation(s)
- Adrian T. Fung
- Westmead Clinical SchoolDiscipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South WalesAustralia
- Department of Ophthalmology, Faculty of Medicine and Health SciencesMacquarie UniversitySydneyNew South WalesAustralia
- Save Sight InstituteCentral Clinical School, Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South WalesAustralia
| | - Tuan Tran
- Save Sight InstituteCentral Clinical School, Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South WalesAustralia
| | - Lyndell L. Lim
- Royal Victorian Eye and Ear HospitalMelbourneVictoriaAustralia
- Centre for Eye Research AustraliaMelbourneVictoriaAustralia
- University of MelbourneMelbourneVictoriaAustralia
| | - Chameen Samarawickrama
- Westmead Clinical SchoolDiscipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South WalesAustralia
- Save Sight InstituteCentral Clinical School, Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South WalesAustralia
- Liverpool Clinical School, Faculty of MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | | | - Mark Gillies
- Save Sight InstituteCentral Clinical School, Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South WalesAustralia
| | - Caroline Catt
- Save Sight InstituteCentral Clinical School, Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South WalesAustralia
- Children's Hospital WestmeadWestmeadNew South WalesAustralia
| | | | | | | | - Lisa Cottee
- Eye Doctors Mona ValeSydneyNew South WalesAustralia
| | - Krishna Tumuluri
- Westmead Clinical SchoolDiscipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South WalesAustralia
- Department of Ophthalmology, Faculty of Medicine and Health SciencesMacquarie UniversitySydneyNew South WalesAustralia
- Save Sight InstituteCentral Clinical School, Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South WalesAustralia
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Li T, Jiang B, Zhou X. Clinical characteristics of patients hospitalized for ocular chemical injuries in Shanghai from 2012 to 2017. Int Ophthalmol 2020; 40:909-916. [DOI: 10.1007/s10792-019-01263-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 12/28/2019] [Indexed: 01/07/2023]
Abstract
Abstract
Purpose
To summarize the clinical characteristics of patients with ocular chemical injuries and evaluate their potential relationship with the visual outcome by analyzing the medical records of these patients from January 1, 2012, to December 31, 2017.
Methods
This is a retrospective case series study. Patient data included age, gender, occupational classification, location of ocular chemical injury, initial and final best-corrected distance visual acuity (BCDVA), intraocular pressure (IOP), nature and chemical phase, distribution and severity of chemical injury, management methods, and complications. All variables were evaluated for their potential relationship with visual outcome.
Results
A total of 160 patients were hospitalized with ocular chemical injuries. Majority of the patients were factory workers and arrived at the consultation room less than 24 h after injury. The most common ocular injury setting, classification of severity, causative chemical, chemical phase, and complications were workplace, grade II, unknown and mixed substance, liquid, and elevated IOP, respectively. The risk factors for poor final BCDVA were identified as older age, poor initial BCDVA, and irrigation 24 h after injury (P < 0.001, P < 0.001, and P = 0.011, respectively).
Conclusions
We elaborate the clinical characteristics and outcomes of patients with ocular chemical injuries in Jinshan District, Shanghai. A comprehensive education program should be established and the use of protective eyewear should be promoted to prevent occupation-related ocular chemical injuries.
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Quesada JMA, Lloves JM, Delgado DV. Ocular chemical burns in the workplace: Epidemiological characteristics. Burns 2019; 46:1212-1218. [PMID: 31791857 DOI: 10.1016/j.burns.2019.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 11/05/2019] [Accepted: 11/13/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Epidemiological studies focusing on occupational pathologies can be an important medium through which to bring about change with respect to workplace accidents, both in terms of prevention planning and management as well as the appropriate care following an accident. Ocular chemical burns benefit from urgent attention as, if not treated early and appropriately, the tissue of the eye and its functionality can be seriously compromised. The objective of this study was to collate epidemiological data on workplace ocular chemical burns which could in turn serve to identify key action points in terms of occupational health. METHODS Cohort study with 604 cases of chemical burns to the eye occurring in the workplace between 2014 and 2015. Criteria inclusion were diagnosis of chemical burn, patient seen at the medical centre of the mutual society, workplace acquired ophthalmic pathology leading to the issuing of a sickness certificate. No exclusion criteria were defined. RESULTS Ocular chemical burns were the second most common workplace eye injury (12.68%) behind foreign bodies in the eye (43.42%). Men accounted for 68.54% of cases of ocular chemical burns. In around 75% of cases, sickness certification was for less than 7 days, although 6 patients suffered permanent disability. The occupational sector which was most affected particularly the industry service industry. The economic costs with these workplace injuries were extracted. CONCLUSIONS Appropriate early medical assistance is essential. The production and distribution of clinical guides for health care workers could optimise first line assistance and mitigate possible training deficiencies.
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Affiliation(s)
- Jesús Moreno-Arrones Quesada
- Care Centre FREMAP, Oviedo, Spain; University Institute Fernández Vega. Ophthalmologic Research Foundation, Oviedo University, Spain.
| | - Jesús Merayo Lloves
- University Institute Fernández Vega. Ophthalmologic Research Foundation, Oviedo University, Spain.
| | - David Varillas Delgado
- Universidad Francisco de Vitoria, Faculty of Medicine, Pozuelo de Alarcón, Madrid, Spain.
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Bizrah M, Yusuf A, Ahmad S. An update on chemical eye burns. Eye (Lond) 2019; 33:1362-1377. [PMID: 31086244 PMCID: PMC7002428 DOI: 10.1038/s41433-019-0456-5] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 02/06/2019] [Accepted: 04/02/2019] [Indexed: 01/20/2023] Open
Abstract
Ocular chemical injuries vary in severity, with the more severe end of the spectrum having profound visual consequences and medicolegal implications. Grading of ocular injuries is critical for determining acute treatment and visual prognosis. Poor immediate management results in more challenging treatment of acute disease. Similarly, poorly controlled acute disease results in more treatment-resistant chronic ocular disease. Despite several decades of research and public health initiatives, simple and effective interventions such as wearing protective eyewear and immediate irrigation of eyes remain as key challenges. Education and prevention are therefore important public health messages. Hurdles in the acute management of disease include poor evidence-base for commonly used treatments (e.g. based on experimental animal studies), reduced treatment adherence rates and high clinic non-attendance rates. The evolution of treatment strategies, particularly limbal stem cell transplantation, has revolutionised the visual and cosmetic outcomes in chronic phases of disease. It is therefore increasingly important to consider tertiary referral for patients with limbal stem cell failure or vision-limiting corneal scarring.
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Affiliation(s)
- Mukhtar Bizrah
- Imperial College Healthcare NHS Trust, Western Eye Hospital, 153-173 Marylebone Road, London, NW1 5QH, UK.
| | - Ammar Yusuf
- UCL Institute of Ophthalmology, 11-43 Bath Street, London, EC1V 9EL, UK
| | - Sajjad Ahmad
- Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK
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Singh SR, Yangzes S, Ram J. Saving the melting eye-alkali burns. QJM 2019; 112:621-622. [PMID: 30690637 DOI: 10.1093/qjmed/hcz013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S R Singh
- Advanced Eye Centre, Department of Ophthalmology, Post graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Yangzes
- Advanced Eye Centre, Department of Ophthalmology, Post graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - J Ram
- Advanced Eye Centre, Department of Ophthalmology, Post graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Kam KW, Patel CN, Nikpoor N, Yu M, Basu S. Limbal ischemia: Reliability of clinical assessment and implications in the management of ocular burns. Indian J Ophthalmol 2019; 67:32-36. [PMID: 30574887 PMCID: PMC6324115 DOI: 10.4103/ijo.ijo_945_18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose: Limbal ischemia is an important prognostic factor in the management of ocular burns. In this study, we evaluated the reliability of clinically assessing limbal ischemia among ophthalmic professionals. Methods: This study included 111 ophthalmic professionals who were shown 12 diffuse illumination color slit-lamp photographs of eyes with recent chemical injuries. Respondents were asked whether the photos were assessable and if yes, then to indicate the presence, location, and grade of limbal ischemia in each case. The responses were collected using a standard data collection sheet and the inter-observer agreement was calculated. Results: All participants responded to every question. Of the 1,332 responses, images were deemed assessable in 1,222 (91.7%) instances. The overall agreement (Fleiss’ kappa) for the presence of limbal ischemia and severity of limbal ischemia was 0.106 and 0.139, respectively (P < 0.012). Among the four groups of observers, practicing cornea specialists displayed significantly (P < 0.003) higher kappa values (0.201–0.203) when compared to residents (0.131–0.185), fellows (0.086–0.127), and optometrists (0.077–0.102). All indicated a poor level of inter-rater consistency. Conclusion: The results indicate that clinical assessment of limbal ischemia is highly subjective and there is lack of reliability even among cornea specialists who regularly manage patients with ocular burns. A non-invasive, standardized, objective, accurate, and reliable modality for ocular surface angiography is desperately needed for proper assessment and prognostication of ocular burns.
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Affiliation(s)
- Ka Wai Kam
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Chaitali N Patel
- Brien Holden Eye Research Center, LV Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India
| | - Neda Nikpoor
- Himalayan Cataract Project, Stanford University, Stanford, CA, USA
| | - Marco Yu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong; Department of Mathematics and Statistics, Hang Seng Management College, Sha Tin, Hong Kong
| | - Sayan Basu
- Brien Holden Eye Research Center, LV Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India
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Choi H, Phillips C, Oh JY, Potts L, Reger RL, Prockop DJ, Fulcher S. Absence of Therapeutic Benefit of the Anti-Inflammatory Protein TSG-6 for Corneal Alkali Injury in a Rat Model. Curr Eye Res 2019; 44:873-881. [PMID: 30935217 DOI: 10.1080/02713683.2019.1597893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose: To investigate the therapeutic efficacy of tumor necrosis factor (TNF)-α stimulated gene/protein 6 (TSG-6) in a rat model of corneal alkali injury. Methods: Corneal alkali injury was produced by placing an NaOH-soaked filter paper disk on the central cornea of the right eye of an anesthetized male Lewis (LEW/Crl) rat. Recombinant human TSG-6, or an equal volume of phosphate-buffered saline (PBS), was administered intravenously (IV), by anterior chamber (AC) injection, or as a topical drop. The affected eyes were photographed daily using a dissecting microscope and documented for clinical time course analysis of corneal opacification. Corneal tissue was excised at pre-determined therapeutic endpoints, with subsequent qRT-PCR or histological analyses. Results: The continuous monitoring of corneal alkali injury progression revealed TSG-6 treatments do not show sufficient effectiveness in vivo regardless of IV injection, AC injection, or topical application. Corneal opacification and neovascularization were not diminished, and gene expression was not impacted by these treatments. However, both IV and AC administration of TSG-6 significantly suppressed pro-inflammatory cytokines compared to PBS-treated eyes. Conclusion: We conclude that the therapeutic potential of TSG-6 is insufficient in a rat corneal alkali injury model.
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Affiliation(s)
- Hosoon Choi
- a Department of Basic Research, Central Texas Veterans Research Foundation , Temple , Texas , USA
| | - Casie Phillips
- a Department of Basic Research, Central Texas Veterans Research Foundation , Temple , Texas , USA
| | - Joo Youn Oh
- b Department of Ophthalmology, Seoul National University Hospital , Seoul , Republic of Korea
| | - Luke Potts
- c Department of Ophthalmology and Surgery, Scott and White Eye Institute , Temple , Texas , USA
| | - Roxanne L Reger
- d Institute for Regenerative Medicine, College of Medicine, Texas A&M University , College Station , Texas , USA
| | - Darwin J Prockop
- d Institute for Regenerative Medicine, College of Medicine, Texas A&M University , College Station , Texas , USA
| | - Samuel Fulcher
- e Department of Surgery, Central Texas Veterans Health Care System , Temple , Texas , United States of America
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Lee CY, Chen HT, Hsueh YJ, Chen HC, Huang CC, Meir YJJ, Cheng CM, Wu WC. Perioperative topical ascorbic acid for the prevention of phacoemulsification-related corneal endothelial damage: Two case reports and review of literature. World J Clin Cases 2019; 7:642-649. [PMID: 30863764 PMCID: PMC6406191 DOI: 10.12998/wjcc.v7.i5.642] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 01/16/2019] [Accepted: 01/26/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The current case report describes successful phacoemulsification with the aid of perioperative topical ascorbic acid (AA) in two patients with corneal endothelial disorders to prevent postoperative corneal endothelial decompensation.
CASE SUMMARY Two eyes of two patients underwent phacoemulsification with pre-existing corneal endothelial disorders including Fuchs corneal endothelial dystrophy (Patient 1) and endotheliitis (Patient 2). Topical AA was applied to both patients at least one month before and after with a frequency of four times per day. After the surgery, both eyes improved best-corrected visual acuity (BCVA) and there was limited human corneal endothelial cell loss without signs of corneal endothelial decompensation, such as deteriorated BCVA or persistent corneal edema during the follow-up of at least two years.
CONCLUSION Perioperative administration of topical AA may be an alternative therapy to the triple procedure in patients expecting to undergo cataract surgery.
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Affiliation(s)
- Chia-Yi Lee
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua 50093, Taiwan
- Department of Optometry, College of Medicine and Life Science, Chung Hwa University of Medical Technology, Tainan 71241, Taiwan
| | - Hung-Ta Chen
- Department of Internal Medicine, Taipei City Hospital- Heping Branch, Taipei 10341, Taiwan
| | - Yi-Jen Hsueh
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 20012, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou 20012, Taiwan
| | - Hung-Chi Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 20012, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou 20012, Taiwan
- Department of Medicine, College of Medicine Chang Gung University, Taoyuan 33305, Taiwan
| | - Chieh-Cheng Huang
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou 20012, Taiwan
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30010, Taiwan
| | - Yaa-Jyuhn James Meir
- Department of Biomedical Sciences, College of Medicine Chang Gung University, Taoyuan 33305, Taiwan
| | - Chao-Min Cheng
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou 20012, Taiwan
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30010, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 20012, Taiwan
- Department of Medicine, College of Medicine Chang Gung University, Taoyuan 33305, Taiwan
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Jolly R, Arjunan M, Theodorou M, Dahlmann-Noor AH. Eye injuries in children - incidence and outcomes: An observational study at a dedicated children's eye casualty. Eur J Ophthalmol 2018; 29:499-503. [PMID: 30270661 DOI: 10.1177/1120672118803512] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Trauma is an important cause of visual loss in children and may affect their quality of life. Prevention and legislation can reduce the incidence of trauma, and appropriate and timely treatment can improve prognosis. We aimed to describe incidence of eye injuries in children and the adherence to national and local management guidelines. METHODS Retrospective service evaluation at a tertiary hospital (Moorfields Eye Hospital, London, UK) which operates a dedicated children's eye casualty. The electronic patient administration system and electronic patient record system (Openeyes) were used to identify children who presented with eye injuries between January 2015 and December 2015. RESULTS Of 2397 first-time attendances to our children's casualty, 508 were for injuries (estimated incidence 21.1%, 95% confidence interval: 19.5%-22.7%). Mean age at presentation was 7.51 (standard deviation: 7.97) years; boys were more commonly affected than girls (69%). The most common injury was corneal abrasion, followed by blunt and chemical injury; severe injuries such as penetrating trauma were rare. Injuries were sustained mostly during play or sports. Two children sustained permanent loss of vision in the affected eye. CONCLUSION Our findings are comparable to other published reports. Adherence to management guidelines is high, but documentation of advice given to families can be improved. Regular training of staff and collaboration with organisations outside the hospital can increase awareness of eye injuries in children.
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Affiliation(s)
| | | | - Maria Theodorou
- Moorfields Eye Hospital, London, UK.,NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Annegret H Dahlmann-Noor
- Moorfields Eye Hospital, London, UK.,NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
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Genova RM, Meyer KJ, Anderson MG, Harper MM, Pieper AA. Neprilysin inhibition promotes corneal wound healing. Sci Rep 2018; 8:14385. [PMID: 30258206 PMCID: PMC6158251 DOI: 10.1038/s41598-018-32773-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 09/10/2018] [Indexed: 12/11/2022] Open
Abstract
Neprilysin (NEP), an ectoenzyme that modulates inflammation by degrading neuropeptides, was recently identified in the human corneal epithelium. The cornea expresses many NEP substrates, but the function of NEP in homeostatic maintenance and wound healing of the cornea is unknown. We therefore investigated the role of this enzyme under naive and injured conditions using NEP-deficient (NEP-/-) and wild type (WT) control mice. In vivo ocular surface imaging and histological analysis of corneal tissue showed no differences in limbal vasculature or corneal anatomy between naive NEP-/- and WT mice. Histological examination revealed increased corneal innervation in NEP-/- mice. In an alkali burn model of corneal injury, corneal wound healing was significantly accelerated in NEP-/- mice compared to WT controls 3 days after injury. Daily intraperitoneal administration of the NEP inhibitor thiorphan also accelerated corneal wound healing after alkali injury in WT mice. Collectively, our data identify a previously unknown role of NEP in the cornea, in which pharmacologic inhibition of its activity may provide a novel therapeutic option for patients with corneal injury.
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Affiliation(s)
- Rachel M Genova
- Department of Molecular Physiology and Biophysics, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Kacie J Meyer
- Department of Molecular Physiology and Biophysics, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Iowa City Department of Veterans Affairs Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA
- Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Stephen A. Wynn Institute for Vision Research, Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Michael G Anderson
- Department of Molecular Physiology and Biophysics, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Iowa City Department of Veterans Affairs Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA
- Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Stephen A. Wynn Institute for Vision Research, Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Matthew M Harper
- Iowa City Department of Veterans Affairs Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA.
- Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
| | - Andrew A Pieper
- Department of Molecular Physiology and Biophysics, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
- Iowa City Department of Veterans Affairs Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA.
- Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
- Stephen A. Wynn Institute for Vision Research, Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
- Harrington Discovery Institute, University Hospital Case Medical Center, Department of Psychiatry, Case Western Reserve University, Geriatric Research Education and Clinical Centers, Louis Stokes Cleveland VAMC, Cleveland, OH, USA.
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Chen L, Zhong J, Li S, Li W, Wang B, Deng Y, Yuan J. The long-term effect of tacrolimus on alkali burn-induced corneal neovascularization and inflammation surpasses that of anti-vascular endothelial growth factor. DRUG DESIGN DEVELOPMENT AND THERAPY 2018; 12:2959-2969. [PMID: 30254425 PMCID: PMC6140698 DOI: 10.2147/dddt.s175297] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Purpose To investigate the effect of tacrolimus in alkali burn-induced corneal neovascularization (NV) and inflammation and to compare with anti-vascular endothelial growth factor (anti-VEGF). Methods After corneal alkali-burn, 84 Wistar rats were randomly divided into three groups and received either saline solution or 0.05% tacrolimus (0.5 mg/mL) four times daily, or subconjunctival anti-VEGF injection (0.5 mg/0.05 mL). Corneal NV, opacity and epithelial defects, the status of inflammation, and the levels of proinflammatory and angiogenic cytokines were assessed on Days 3, 7, 14 and 28 post-injury. Results Compared with the control, tacrolimus significantly reduced corneal NV on Days 7, 14 and 28 post-injury, and anti-VEGF significantly reduced corneal NV at each assessment. Nevertheless, the tacrolimus group had significantly less corneal NV than the anti-VEGF group on Days 14 and 28. Furthermore, both tacrolimus and anti-VEGF significantly decreased the VEGF-A expression on Days 7 and 14, with no significant difference between the two groups. Moreover, corneal inflammatory response was alleviated, and corneal opacity and epithelial defects were significantly reduced by tacrolimus. Additionally, the expression of IL-1β, IL-6, monocyte chemotactic protein-1, macrophage inflammatory protein-1α and TGF-β were significantly decreased by tacrolimus. Conclusion Our findings suggested that 0.05% tacrolimus suspension eye drops effectively reduced alkali burn-induced corneal NV and inflammation, with a better effect than subconjunctival anti-VEGF injections on Days 14 and 28.
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Affiliation(s)
- Ling Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China,
| | - Jing Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China,
| | - Saiqun Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China,
| | - Weihua Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China,
| | - Bowen Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China,
| | - Yuqing Deng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China,
| | - Jin Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China,
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Impaired healing of cornea incision injury in a TRPV1-deficient mouse. Cell Tissue Res 2018; 374:329-338. [PMID: 29971480 PMCID: PMC6209059 DOI: 10.1007/s00441-018-2878-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 06/21/2018] [Indexed: 12/19/2022]
Abstract
The present study attempts to elucidate the role of TRPV1 cation channel receptor on primary repair in an incision-wounded mouse cornea in vivo. Previous study revealed that blocking TRPV1 suppressed myofibroblast formation and expression of transforming growth factor β1 (TGFβ1) in cultured keratocytes or ocular fibroblasts. Male C57BL/6 (wild-type; WT) mice and male C57BL/6 Trpv1-null (KO) mice incurred a full-thickness incision injury (1.8 mm in length, limbus to limbus) in the central cornea of one eye with a surgical blade under general and topical anesthesia. The injury was not sutured. On days 0, 5, and 10, the eyes were enucleated, processed for histology, immunohistochemistry, and real-time RT-PCR gene expression analysis to evaluate the effects of the loss of TRPV1 on primary healing. Electron microscopy observation was also performed to know the effect of the loss of TRPV1 on ultrastructure of keratocytes. The results showed that the loss of Trpv1 gene delayed closure of corneal stromal incision with hindered myofibroblast transdifferentiation along with declines in the expression of collagen Ia1 and TGFβ1. Inflammatory cell infiltration was not affected by the loss of TRPV1. Ultrastructurally endoplasmic reticulum of TRPV1-null keratocytes was more extensively dilated as compared with WT keratocytes, suggesting an impairment of protein secretion by TRPV1-gene knockout. These results indicate that injury-related TRPV1 signal is involved in healing of stromal incision injury in a mouse cornea by selectively stimulating TGFβ-induced granulation tissue formation.
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Singh G, Singh Bhinder H. Evaluation of Therapeutic Deep Anterior Lamellar Keratoplasty in Acute Ocular Chemical Burns. Eur J Ophthalmol 2018; 18:517-28. [DOI: 10.1177/112067210801800403] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- G. Singh
- Guru Gobind Singh International, Eye Research and Cure Centre, New Delhi - India
- Ex Prof. M.A.M. College and Associated Guru Nanak Eye Centre, New Delhi - India
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Peroxisome proliferator-activated receptor alpha agonist suppresses neovascularization by reducing both vascular endothelial growth factor and angiopoietin-2 in corneal alkali burn. Sci Rep 2017; 7:17763. [PMID: 29259285 PMCID: PMC5736552 DOI: 10.1038/s41598-017-18113-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 12/05/2017] [Indexed: 02/08/2023] Open
Abstract
We investigated the effect of a peroxisome proliferator-activated receptor alpha (PPARα) agonist ophthalmic solution in wound healing using a rat corneal alkali burn model. After instillation of a selective agonist of PPARα, fenofibrate, onto the burned cornea, PPARα-positive cells were observed in vascular endothelial cells, and there was upregulation of mRNA of PPARα in corneal stroma. Fenofibrate suppressed expression of neutrophils and macrophages during the early phase, and development of neovascularization and myofibroblast generation during the late phase. Fenofibrate reduced not only mRNA expression of vascular endothelial growth factor-A but also angiopoietin-1 and angiopoietin-2. Furthermore, fenofibrate suppressed scar formation by reducing type III collagen expression. These data suggest that a PPARα agonist ophthalmic solution might be a new strategy for treating corneal wounds through not only anti-inflammatory effects but also by preventing neovascularization.
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Sumioka T, Iwanishi H, Okada Y, Nidegawa Y, Miyajima M, Matsumoto KI, Saika S. Loss of tenascin X gene function impairs injury-induced stromal angiogenesis in mouse corneas. J Cell Mol Med 2017; 22:948-956. [PMID: 29160014 PMCID: PMC5783828 DOI: 10.1111/jcmm.13397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 08/26/2017] [Indexed: 12/18/2022] Open
Abstract
To determine the contribution by tenascin X (Tnx) gene expression to corneal stromal angiogenesis, the effects were determined of its loss on this response in TNX knockout (KO) mice. In parallel, the effects of such a loss were evaluated on vascular endothelial growth factor (VEGF) and transforming growth factor β1 (TGFβ1) gene and protein expression in fibroblasts and macrophages in cell culture. Histological, immunohistochemical and quantitative RT‐PCR changes determined if Tnx gene ablation on angiogenic gene expression, inflammatory cell infiltration and neovascularization induced by central corneal stromal cauterization. The role was determined of Tnx function in controlling VEGF‐A or TGFβ1 gene expression by comparing their expression levels in ocular fibroblasts and macrophages obtained from wild‐type (WT) and body‐wide Tnx KO mice. Tnx was up‐regulated in cauterized cornea. In Tnx KO, macrophage invasion was attenuated, VEGF‐A and its cognate receptor mRNA expression along with neovascularization were lessened in Tnx KOs relative to the changes occurring in their WT counterpart. Loss of Tnx instead up‐regulated in vivo mRNA expression of anti‐angiogenic VEGF‐B but not VEGF‐A. On the other hand, TGFβ1 mRNA expression declined in Tnx KO cultured ocular fibroblasts. Loss of Tnx gene expression caused VEGF‐A expression to decline in macrophages. Tnx gene expression contributes to promoting TGFβ1 mRNA expression in ocular fibroblasts and VEGF‐A in macrophages, macrophage invasion, up‐regulation of VEGF‐A expression and neovascularization in an injured corneal stroma. On the other hand, it suppresses anti‐angiogenic VEGF‐B mRNA expression in vivo.
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Affiliation(s)
- Takayoshi Sumioka
- Department of Ophthalmology, Wakayama Medical University School of Medicine, Wakayama, Japan
| | - Hiroki Iwanishi
- Department of Ophthalmology, Wakayama Medical University School of Medicine, Wakayama, Japan
| | - Yuka Okada
- Department of Ophthalmology, Wakayama Medical University School of Medicine, Wakayama, Japan
| | - Yuka Nidegawa
- Department of Ophthalmology, Wakayama Medical University School of Medicine, Wakayama, Japan
| | - Masayasu Miyajima
- Animal Center, Wakayama Medical University School of Medicine, Wakayama, Japan
| | - Ken-Ichi Matsumoto
- Department of Biosignaling and Radioisotope Experiment, Interdisciplinary Center for Science Research, Organization for Research and Academic Information, Shimane University, Izumo, Japan
| | - Shizuya Saika
- Department of Ophthalmology, Wakayama Medical University School of Medicine, Wakayama, Japan
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Corneal Nerve Fiber Structure, Its Role in Corneal Function, and Its Changes in Corneal Diseases. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3242649. [PMID: 29238714 PMCID: PMC5697388 DOI: 10.1155/2017/3242649] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/27/2017] [Accepted: 10/15/2017] [Indexed: 01/04/2023]
Abstract
Recently, in vivo confocal microscopy is used to examine the human corneal nerve fibers morphology. Corneal nerve fiber architecture and its role are studied in healthy and pathological conditions. Corneal nerves of rats were studied by nonspecific acetylcholinesterase (NsAchE) staining. NsAchE-positive subepithelial (stromal) nerve fiber has been found to be insensitive to capsaicin. Besides, NsAchE-negative but capsaicin-sensitive subbasal nerve (leash) fibers formed thick mesh-like structure showing close interconnections and exhibit both isolectin B4- and transient receptor potential vanilloid channel 1- (TRPV1-) positive. TRPV1, TRPV3, TRPA (ankyrin) 1, and TRPM (melastatin) 8 are expressed in corneal nerve fibers. Besides the corneal nerve fibers, the expressions of TRPV (1, 3, and 4), TRPC (canonical) 4, and TRPM8 are demonstrated in the corneal epithelial cell membrane. The realization of the importance of TRP channels acting as polymodal sensors of environmental stresses has identified potential drug targets for corneal disease. The pathophysiological conditions of corneal diseases are associated with disruption of normal tissue innervation, especially capsaicin-sensitive small sensory nerve fibers. The relationships between subbasal corneal nerve fiber morphology and neurotrophic keratopathy in corneal diseases are well studied. The recommended treatment for neurotrophic keratopathy is administration of preservative free eye drops.
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Massoudi D, Germer CJ, Glisch JM, Greenspan DS. Procollagen C-proteinase enhancer 1 (PCPE-1) functions as an anti-angiogenic factor and enhances epithelial recovery in injured cornea. Cell Tissue Res 2017; 370:461-476. [PMID: 28936615 DOI: 10.1007/s00441-017-2689-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 08/28/2017] [Indexed: 12/19/2022]
Abstract
Procollagen C-proteinase enhancer 1 (PCPE-1) has been characterized as a protein capable of enhancing the activity of bone morphogenetic protein 1/tolloid-like proteinases in the biosynthetic processing of C-propeptides from procollagens I-III. This processing step is thought necessary to the formation of collagen I-III monomers capable of forming fibrils. Thus, PCPE-1 is predicted to play an important role in scarring, as scar tissue is predominantly composed of fibrillar collagen. Corneal scarring is of great clinical importance, as it leads to loss of visual acuity and, in severe cases, blindness. Here, we investigate a possible role for PCPE-1 in corneal scarring. Although differences in corneal opacity associated with scarring following injury of Pcolce -/- and wild-type (WT) mice using full-thickness excision or alkali burn models of corneal injury were not grossly apparent, differences in procollagen I processing levels between Pcolce -/- and WT primary corneal keratocytes were consistent with a role for PCPE-1 in corneal collagen deposition. An unexpected finding was that neoangiogenesis, which follows alkali burn cornea injury, was strikingly increased in Pcolce -/- cornea, compared to WT. A series of aortic ring assays confirmed the anti-angiogenic effects of PCPE-1. Another unexpected finding was of abnormalities of epithelial basement membrane and of re-epithelialization following Pcolce -/- corneal injury. Thus, PCPE-1 appears to be of importance as an anti-angiogenic factor and in re-epithelialization following injury in cornea and perhaps in other tissues as well.
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Affiliation(s)
- Dawiyat Massoudi
- Department of Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, 4503 WIMRII, 1111 Highland Ave., Madison, WI, 53705, USA
| | - Colin J Germer
- Department of Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, 4503 WIMRII, 1111 Highland Ave., Madison, WI, 53705, USA
| | - Jeffrey M Glisch
- Department of Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, 4503 WIMRII, 1111 Highland Ave., Madison, WI, 53705, USA
| | - Daniel S Greenspan
- Department of Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, 4503 WIMRII, 1111 Highland Ave., Madison, WI, 53705, USA.
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42
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Treatment of acute ocular chemical burns. Surv Ophthalmol 2017; 63:214-235. [PMID: 28935121 DOI: 10.1016/j.survophthal.2017.09.005] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 09/08/2017] [Accepted: 09/11/2017] [Indexed: 01/15/2023]
Abstract
Ocular chemical burns are an ophthalmic emergency and are responsible for 11.5%-22.1% of ocular injuries. Immediate copious irrigation is universally recommended in acute ocular burns to remove the offending agent and minimize damage. Conventional medical therapy consists of the use of agents that promote epithelialization, minimize inflammation, and prevent cicatricial complications. Biological fluids such as autologous serum, umbilical cord blood serum, platelet-rich plasma, and amniotic membrane suspension are a rich source of growth factors and promote healing when used as adjuncts to conventional therapy. Surgical treatment of acute ocular burns includes the debridement of the necrotic tissue, application of tissue adhesives, tenoplasty, and tectonic keratoplasty. Amniotic membrane transplantation is a novel surgical treatment that is increasingly being used as an adjunct to conventional treatment to promote epithelial healing, minimize pain, and restore visual acuity. Various experimental treatments that aim to promote wound healing and minimize inflammation are being evaluated such as human mesenchymal and adipose stem cells, beta-1,3 glucan, angiotensin-converting enzyme inhibitors, cultivated fibroblasts, zinc desferrioxamine, antifibrinolytic agents, antioxidants, collagen cross-linking, and inhibitors of corneal neovascularization.
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Choi H, Phillips C, Oh JY, Stock EM, Kim DK, Won JK, Fulcher S. Comprehensive Modeling of Corneal Alkali Injury in the Rat Eye. Curr Eye Res 2017. [DOI: 10.1080/02713683.2017.1317817] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Hosoon Choi
- Department of Basic Research, Central Texas Veterans Research Foundation, Temple, TX, USA
| | - Casie Phillips
- Department of Basic Research, Central Texas Veterans Research Foundation, Temple, TX, USA
| | - Joo Youn Oh
- Department of Ophthalmology, Seoul National University Hospital, Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Eileen M. Stock
- Cooperative Studies Program Coordinating Center, VA Maryland Health Care System, Perry Point, MD, USA
| | - Dong-Ki Kim
- Institute for Regenerative Medicine, Texas A&M Health Science Center, College Station, TX, USA
| | - Jae-Kyung Won
- Department of Pathology, Seoul National University Hospital, Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Samuel Fulcher
- Department of Surgery, Ophthalmology Section, Central Texas Veterans Health Care System, Temple, TX, USA
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Al-Debasi T, Al-Bekairy A, Al-Katheri A, Al Harbi S, Mansour M. Topical versus subconjunctival anti-vascular endothelial growth factor therapy (Bevacizumab, Ranibizumab and Aflibercept) for treatment of corneal neovascularization. Saudi J Ophthalmol 2017; 31:99-105. [PMID: 28559722 PMCID: PMC5436388 DOI: 10.1016/j.sjopt.2017.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 02/28/2017] [Indexed: 12/01/2022] Open
Abstract
In order to evaluate the effect of topical and subconjunctival anti-vascular endothelial growth factor (anti-VEGF) therapy, Ranibizumab, Bevacizumab and Aflibercept as a therapy for corneal neovascularization (NV) treatment, the aim of this study was to review all data related to some of anti-VEGF as a promising therapies for corneal NV treatment. Corneal NV is a dangerous condition leading to a marked reduction in vision due to angiogenesis of abnormal vessels that block light. During the recent years, we have recognized new drug proliferation for corneal NV treatment. Recently, anti-VEGF therapies are one of the most important drugs used for corneal NV treatment. Several growth factors are involved in angiogenesis. The most important growth factor in corneal angiogenesis is VEGF. VEGF can be considered as key mediators in corneal angiogenesis. It is upregulated during corneal NV. In fact, anti-VEGF therapies have shown efficacy in attenuation of corneal NV in both animal models and clinical trials. A promising therapeutic success has been achieved using antibodies directed against VEGF. Bevacizumab has demonstrated efficacy and efficiency in the treatment of different neo-vascular ocular diseases and it has partially reduced corneal NV through different routes of administrations: topical, subconjunctival, and intraocular application. A similar efficacy to bevacizumab profiles in the treatment of neo-vascular age-related macular degeneration was induced by ranibizumab. Moreover, at worse levels of initial visual acuity of diabetic macular edema, aflibercept was more effective at improving vision. Anti-VEGF agents (Bevacizumab, Ranibizumab and Aflibercept) seem to have a higher efficiency and efficacy for corneal NV treatment. Both subconjunctival therapy and topical therapy of bevacizumab prohibit corneal NV, while early treatment with subconjunctival administration of ranibizumab may successfully reduce corneal NV. Therefore, establishment of safe doses is highly important before these drugs can be involved in the clinical setting. Further investigations and studies are highly warranted to adjust the dose and route of administration for the antibodies directed against VEGF to be the key therapeutic agents in the corneal NV treatment.
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Affiliation(s)
- Tariq Al-Debasi
- Division of Ophthalmology, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia
| | - Abdulkareem Al-Bekairy
- Pharmaceutical Care Services, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia.,Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O Box 3660, Riyadh 11426, Saudi Arabia
| | - Abdulmalik Al-Katheri
- Pharmaceutical Care Services, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia.,Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O Box 3660, Riyadh 11426, Saudi Arabia
| | - Shmeylan Al Harbi
- Pharmaceutical Care Services, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia.,Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O Box 3660, Riyadh 11426, Saudi Arabia
| | - Mahmoud Mansour
- Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O Box 3660, Riyadh 11426, Saudi Arabia
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Baradaran-Rafii A, Eslani M, Haq Z, Shirzadeh E, Huvard MJ, Djalilian AR. Current and Upcoming Therapies for Ocular Surface Chemical Injuries. Ocul Surf 2016; 15:48-64. [PMID: 27650263 DOI: 10.1016/j.jtos.2016.09.002] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 09/01/2016] [Accepted: 09/02/2016] [Indexed: 01/11/2023]
Abstract
Chemical injuries frequently result in vision loss, disfigurement, and challenging ocular surface complications. Acute interventions are directed at decreasing the extent of the injury, suppressing inflammation, and promoting ocular surface re-epithelialization. Chronically, management involves controlling inflammation along with rehabilitation and reconstruction of the ocular surface. Future therapies aimed at inhibiting neovascularization and promoting ocular surface regeneration should provide more effective treatment options for the management of ocular chemical injuries.
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Affiliation(s)
| | - Medi Eslani
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Zeeshan Haq
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ebrahim Shirzadeh
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Michael J Huvard
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ali R Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA.
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46
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Chen Y, Yang W, Zhang X, Yang S, Peng G, Wu T, Zhou Y, Huang C, Reinach PS, Li W, Liu Z. MK2 inhibitor reduces alkali burn-induced inflammation in rat cornea. Sci Rep 2016; 6:28145. [PMID: 27329698 PMCID: PMC4916419 DOI: 10.1038/srep28145] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 05/27/2016] [Indexed: 01/02/2023] Open
Abstract
MK2 activation by p38 MAPK selectively induces inflammation in various diseases. We determined if a MK2 inhibitor (MK2i), improves cornea wound healing by inhibiting inflammation caused by burning rat corneas with alkali. Our study, for the first time, demonstrated that MK2i inhibited alkali burn-induced MK2 activation as well as rises in inflammation based on: a) blunting rises in inflammatory index, inflammatory cell infiltration, ED1+ macrophage and PMN+ neutrophil infiltration; b) suppressing IL-6 and IL-1β gene expression along with those of macrophage inflammatory protein-1α (MIP-1α), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1); c) reducing angiogenic gene expression levels and neovascularization (NV) whereas anti-angiogenic PEDF levels increased. In addition, this study found that MK2i did not affect human corneal epithelial cell (HCEC) proliferation and migration and had no detectable side effects on ocular surface integrity. Taken together, MK2i selectively inhibited alkali burn-induced corneal inflammation by blocking MK2 activation, these effects have clinical relevance in the treatment of inflammation related ocular surface diseases.
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Affiliation(s)
- Yanfeng Chen
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Wenzhao Yang
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Xiaobo Zhang
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Shu Yang
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Gao Peng
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Ting Wu
- Department of Basic Medical Sciences, Cancer Research Center, Medical College, Xiamen University, Xiamen, China
| | - Yueping Zhou
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Caihong Huang
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Peter S Reinach
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health, People's Republic of China.,Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Wei Li
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China.,Affiliated Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Zuguo Liu
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China.,Affiliated Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
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Li Z, Cui L, Yang JM, Lee HS, Choi JS, Woo JM, Lim SK, Yoon KC. The Wound Healing Effects of Adiponectin Eye Drops after Corneal Alkali Burn. Curr Eye Res 2016; 41:1424-1432. [DOI: 10.3109/02713683.2015.1133834] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Zhengri Li
- Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
- Department of Ophthalmology, Chonnam National University Medical School and Hospital and Center for Creative Biomedical Scientists at Chonnam National University, Gwangju, South Korea
| | - Lian Cui
- Department of Ophthalmology, Chonnam National University Medical School and Hospital and Center for Creative Biomedical Scientists at Chonnam National University, Gwangju, South Korea
| | - Jee Myung Yang
- Department of Ophthalmology, Chonnam National University Medical School and Hospital and Center for Creative Biomedical Scientists at Chonnam National University, Gwangju, South Korea
| | - Hyo Seok Lee
- Department of Ophthalmology, Chonnam National University Medical School and Hospital and Center for Creative Biomedical Scientists at Chonnam National University, Gwangju, South Korea
| | - Ji Suk Choi
- Department of Ophthalmology, Chonnam National University Medical School and Hospital and Center for Creative Biomedical Scientists at Chonnam National University, Gwangju, South Korea
| | - Je Moon Woo
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Seul Ki Lim
- Microbiology and Functionality Research Group, R & D Division, World Institute of Kimchi, Gwangju, South Korea
| | - Kyung Chul Yoon
- Department of Ophthalmology, Chonnam National University Medical School and Hospital and Center for Creative Biomedical Scientists at Chonnam National University, Gwangju, South Korea
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49
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Tuncel N, Yildirim N, Gurer F, Basmak H, Uzuner K, Sahinturk V, Gursoy H. Effect of vasoactive intestinal peptide on the wound healing of alkali-burned corneas. Int J Ophthalmol 2016; 9:204-10. [PMID: 26949636 DOI: 10.18240/ijo.2016.02.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 04/29/2015] [Indexed: 12/16/2022] Open
Abstract
AIM To study the effect of vasoactive intestinal peptide (VIP) on wound healing in experimental alkali burns of the cornea. METHODS Twenty-seven albino rabbits, weighing 3.2±0.75 kg were used. Alkali burns were induced on corneas by applying 10 mm Whatman paper No:50 soaked in 1 mol/L NaOH. They have further classified into 5 groups as follows: 1) control group given no treatment (n=5); 2) VIP given subconjunctivally (n=6); 3) VIP injected into anterior chamber (n=6); 4) NaCl 0.9% given subconjunctivally (n=5); 5) NaCl 0.9% given into the anterior chamber (n=5). All treatment protocols except control group were followed by topical eye drops composed of VIP at two hourly intervals for one week from 8 a.m. to 6 p.m. RESULTS VIP treated groups of rabbits with alkali burns were found to have better wound healing findings histo-pathologically when compared to those of control group who have received no treatment on day 30. No differences were observed between groups in respect to degree of polymorphonuclear leukocytes (PMNL) infiltration and degree of loss of amorphous substrate on day 15. However, PMNL infiltration and degree of loss of amorphous substrate were lower in Groups 2 and 3 when compared to that of control group on day 30 (P<0.05). CONCLUSION We have shown that VIP has positive effects on alkali induced corneal burns. VIP may inhibit PMNL migration to cornea through an immunomodulatory effect. Inhibition of PMNL migration might reduce the release of collagenases and this might prevent the extracellular amorphous substance loss.
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Affiliation(s)
- Nese Tuncel
- Department of Physiology, Eskisehir Osmangazi University Medical Faculty, Eskisehir 26480, Turkey
| | - Nilgun Yildirim
- Department of Ophthalmology, Eskisehir Osmangazi University Medical Faculty, Eskisehir 26480, Turkey
| | - Firdevs Gurer
- Department of Histology, Eskisehir Osmangazi University Medical Faculty, Eskisehir 26480, Turkey
| | - Hikmet Basmak
- Department of Ophthalmology, Eskisehir Osmangazi University Medical Faculty, Eskisehir 26480, Turkey
| | - Kubilay Uzuner
- Department of Physiology, Eskisehir Osmangazi University Medical Faculty, Eskisehir 26480, Turkey
| | - Varol Sahinturk
- Department of Histology, Eskisehir Osmangazi University Medical Faculty, Eskisehir 26480, Turkey
| | - Huseyin Gursoy
- Department of Ophthalmology, Eskisehir Osmangazi University Medical Faculty, Eskisehir 26480, Turkey
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High MMP-9 Expression May Contribute to Retroprosthetic Membrane Formation after KPro Implantation in Rabbit Corneal Alkali Burn Model. J Ophthalmol 2016; 2016:1094279. [PMID: 26949542 PMCID: PMC4753725 DOI: 10.1155/2016/1094279] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 12/04/2015] [Accepted: 12/17/2015] [Indexed: 01/26/2023] Open
Abstract
Purpose. To evaluate aqueous humor MMP-9 levels in alkali-burned rabbit cornea following KPr implantation and their roles in RPMs formation. Methods. Left eyes of 36 rabbits received a deep corneal alkali wound. 12 corneas were implanted with KPro and the other 24 control corneas were either penetrating keratoplasty or left without keratoplasty. Aqueous humor MMP-9 and TIMP-1 levels were determined and RPMs were obtained for histopathological and ultrastructural examination. Results. Alkali exposure induced significant increase in aqueous humor MMP-9 level and the data were further enhanced by KPro implantation. By contrast, TMIP-1 levels in aqueous humor showed a decreased trend following corneal alkali burn and KPro surgery. RPMs were developed in 5 out of 10 cases of KPro successfully implanted eyes. Histopathology showed the presence of a large number of fibroblasts and collagen fibers arranged irregularly with inflammatory cells infiltration, and an ingrowth of new blood vessels in this retrokeratoprosthesis fibrous tissue. Immunohistochemical analysis showed positive stain of RPMs for both MMP-9 and TIMP-1. Aqueous humor MMP-9 levels were significantly higher in RPM group postoperatively, while TIMP-1 levels were comparatively lower than that of No-RPM group. Conclusions. Our study evidenced the potential pathophysiological role of MMP-9 expression in RPM formation following KPro implantation.
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