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Yan Q, Fu M, Zhou X. Sildenafil-induced bilateral ciliochoroidal effusion syndrome: Case report. Eur J Ophthalmol 2024; 34:NP22-NP26. [PMID: 38751097 DOI: 10.1177/11206721241254407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
PURPOSE To report a case of bilateral ciliochoroidal effusion syndrome associated with sildenafil use. CASE REPORT A 41-year-old male presented with a five-day history of bilateral blurred vision, elevated intraocular pressure, and myopic shift. Ultrasound biomicroscopy radial scans showed closed angles and 360 degrees of ciliochoroidal effusion in both eyes. Anterior segment coherence tomography angiography showed bilateral shallow anterior chamber. Further questioning revealed that the patient had taken sildenafil several times just a few days before symptoms appeared. Since then, the patient stopped dosing sildenafil. After treatment of anti-inflammation and shifting the lens-iris diaphragm posteriorly, the patient's visual acuity improved and intraocular pressure decreased. Follow-up ultrasound biomicroscopy and anterior segment coherence tomography angiography revealed resolution of ciliochoroidal effusion and increase of anterior chamber depth in both eyes. CONCLUSIONS The patient demonstrated a rare case of sildenafil-induced bilateral ciliochoroidal effusion syndrome. This case report shows that sildenafil should be added to the possible causative agents of ciliochoroidal effusion syndrome.
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Affiliation(s)
- Quan Yan
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Mingshui Fu
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Xinrong Zhou
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Ophthalmology, TongRen Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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2
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Cui X, Buonfiglio F, Pfeiffer N, Gericke A. Aging in Ocular Blood Vessels: Molecular Insights and the Role of Oxidative Stress. Biomedicines 2024; 12:817. [PMID: 38672172 PMCID: PMC11048681 DOI: 10.3390/biomedicines12040817] [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: 03/13/2024] [Revised: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Acknowledged as a significant pathogenetic driver for numerous diseases, aging has become a focal point in addressing the profound changes associated with increasing human life expectancy, posing a critical concern for global public health. Emerging evidence suggests that factors influencing vascular aging extend their impact to choroidal and retinal blood vessels. The objective of this work is to provide a comprehensive overview of the impact of vascular aging on ocular blood vessels and related diseases. Additionally, this study aims to illuminate molecular insights contributing to vascular cell aging, with a particular emphasis on the choroid and retina. Moreover, innovative molecular targets operating within the domain of ocular vascular aging are presented and discussed.
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Affiliation(s)
- Xiuting Cui
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (F.B.); (N.P.)
| | | | | | - Adrian Gericke
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (F.B.); (N.P.)
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Han JED, Subramanian A, Lee WH, Coker J, Denniston AK, Nirantharakumar K, Adderley NJ. Association of sildenafil use with age-related macular degeneration: a retrospective cohort study. BMJ Open Ophthalmol 2024; 9:e001525. [PMID: 38490689 PMCID: PMC10946355 DOI: 10.1136/bmjophth-2023-001525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 03/06/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE Despite significant advances in clinical care and understanding of the underlying pathophysiology, age-related macular degeneration (AMD)-a major cause of global blindness-lacks effective treatment to prevent the irreversible degeneration of photoreceptors leading to central vision loss. Limited studies suggest phosphodiesterase type 5 (PDE5) inhibitors, such as sildenafil, may prevent AMD by increasing retinal blood flow. This study explores the potential association between sildenafil use and AMD risk in men with erectile dysfunction using UK data. METHODS AND ANALYSIS Using the UK's IQVIA Medical Research Data, the study analysed 31 575 men prescribed sildenafil for erectile dysfunction and no AMD history from 2007 to 2015, matched with a comparator group of 62 155 non-sildenafil users in a 1:2 ratio, over a median follow-up of approximately three years. RESULTS The primary outcome was the incidence of AMD in the two groups. The study found no significant difference in AMD incidence between the sildenafil users and the non-users, with an adjusted hazard ratio (HR) of 0.99 (95% CI 0.84 to 1.16), after accounting for confounders such as age, ethnicity, Townsend deprivation quintile, body mass index category, and diagnosis of hypertension and type 2 diabetes. CONCLUSION The study results indicated no significant association between sildenafil use and AMD prevention in UK men with erectile dysfunction, suggesting sildenafil's protective effect on AMD is likely insignificant.
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Affiliation(s)
- Ji Eun Diana Han
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Wen Hwa Lee
- Action Against Age-Related Macular Degeneration, London, UK
| | - Jesse Coker
- Action Against Age-Related Macular Degeneration, London, UK
| | - Alastair K Denniston
- Department of Ophthalmology, University Hospitals Birmingham NHSFT, Birmingham, UK
- Moorfields Eye Hospital NHS Foundation Trust and Institute of Ophthalmology, University College London, London, UK
- Health Data Research UK (HDRUK), London, UK
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, Birmingham, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Health Data Research UK (HDRUK), London, UK
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, Birmingham, UK
| | - Nicola Jaime Adderley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, Birmingham, UK
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4
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Sazhnyev Y, Sin TN, Ma A, Chang E, Huynh L, Roszak K, Park S, Choy K, Farsiu S, Moshiri A, Thomasy SM, Yiu G. Choroidal Changes in Rhesus Macaques in Aging and Age-Related Drusen. Invest Ophthalmol Vis Sci 2023; 64:44. [PMID: 37773500 PMCID: PMC10547013 DOI: 10.1167/iovs.64.12.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/07/2023] [Indexed: 10/01/2023] Open
Abstract
Purpose Choroidal vascular changes occur with normal aging and age-related macular degeneration (AMD). Here, we evaluate choroidal thickness and vascularity in aged rhesus macaques to better understand the choroid's role in this nonhuman primate model of AMD. Methods We analyzed optical coherence tomography (OCT) images of 244 eyes from 122 rhesus macaques (aged 4-32 years) to measure choroidal thickness (CT) and choroidal vascularity index (CVI). Drusen number, size, and volume were measured by semiautomated annotation and segmentation of OCT images. We performed regression analyses to determine any association of CT or CVI with age, sex, and axial length and to determine if the presence and volume of soft drusen impacted these choroidal parameters. Results In rhesus macaques, subfoveal CT decreased with age at 3.2 µm/y (R2 = 0.481, P < 0.001), while CVI decreased at 0.66% per year (R2 = 0.257, P < 0.001). Eyes with soft drusen exhibited thicker choroid (179.9 ± 17.5 µm vs. 162.0 ± 27.9 µm, P < 0.001) and higher CVI (0.612 ± 0.051 vs. 0.577 ± 0.093, P = 0.005) than age-matched control animals. Neither CT or CVI appeared to be associated with drusen number, size, or volume in this cohort. However, some drusen in macaques were associated with underlying choroidal vessel enlargement resembling pachydrusen in human patients with AMD. Conclusions Changes in the choroidal vasculature in rhesus macaques resemble choroidal changes in human aging, but eyes with drusen exhibit choroidal thickening, increased vascularity, and phenotypic characteristics of pachydrusen observed in some patients with AMD.
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Affiliation(s)
- Yevgeniy Sazhnyev
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
- Department of Ophthalmology, California Northstate University, College of Medicine, Elk Grove, California, United States
| | - Tzu-Ni Sin
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Anthony Ma
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
- Department of Ophthalmology, California Northstate University, College of Medicine, Elk Grove, California, United States
| | - Ellie Chang
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Leon Huynh
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Karolina Roszak
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Sangwan Park
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Kevin Choy
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States
| | - Sina Farsiu
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, United States
| | - Ala Moshiri
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Sara M. Thomasy
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Glenn Yiu
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
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Grimes KR, Aloney A, Skondra D, Chhablani J. Effects of systemic drugs on the development and progression of age-related macular degeneration. Surv Ophthalmol 2023; 68:332-346. [PMID: 36731638 DOI: 10.1016/j.survophthal.2023.01.007] [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: 01/17/2022] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 02/01/2023]
Abstract
Age-related macular degeneration (AMD) is the leading cause of severe loss of central vision among people over 50. The pathophysiology of the disease is multifactorial and can be attributed to genetics, aging, inflammation, environmental factors, and lifestyle factors including smoking, diet, obesity, and alcohol consumption. While there is no treatment for dry AMD, the current standard treatment for wet AMD is an intraocular injection of anti-vascular endothelial growth factor-an effective, yet expensive, therapy that requires ongoing treatment. As the aging population continues to grow, and AMD diagnoses continue to rise, new treatments should be explored to reduce vision complications and decrease treatment burdens. Many systemic conditions have progressive pathological changes that may affect AMD, particularly those affecting systemic vasculature like diabetes and cardiovascular status. Consequently, systemic drugs used to treat coexistent systemic diseases may influence some of the pathogenic mechanisms of AMD and lead its progression or delay. In this review we explore the current literature to summarize the findings of the reported effects of antihypertensive, immunosuppressants, cholesterol lowering agents, nonsteroidal anti-inflammatory drugs, dopamine precursors, hypoglycemic agents, and anticoagulants on AMD.
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Affiliation(s)
- Kara R Grimes
- School of Medicine, New York Medical College, Valhalla, NY, USA
| | - Abhilasha Aloney
- Eye Care Institute, PBMA'S H.V. Desai Eye Hospital, Pune, Maharashtra, India
| | - Dimitra Skondra
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, IL, USA
| | - Jay Chhablani
- Department of Ophthalmology, The University of Pittsburgh, Pittsburgh, PA, USA.
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Samidurai A, Xi L, Das A, Kukreja RC. Beyond Erectile Dysfunction: cGMP-Specific Phosphodiesterase 5 Inhibitors for Other Clinical Disorders. Annu Rev Pharmacol Toxicol 2023; 63:585-615. [PMID: 36206989 DOI: 10.1146/annurev-pharmtox-040122-034745] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Cyclic guanosine monophosphate (cGMP), an important intracellular second messenger, mediates cellular functional responses in all vital organs. Phosphodiesterase 5 (PDE5) is one of the 11 members of the cyclic nucleotide phosphodiesterase (PDE) family that specifically targets cGMP generated by nitric oxide-driven activation of the soluble guanylyl cyclase. PDE5 inhibitors, including sildenafil and tadalafil, are widely used for the treatment of erectile dysfunction, pulmonary arterial hypertension, and certain urological disorders. Preclinical studies have shown promising effects of PDE5 inhibitors in the treatment of myocardial infarction, cardiac hypertrophy, heart failure, cancer and anticancer-drug-associated cardiotoxicity, diabetes, Duchenne muscular dystrophy, Alzheimer's disease, and other aging-related conditions. Many clinical trials with PDE5 inhibitors have focused on the potential cardiovascular, anticancer, and neurological benefits. In this review, we provide an overview of the current state of knowledge on PDE5 inhibitors and their potential therapeutic indications for various clinical disorders beyond erectile dysfunction.
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Affiliation(s)
- Arun Samidurai
- Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA;
| | - Lei Xi
- Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA;
| | - Anindita Das
- Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA;
| | - Rakesh C Kukreja
- Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA;
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Finzi A, Valsecchi N, Tassi F, Cellini M, Fontana L. Chronic Central Serous Chorioretinopathy with Pigment Epithelium Detachment Treated with Sildenafil: A Case Report. Case Rep Ophthalmol 2022; 13:692-699. [PMID: 36845460 PMCID: PMC9944586 DOI: 10.1159/000524992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/09/2022] [Indexed: 11/19/2022] Open
Abstract
Central serous chorioretinopathy (CSCR) is a retinal disease that may be complicated by the development of serous retinal pigment epithelial detachment (PED). The exact molecular mechanisms of CSCR have remained uncertain as well as there is no effective medical therapy. Herein, we describe a case of a 43-year-old male suffering from chronic CSCR with PED and visual acuity reduction (20/40) that showed improvement in visual acuity (20/25) and metamorphopsia 2 weeks after daily intake of 20 mg sildenafil tablets. Optical coherence tomography (OCT) scan showed resolution of PED with residual degeneration of the photoreceptor inner and outer segment layer and retinal pigmented epithelium. The patient continued treatment with sildenafil 20 mg for 2 months. Six months after the discontinuation of therapy, visual acuity was maintained, with absence of PED at OCT. Our case supports the hypothesis that phosphodiesterase type 5 (PDE-5) inhibitors may be an alternative in the treatment of patients with CSCR, alone or combined with other medications.
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Affiliation(s)
- Alessandro Finzi
- aOphthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy,*Alessandro Finzi,
| | - Nicola Valsecchi
- aOphthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Filippo Tassi
- bOphthalmology Unit, Policlinico di Monza, University of Milano Bicocca, Monza, Italy
| | - Mauro Cellini
- aOphthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Luigi Fontana
- aOphthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Fabre M, Mateo L, Lamaa D, Baillif S, Pagès G, Demange L, Ronco C, Benhida R. Recent Advances in Age-Related Macular Degeneration Therapies. Molecules 2022; 27:molecules27165089. [PMID: 36014339 PMCID: PMC9414333 DOI: 10.3390/molecules27165089] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Age-related macular degeneration (AMD) was described for the first time in the 1840s and is currently the leading cause of blindness for patients over 65 years in Western Countries. This disease impacts the eye’s posterior segment and damages the macula, a retina section with high levels of photoreceptor cells and responsible for the central vision. Advanced AMD stages are divided into the atrophic (dry) form and the exudative (wet) form. Atrophic AMD consists in the progressive atrophy of the retinal pigment epithelium (RPE) and the outer retinal layers, while the exudative form results in the anarchic invasion by choroidal neo-vessels of RPE and the retina. This invasion is responsible for fluid accumulation in the intra/sub-retinal spaces and for a progressive dysfunction of the photoreceptor cells. To date, the few existing anti-AMD therapies may only delay or suspend its progression, without providing cure to patients. However, in the last decade, an outstanding number of research programs targeting its different aspects have been initiated by academics and industrials. This review aims to bring together the most recent advances and insights into the mechanisms underlying AMD pathogenicity and disease evolution, and to highlight the current hypotheses towards the development of new treatments, i.e., symptomatic vs. curative. The therapeutic options and drugs proposed to tackle these mechanisms are analyzed and critically compared. A particular emphasis has been given to the therapeutic agents currently tested in clinical trials, whose results have been carefully collected and discussed whenever possible.
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Affiliation(s)
- Marie Fabre
- Institut de Chimie de Nice UMR 7272, Université Côte d’Azur, CNRS, 06108 Nice, France
| | - Lou Mateo
- Institut de Chimie de Nice UMR 7272, Université Côte d’Azur, CNRS, 06108 Nice, France
| | - Diana Lamaa
- CiTCoM, UMR 8038 CNRS, Faculté de Pharmacie, Université de Paris Cité, 4, Avenue de l’Observatoire, 75006 Paris, France
| | - Stéphanie Baillif
- Ophthalmology Department, University Hospital of Nice, 30 Avenue De La Voie Romaine, 06000 Nice, France
| | - Gilles Pagès
- Institute for Research on Cancer and Aging (IRCAN), UMR 7284 and INSERM U 1081, Université Côte d’Azur, CNRS 28 Avenue de Valombrose, 06107 Nice, France
| | - Luc Demange
- Institut de Chimie de Nice UMR 7272, Université Côte d’Azur, CNRS, 06108 Nice, France
- CiTCoM, UMR 8038 CNRS, Faculté de Pharmacie, Université de Paris Cité, 4, Avenue de l’Observatoire, 75006 Paris, France
- Correspondence: (L.D.); (C.R.); (R.B.)
| | - Cyril Ronco
- Institut de Chimie de Nice UMR 7272, Université Côte d’Azur, CNRS, 06108 Nice, France
- Correspondence: (L.D.); (C.R.); (R.B.)
| | - Rachid Benhida
- Institut de Chimie de Nice UMR 7272, Université Côte d’Azur, CNRS, 06108 Nice, France
- Department of Chemical and Biochemical Sciences-Green Process Engineering (CBS-GPE), Mohamed VI Polytechnic University (UM6P), Benguerir 43150, Morocco
- Correspondence: (L.D.); (C.R.); (R.B.)
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Toulouie S, Chang S, Pan J, Snyder K, Yiu G. Relationship of Retinal Vessel Caliber with Age-Related Macular Degeneration. J Ophthalmol 2022; 2022:8210599. [PMID: 35957743 PMCID: PMC9357695 DOI: 10.1155/2022/8210599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 12/05/2022] Open
Abstract
Purpose Evaluate the relationship between retinal vascular caliber and age-related macular degeneration (AMD) severity or progression. Methods A retrospective secondary analysis of 1172 fundus photographs and clinical data from the prospective Age-Related Eye Disease Study (AREDS). Central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole-to-venule ratio (AVR) were measured using the Parr-Hubbard-Knudtson formula. Univariate and multivariate regressions were used to determine the association of CRAE, CRVE, and AVR with age, sex, smoking status, presence of cilioretinal artery, and AMD severity at baseline and 5 years using the 9-step AMD severity score. Results Only CRAE and CRVE were higher in men (P < 0.001), current smokers (P < 0.001), and the eyes with a cilioretinal artery (P=0.009 - 0.043). AMD severity was greater in older patients (P=0.001), current smokers (P=0.012), the eyes without a cilioretinal artery (P=0.001), and lower AVR (P=0.034) on multivariate regression but was not influenced by CRAE or CRVE (P=0.240 - 0.500). Choroidal neovascularization (CNV) presence was associated with older age (P=0.003) and absence of a cilioretinal artery (P=0.009), while central geographic atrophy (CGA) was associated with narrower CRAE (P=0.002) and possibly AVR (P=0.046). None of the retinal vessel parameters were predictive of AMD severity score or new onset of CNV or CGA at 5 years. Conclusion A lower arteriole-to-venule ratio may be associated with AMD severity, with narrower arterioles seen in the eyes with geographic atrophy, suggesting a role of the retinal vasculature in AMD pathophysiology. This trial is registered with ClinicalTrials.gov Identifier: NCT00000145.
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Affiliation(s)
- Sara Toulouie
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, CA, USA
- California Northstate University, College of Medicine, Elk Grove, CA, USA
| | - Sean Chang
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, CA, USA
| | - Julia Pan
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, CA, USA
| | - Kiersten Snyder
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, CA, USA
| | - Glenn Yiu
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, CA, USA
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10
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Arora S, Arora T. Re: Breazzano et al: Prospective Impact of Sildenafil on Chronic Central Serous Chorioretinopathy (Ophthalmology Retina. 2020;4:1119-1123). Ophthalmol Retina 2021; 5:e7. [PMID: 34243973 DOI: 10.1016/j.oret.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/05/2020] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Supriya Arora
- Bahamas Vision Center, Nassau NP, Bahamas; Princess Margaret Hospital, Nassau NP, Bahamas
| | - Tarun Arora
- Bahamas Vision Center, Nassau NP, Bahamas; Princess Margaret Hospital, Nassau NP, Bahamas
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11
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Arora S, Surakiatchanukul T, Arora T, Cagini C, Lupidi M, Chhablani J. Sildenafil in ophthalmology: An update. Surv Ophthalmol 2021; 67:463-487. [PMID: 34175342 DOI: 10.1016/j.survophthal.2021.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 12/14/2022]
Abstract
Sildenafil citrate, a selective oral phosphodiesterase 5 inhibitor, is a widely used drug for erectile dysfunction that acts by elevating cGMP levels and causing smooth muscle relaxation. It also has 10% activity against PDE6, a key enzyme in phototransduction cascade in the retina. Recent ocular imaging developments have further revealed the influence of sildenafil on ocular hemodynamics, particularly choroidal perfusion. Choroidal thickness is increased, and choroidal perfusion is also enhanced by autoregulatory mechanisms that are further dependent on age and microvascular abnormalities. Studies demonstrating high intraocular pressure via a "parallel pathway" from increased choroidal volume and blood flow to the ciliary body have challenged previous concepts. Another new observation is the effect of sildenafil on bipolar cells and cyclic-nucleotide gated channels. We discuss potential deleterious effects (central serous chorioretinopathy, glaucoma, ischemic optic neuropathy, and risks to recessive carriers of retinitis pigmentosa), potential beneficial effects (ameliorate choroidal ischemia, prevent thickening of Bruch membrane, and promote recovery of the ellipsoid zone) in macular degeneration, as well as potential drug interactions of sildenafil.
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Affiliation(s)
- Supriya Arora
- Bahamas Vision Centre and Princess Margaret Hospital, Nassau NP, Bahamas.
| | - Thamolwan Surakiatchanukul
- Department of Ophthalmology, Jamaica Hospital Medical Center, New York Medical College, Jamaica, NY, USA
| | - Tarun Arora
- Bahamas Vision Centre and Princess Margaret Hospital, Nassau NP, Bahamas.
| | - Carlo Cagini
- Department of Biochemical and Surgical Sciences, Section of ophthalmology, University of Perugia, Perugia, Italy
| | - Marco Lupidi
- Department of Biochemical and Surgical Sciences, Section of ophthalmology, University of Perugia, Perugia, Italy
| | - Jay Chhablani
- University of Pittsburgh, UPMC Eye Center, Pittsburgh, PA, USA.
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12
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Capece M, Montorio D, Comune C, Aveta A, Melchionna A, Celentano G, Imbimbo C, Crocetto F, Califano G, Cennamo G. Retinal and Optic Disc Vascular Changes in Patients Using Long-Term Tadalafil: A Prospective Non-Randomized Matched-Pair Study. Diagnostics (Basel) 2021; 11:802. [PMID: 33925202 PMCID: PMC8146942 DOI: 10.3390/diagnostics11050802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 12/02/2022] Open
Abstract
Retinal, choroidal and optic disc vascularity has never been evaluated in patients taking PDE5is long-term. The aim of our study was to evaluate the neurostructural and vascular changes after long-term use of tadalafil, using spectral domain (SD)-optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). In the present clinical trial, 27 patients who have been taking tadalafil 20 mg on alternate days (OAD) for at least 6 months (Group A) were enrolled. The matched group consisted of 27 healthy men (Group B). Both groups of patients underwent SD-OCT to study ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) and choroidal thickness and OCTA for the evaluation of superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC) and radial peripapillary capillary (RPC). A reduction in SCP, DCP and RPC vessel density was found in patients using tadalafil long-term. Retinal and optic disc toxicity may be detected using modifications of capillary vessel density. Further studies are needed to investigate the possibility of a causal association.
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Affiliation(s)
- Marco Capece
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Daniela Montorio
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Chiara Comune
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Achille Aveta
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Alberto Melchionna
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.C.); (D.M.); (C.C.); (A.A.); (A.M.); (G.C.); (C.I.); (F.C.); (G.C.)
| | - Gilda Cennamo
- Eye Clinic, Public Health Department, University of Naples “Federico II”, 80131 Naples, Italy
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13
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Tran TM, Kim S, Lin KH, Chung SH, Park S, Sazhnyev Y, Wang Y, Cunefare D, Farsiu S, Thomasy SM, Moshiri A, Yiu G. Quantitative Fundus Autofluorescence in Rhesus Macaques in Aging and Age-Related Drusen. Invest Ophthalmol Vis Sci 2021; 61:16. [PMID: 32663290 PMCID: PMC7425688 DOI: 10.1167/iovs.61.8.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose To employ quantitative fundus autofluorescence (qAF) imaging in rhesus macaques to noninvasively assess retinal pigment epithelial (RPE) lipofuscin in nonhuman primates (NHPs) as a model of aging and age-related macular degeneration (AMD). Methods The qAF imaging was performed on eyes of 26 rhesus macaques (mean age 18.8 ± 8.2 years, range 4–27 years) with normal-appearing fundus or with age-related soft drusen using a confocal scanning laser ophthalmoscope with 488 nm excitation and an internal fluorescence reference. Eyes with soft drusen also underwent spectral-domain optical coherence tomography imaging to measure drusen volume and height of individual drusen lesions. The qAF levels were measured from the perifoveal annular ring (quantitative autofluorescence 8 [qAF8]) using the Delori grid, as well as focally over individual drusen lesions in this region. The association between qAF levels and age, sex, and drusen presence and volume were determined using multivariable regression analysis. Results Mean qAF levels increased with age (P < 0.001) and were higher in females (P = 0.047). Eyes with soft drusen exhibited reduced mean qAF compared with age-matched normal eyes (P = 0.003), with greater drusen volume showing a trend toward decreased qAF levels. However, qAF levels are focally increased over most individual drusen (P < 0.001), with larger drusen appearing more hyperautofluorescent (R2 = 0.391, P < 0.001). Conclusions In rhesus macaques, qAF levels are increased with age and female sex, but decreased in eyes with soft drusen, similar to human AMD. However, drusen lesions appear hyperautofluorescent unlike those in humans, suggesting similarities and differences in RPE lipofuscin between humans and NHPs that may provide insight into drusen biogenesis and AMD pathogenesis.
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14
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Chung SH, Sin TN, Ngo T, Yiu G. CRISPR Technology for Ocular Angiogenesis. Front Genome Ed 2020; 2:594984. [PMID: 34713223 PMCID: PMC8525361 DOI: 10.3389/fgeed.2020.594984] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/01/2020] [Indexed: 12/24/2022] Open
Abstract
Among genome engineering tools, Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-based approaches have been widely adopted for translational studies due to their robustness, precision, and ease of use. When delivered to diseased tissues with a viral vector such as adeno-associated virus, direct genome editing can be efficiently achieved in vivo to treat different ophthalmic conditions. While CRISPR has been actively explored as a strategy for treating inherited retinal diseases, with the first human trial recently initiated, its applications for complex, multifactorial conditions such as ocular angiogenesis has been relatively limited. Currently, neovascular retinal diseases such as retinopathy of prematurity, proliferative diabetic retinopathy, and neovascular age-related macular degeneration, which together constitute the majority of blindness in developed countries, are managed with frequent and costly injections of anti-vascular endothelial growth factor (anti-VEGF) agents that are short-lived and burdensome for patients. By contrast, CRISPR technology has the potential to suppress angiogenesis permanently, with the added benefit of targeting intracellular signals or regulatory elements, cell-specific delivery, and multiplexing to disrupt different pro-angiogenic factors simultaneously. However, the prospect of permanently suppressing physiologic pathways, the unpredictability of gene editing efficacy, and concerns for off-target effects have limited enthusiasm for these approaches. Here, we review the evolution of gene therapy and advances in adapting CRISPR platforms to suppress retinal angiogenesis. We discuss different Cas9 orthologs, delivery strategies, and different genomic targets including VEGF, VEGF receptor, and HIF-1α, as well as the advantages and disadvantages of genome editing vs. conventional gene therapies for multifactorial disease processes as compared to inherited monogenic retinal disorders. Lastly, we describe barriers that must be overcome to enable effective adoption of CRISPR-based strategies for the management of ocular angiogenesis.
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Affiliation(s)
| | | | | | - Glenn Yiu
- Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento, CA, United States
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15
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Yiu G, Thomasy SM, Casanova MI, Rusakevich A, Keesler RI, Watanabe J, Usachenko J, Singapuri A, Ball EE, Bliss-Moreau E, Guo W, Webster H, Singh T, Permar S, Ardeshir A, Coffey LL, Van Rompay KK. Evolution of ocular defects in infant macaques following in utero Zika virus infection. JCI Insight 2020; 5:143947. [PMID: 33180748 PMCID: PMC7819741 DOI: 10.1172/jci.insight.143947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/04/2020] [Indexed: 12/28/2022] Open
Abstract
Congenital Zika syndrome (CZS) is associated with microcephaly and various neurological, musculoskeletal, and ocular abnormalities, but the long-term pathogenesis and postnatal progression of ocular defects in infants are not well characterized. Rhesus macaques are superior to rodents as models of CZS because they are natural hosts of the virus and share similar immune and ocular characteristics, including blood–retinal barrier characteristics and the unique presence of a macula. Using a previously described model of CZS, we infected pregnant rhesus macaques with Zika virus (ZIKV) during the late first trimester and characterized postnatal ocular development and evolution of ocular defects in 2 infant macaques over 2 years. We found that one of them exhibited colobomatous chorioretinal atrophic lesions with macular and vascular dragging as well as retinal thinning caused by loss of retinal ganglion neuron and photoreceptor layers. Despite these congenital ocular malformations, axial elongation and retinal development in these infants progressed at normal rates compared with healthy animals. The ZIKV-exposed infants displayed a rapid loss of ZIKV-specific antibodies, suggesting the absence of viral replication after birth, and did not show any behavioral or neurological defects postnatally. Our findings suggest that ZIKV infection during early pregnancy can impact fetal retinal development and cause congenital ocular anomalies but does not appear to affect postnatal ocular growth.
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Affiliation(s)
- Glenn Yiu
- Department of Ophthalmology & Vision Science, School of Medicine, and
| | - Sara M Thomasy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - M Isabel Casanova
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | | | | | | | - Jodie Usachenko
- California National Primate Research Center, Davis, California, USA
| | - Anil Singapuri
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, and
| | - Erin E Ball
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, and
| | - Eliza Bliss-Moreau
- California National Primate Research Center, Davis, California, USA.,Department of Psychology, University of California, Davis, Davis, California, USA
| | - Wendi Guo
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Helen Webster
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Tulika Singh
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Sallie Permar
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Amir Ardeshir
- California National Primate Research Center, Davis, California, USA
| | - Lark L Coffey
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, and
| | - Koen Ka Van Rompay
- California National Primate Research Center, Davis, California, USA.,Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, and
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16
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Coleman DJ, Lee W, Daly S, Breazzano MP, Sparrow J, Tsang SH. Central serous chorioretinopathy treatment with a systemic PDE5 and PDE6 inhibitor (sildenafil). Am J Ophthalmol Case Rep 2020; 21:100998. [PMID: 33364520 PMCID: PMC7750488 DOI: 10.1016/j.ajoc.2020.100998] [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: 10/16/2019] [Revised: 10/30/2020] [Accepted: 11/16/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose Examine the use of systemic phosphodiesterase inhibition (sildenafil) to clear central serous chorioretinopathy (CSCR). Observations In a long-standing CSCR patient, sildenafil produced a rapid resolution. When discontinued (dechallenge) the CSCR returned. When rechallenged, the CSCR again rapidly disappeared and did not recur in 5 months of continued therapy. Conclusions AND IMPORTANCE: Systemic sildenafil can cause rapid clearance of CSCR and can augment or replace other treatments.
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Affiliation(s)
- D Jackson Coleman
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA
| | - Winston Lee
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA
| | - Suzanne Daly
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA
| | - Mark P Breazzano
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA
| | - Janet Sparrow
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA
| | - Stephen H Tsang
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA.,Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia Stem Cell Initiative, Departments of Ophthalmology, Pathology & Cell Biology, Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University, NY, USA
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17
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Effects of phosphodiesterase type 5 inhibitors on choroid and ocular vasculature: a literature review. Int J Retina Vitreous 2020; 6:38. [PMID: 32782824 PMCID: PMC7412824 DOI: 10.1186/s40942-020-00241-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/29/2020] [Indexed: 11/10/2022] Open
Abstract
To provide information on the effects of phosphodiesterase type 5 (PDE5) inhibitors on choroidal vessels and central serous chorioretinopathy (CSC) and possible implications for development of exudative age-related macular degeneration (AMD). Two independent investigators conducted a qualitative review of PubMed to identify studies on the choroidal effect of PDE5 inhibitors in June 2019. The search used key words that included PDE5 inhibitors, sildenafil, tadalafil, vardenafil, choroid, choroidal flow, choroidal vessels, choroidal thickness, CSC, AMD or a combination. Only studies which assessed choroidal findings were included. Many ocular diseases are related to changes in choroidal thickness and perfusion. Patients with AMD, who have decreased choroidal perfusion, may manifest more severely diminished choroidal ability to deliver oxygen and other metabolites to the retina, leading to growth of neovascular tissue. As a result of this engorgement of the choroidal vasculature, some patients may have leakage across the retinal pigment epithelium (RPE) and accumulation of subretinal fluid, resulting in CSC. Transient visual symptoms, i.e., changes in color perception and increased light sensitivity, are well-known adverse effects, but there have been rare reports of vision-threatening ocular complications in users of PDE5 inhibitors, such as nonarteritic anterior ischemic optic neuropathy and cilioretinal artery occlusion. The choroid is a vascular tissue analogous in many respects to the corpus cavernosum, and PDE5 inhibitors may increase the choroidal thickness and perfusion. While it is intuitively obvious that thickness of the choroid alone does not guarantee better choriocapillaris oxygenation, it is a reasonable step towards ameliorating ischemia. These drugs have numerous physiologic effects on the choroid related to blood flow, such as clinical consequences in CSC and AMD.
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18
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Lee SC, Tran S, Amin A, Morse LS, Moshiri A, Park SS, Yiu G. Retinal Vessel Density in Exudative and Nonexudative Age-Related Macular Degeneration on Optical Coherence Tomography Angiography. Am J Ophthalmol 2020; 212:7-16. [PMID: 31837316 PMCID: PMC7113105 DOI: 10.1016/j.ajo.2019.11.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 01/21/2023]
Abstract
PURPOSE Although the choroid contributes to the pathogenesis of age-related macular degeneration (AMD), the role of retinal perfusion is unclear. We sought to compare retinal vascular measurements between eyes with nonexudative and exudative AMD using optical coherence tomography angiography (OCT-A). DESIGN Retrospective, cross-sectional study. METHODS OCT-A images were analyzed from 310 eyes of 182 patients (mean age ± standard deviation [SD], 78.8 ± 8.8 years) with nonexudative (54.2%) and exudative (45.8%) AMD to measure retinal vessel density (VD) from the superficial capillary plexus in the foveal, parafoveal, and full macular regions and foveal avascular zone (FAZ) area, perimeter, and circularity. Multivariate regressions were used to compare nonexudative and exudative AMD eyes and the impact of anti-vascular endothelial growth factor (anti-VEGF) treatments or geographic atrophy (GA). RESULTS In eyes with AMD, VD decreases with age in the foveal (β = -0.211, P < .001), parafoveal (β = -0.305, P < .001), and full macular regions (β = -0.295, P < .001). Eyes with exudative AMD demonstrated lower VD, especially in the parafoveal (29.8% ± 6.3% vs 33.0% ± 5.7%, P < .001) and full regions (27.9% ± 6.2% vs 31.2% ± 5.5%, P < .001) compared with nonexudative AMD. There were no differences in FAZ area, perimeter, or circularity between the 2 groups (P = .503-.907). In eyes with exudative AMD, previous anti-VEGF treatments did not impact retinal vascular measurements (P = .324-.986). Nonexudative AMD severity and presence of central GA also impacted retinal VD and FAZ morphology. CONCLUSIONS Retinal VD is decreased in eyes with exudative AMD compared with nonexudative AMD but is unaffected by anti-VEGF treatments, suggesting a retinal vascular contribution to the pathogenesis of AMD.
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Affiliation(s)
- Sophie C Lee
- Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento, California
| | - Steven Tran
- Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento, California; Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Aana Amin
- Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento, California
| | - Lawrence S Morse
- Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento, California
| | - Ala Moshiri
- Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento, California
| | - Susanna S Park
- Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento, California
| | - Glenn Yiu
- Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento, California.
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19
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Aslan F, Topcuoğlu M, Öktem Ç, Akkoç A, Uçar M. Can subfoveal choroidal thickness replace subjective tests in patients using tadalafil to treat erectile dysfunction? Andrologia 2020; 52:e13580. [PMID: 32216116 DOI: 10.1111/and.13580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 11/30/2022] Open
Abstract
We aimed to determine the effect on choroidal thickness of daily 5 mg tadalafil use in patients with erectile dysfunction (ED) and to evaluate agreement between short form of International Index of Erectile Function (IIEF 1-5, 15) scores and choroidal thickness during follow-up. Enhanced depth imaging spectral domain-optical coherence tomography (EDI-OCT) was used to measure full choroidal thickness in the subfoveal area, choroidal thickness (CT) and small-choroidal-vessel-layer (SCVL) thickness. Thirty of the 45 patients included complete their follow-ups and exhibited medication continuity. Patients were divided into two groups, five (16.7%) with ED at any level at third-month follow-up, and 25 (83.3%) with no ED, and subgroup analysis was then performed. Median changes in SCVL thickness at first- and sixth-month follow-ups were 20.5 µm versus 9.0 μm (p = .001) and 23.5 µm versus 12.5 µm (p = .005) in patients without and with ED respectively. The SCVL thickness increased by 20 μm compared with the baseline level, indicating an improvement in the patient's complaints of erectile dysfunction. The level of increase in SCVL thickness can be a useful and objective guide to clinicians if they cannot be present when the IIEF questionnaire is administered.
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Affiliation(s)
- Fatih Aslan
- Department of Ophthalmology, Alaaddin Keykubat University School of Medicine, Antalya, Turkey
| | - Murat Topcuoğlu
- Department of Urology, Alaaddin Keykubat University School of Medicine, Antalya, Turkey
| | - Çağlar Öktem
- Department of Ophthalmology, Alaaddin Keykubat University School of Medicine, Antalya, Turkey
| | - Ali Akkoç
- Department of Urology, Alaaddin Keykubat University School of Medicine, Antalya, Turkey
| | - Murat Uçar
- Department of Urology, Alaaddin Keykubat University School of Medicine, Antalya, Turkey
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20
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[Chorioretinal folds of interesting etiology]. Ophthalmologe 2020; 117:1234-1238. [PMID: 32108250 DOI: 10.1007/s00347-020-01057-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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21
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Iovino C, Pellegrini M, Bernabei F, Borrelli E, Sacconi R, Govetto A, Vagge A, Di Zazzo A, Forlini M, Finocchio L, Carnevali A, Triolo G, Giannaccare G. Choroidal Vascularity Index: An In-Depth Analysis of This Novel Optical Coherence Tomography Parameter. J Clin Med 2020; 9:jcm9020595. [PMID: 32098215 PMCID: PMC7074450 DOI: 10.3390/jcm9020595] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 12/15/2022] Open
Abstract
Remarkable improvements in optical coherence tomography (OCT) technology have resulted in highly sophisticated, noninvasive machines allowing detailed and advanced morphological evaluation of all retinal and choroidal layers. Postproduction semiautomated imaging analysis with dedicated public-domain software allows precise quantitative analysis of binarized OCT images. In this regard, the choroidal vascularity index (CVI) is emerging as a new imaging tool for the measurement and analysis of the choroidal vascular system by quantifying both luminal and stromal choroidal components. Numerous reports have been published so far regarding CVI and its potential applications in healthy eyes as well as in the evaluation and management of several chorioretinal diseases. Current literature suggests that CVI has a lesser variability and is influenced by fewer physiologic factors as compared to choroidal thickness. It can be considered a relatively stable parameter for evaluating the changes in the choroidal vasculature. In this review, the principles and the applications of this advanced imaging modality for studying and understanding the contributing role of choroid in retinal and optic nerve diseases are discussed. Potential advances that may allow the widespread adoption of this tool in the routine clinical practice are also presented.
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Affiliation(s)
- Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
- Correspondence:
| | - Marco Pellegrini
- Ophthalmology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.P.); (F.B.)
| | - Federico Bernabei
- Ophthalmology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.P.); (F.B.)
| | - Enrico Borrelli
- Department of Ophthalmology, Hospital San Raffaele, University Vita Salute San Raffaele, 20132 Milan, Italy; (E.B.); (R.S.)
| | - Riccardo Sacconi
- Department of Ophthalmology, Hospital San Raffaele, University Vita Salute San Raffaele, 20132 Milan, Italy; (E.B.); (R.S.)
| | - Andrea Govetto
- Ophthalmology Department, Fatebenefratelli and Ophthalmic Hospital, ASST-Fatebenefratelli-Sacco, 63631 Milan, Italy; (A.G.); (G.T.)
- Vitreoretinal Division, Bristol Eye Hospital, University Hospitals Bristol NHS foundation trust, Bristol BS1 2LX, UK
| | - Aldo Vagge
- University Eye Clinic, DINOGMI, Polyclinic Hospital San Martino IRCCS, 16132 Genoa, Italy;
| | - Antonio Di Zazzo
- Department of Ophthalmology, University Campus Bio-Medico of Rome, 00128 Rome, Italy;
| | | | - Lucia Finocchio
- Department of Translational Surgery and Medicine, Ophthalmology, University of Florence, 50134 Careggi Florence, Italy;
| | - Adriano Carnevali
- Department of Ophthalmology, University “Magna Graecia”, 88100 Catanzaro, Italy; (A.C.); (G.G.)
| | - Giacinto Triolo
- Ophthalmology Department, Fatebenefratelli and Ophthalmic Hospital, ASST-Fatebenefratelli-Sacco, 63631 Milan, Italy; (A.G.); (G.T.)
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University “Magna Graecia”, 88100 Catanzaro, Italy; (A.C.); (G.G.)
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22
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Yiu G, Chung SH, Mollhoff IN, Wang Y, Nguyen UT, Shibata B, Cunefare D, Farsiu S, Roberts J, Thomasy SM. Long-term Evolution and Remodeling of Soft Drusen in Rhesus Macaques. Invest Ophthalmol Vis Sci 2020; 61:32. [PMID: 32084273 PMCID: PMC7326602 DOI: 10.1167/iovs.61.2.32] [Citation(s) in RCA: 20] [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: 08/20/2019] [Accepted: 12/05/2019] [Indexed: 01/30/2023] Open
Abstract
Purpose To characterize the evolution and structure of soft drusen in aged rhesus macaques using in vivo multimodal retinal imaging and ex vivo histologic and ultrastructural analyses as a nonhuman primate model of early age-related macular degeneration (AMD). Methods Multimodal imaging including fundus photography, spectral domain optical coherence tomography (SD-OCT), and fundus autofluorescence (FAF) were used to characterize and track individual drusen lesions in 20 aged rhesus macaques (mean age 23.3 ± 2.7 years) with drusenoid lesions over 2 years, followed by semithin histologic analysis and transmission electron microscopy (TEM). Results Although most drusen gradually increased in size, a portion spontaneously regressed or collapsed over 2 years. Histologic analyses showed that soft drusen exhibit hypertrophy and dysmorphia of overlying retinal pigment epithelium (RPE), as seen in early and intermediate AMD, but do not exhibit RPE atrophy, RPE migration, or photoreceptor degeneration characteristic of advanced AMD. Ultrastructure of soft drusen showed abundant lipid particles within Bruch's membrane and AMD-related basal linear deposits (BlinD) resembling those in human drusen. Conclusions The dynamic remodeling, histologic findings, and ultrastructural features of soft drusen in aged rhesus macaques support nonhuman primates as an animal model of early AMD and reveal important insights into drusen biogenesis and AMD development.
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Affiliation(s)
- Glenn Yiu
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Sook Hyun Chung
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Iris Natalie Mollhoff
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Yinwen Wang
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Uyen Tu Nguyen
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - Bradley Shibata
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
| | - David Cunefare
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States
| | - Sina Farsiu
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States
| | - Jeffrey Roberts
- California National Primate Research Center, Davis, California, United States
| | - Sara M. Thomasy
- Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California, United States
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, United States
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