1
|
Ciociola EC, Patel K, Blahnik T, Ghosh A, Klifto MR, Fleischman D. A Retrospective Cohort Study on the Difficulties of Diagnosing and Managing Glaucoma in Patients with Coexistent Neurodegenerative Disease. J Curr Glaucoma Pract 2023; 17:126-133. [PMID: 37920375 PMCID: PMC10618602 DOI: 10.5005/jp-journals-10078-1415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/02/2023] [Indexed: 11/04/2023] Open
Abstract
Aim To investigate the limitations of diagnosing glaucoma in patients with coexistent neurodegenerative disease (NDD) by collecting information on demographics, examination findings, optical coherence tomography (OCT), and visual field (VF) tests. Materials and methods Retrospective cohort study of patients with primary open-angle glaucoma and coexistent dementia, multiple sclerosis (MS), Parkinson's disease (PD), or cerebrovascular accident (CVA) from 2014 to 2020. We included patients with a minimum of 3 years of follow-up. Demographics, ophthalmic exam, OCT, and VF findings were reported and compared across NDD groups using the Chi-squared and analysis of variance tests. Results We included 199 patients with glaucoma and coexistent NDD, including dementia (51.3%), CVA (11.2%), PD (18.1%), and MS (19.6%). Cupping, neuroretinal rim thinning, pallor, and peripapillary atrophy of the optic nerve were most frequently observed. There was a high number of missing values from OCT to VF tests, and zero patients had a complete OCT or VF test. Additionally, 67.8 and 77.4% of patients received <1 OCT and VF/year, respectively. Retinal nerve fiber layer (RNFL) thinning was observed most frequently in the superior (33.2% OD and 30.7% OS) and inferior (25.6% OD and 30.2% OS) quadrants, with the most significant thinning seen in CVA patients compared to other NDDs (p < 0.05). Glaucoma hemifield tests (GHTs) were abnormal in 23.1% OD and 22.6% OS, and the average mean deviation was -7.43 [standard deviation (SD) 8.23] OD and -8.79 (SD 7.99) OS. Conclusion The OCT and VF tests are frequently unavailable and may be confounded in patients with coexistent glaucoma and NDDs, complicating glaucoma diagnosis and management. Clinical significance Diagnosing and managing glaucoma in patients with coexistent NDD is difficult, given the lack of available and reliable OCT and VF testing data. Providers may be forced to rely on intraocular pressure (IOP) and other imperfect measures. How to cite this article Ciociola EC, Patel K, Blahnik T, et al. A Retrospective Cohort Study on the Difficulties of Diagnosing and Managing Glaucoma in Patients with Coexistent Neurodegenerative Disease. J Curr Glaucoma Pract 2023;17(3):126-133.
Collapse
Affiliation(s)
- Elizabeth C Ciociola
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States
| | - Kush Patel
- Medical College of Georgia at Augusta University, Augusta, Georgia, United States
| | - Tyler Blahnik
- Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, United States
| | - Arko Ghosh
- Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, United States
| | - Meredith R Klifto
- Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, United States
| | - David Fleischman
- Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, United States
| |
Collapse
|
2
|
Pattern ERGs suggest a possible retinal contribution to the visual acuity loss in acute optic neuritis. Doc Ophthalmol 2022; 145:185-195. [PMID: 36161379 DOI: 10.1007/s10633-022-09896-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 08/15/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE Macular involvement in optic neuritis (ON) is well-recognised but poorly understood and may be of clinical relevance. This study explores macular structure-function correlates in acute ON. METHODS This cross-sectional cohort study recruited ON patients within 14 days of symptom onset. Subjects underwent pattern electroretinography (PERG), pattern visual evoked potentials (PVEP) and optical coherence tomography (OCT) imaging. PERG P50 and N95 components were correlated with OCT data. RESULTS Twenty-six individuals with ON were recruited, comprising eleven multiple sclerosis (MS-ON), six myelin oligodendrocyte glycoprotein associated (MOG-ON) and nine with isolated ON. These were compared with 28 healthy controls. PVEPs were undetectable in 11 (42%) of individuals with ON. When detectable, PVEP P100 was delayed (median 136 ms range 110-173 ms) and amplitude reduced (median 6 μV, range 3-14 μV) in ON compared with controls (both p < 0.001). PERG P50 component amplitudes, largely reflecting macular function, were reduced in affected eyes (median 2.3 μV; range 0.8-5.0 μV) compared with controls (3.3 μV; range 2.8-5.7 μV) and compared with fellow eyes (p < 0.001). The N95:P50 ratio was below the reference range in the affected eyes of five patients. Eight cases (32%) had subnormal P50 amplitudes (< 2.0 μV), and these patients had poorer visual acuity (p = 0.020). P50 amplitudes were positively correlated with an increase in inner nuclear layer thickness (rs = 0.36; p = 0.009) and macular ganglion cell and inner plexiform layer (mGCIPL) thickness (rs = 0.44, p = 0.022). CONCLUSION PERG P50 component reduction reveals dysfunction of inner macular layers in acute ON and correlates with structural alterations on OCT. These early macular pathologic processes are likely to contribute to the visual loss.
Collapse
|
3
|
Macular Morpho-Functional and Visual Pathways Functional Assessment in Patients with Spinocerebellar Type 1 Ataxia with or without Neurological Signs. J Clin Med 2021; 10:jcm10225271. [PMID: 34830553 PMCID: PMC8625180 DOI: 10.3390/jcm10225271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/04/2021] [Accepted: 11/10/2021] [Indexed: 11/21/2022] Open
Abstract
Spinocerebellar ataxia type 1 (SCA-ATXN1) is an autosomal dominant, neurodegenerative disease, caused by CAG repeat expansion in the ataxin-1 gene (ATXN1). In isolated reports of patients with neurological signs [symptomatic patients (SP)], macular abnormalities have been described. However, no reports exist about macular anomalies in SCA1 subjects carrying the ATXN1 mutation without neurological signs [not symptomatic carriers (NSC)]. Therefore, the main aim of our work was to evaluate whether the macular functional and morphological abnormalities could be detectable in SP, genetically confirmed and with neurological signs, as well as in SCA-ATXN1-NSC, harboring pathogenic CAG expansion in ATXN1. In addition, we investigated whether the macular involvement could be associated or not to an impairment of RGCs and of their fibers and of the neural conduction along the visual pathways. Herein, nine SCA-ATXN1 subjects (6 SP and 3 NSC) underwent the following examinations: visual acuity and chromatic test assessments, fundus oculi (FO) examination, macular and peripapillary retinal nerve fiber layer thickness (RNFL-T) analysis by Spectral domain-Optical Coherence Tomography (Sd-OCT) acquisition, multifocal electroretinogram (mfERG), pattern reversal electroretinogram (PERG) and visual evoked potentials (VEP) recordings. In four eyes of two SP, visual acuity reduction and chromatic abnormalities were observed; in three of them FO changes associated with macular thinning and outer retinal defects were also detected. In three NSC eyes, slight FO abnormalities were associated with qualitative macular morphological changes. By contrast, abnormal mfERG responses (exclusively from foveal and parafoveal areas) were detected in all SP and NSC (18 eyes). No abnormalities of PERG values, RNFL-T, and VEP responses were found, but in one SP, presenting abnormal papillo-macular bundle neural conduction. Results from our SCA-ATXN1 cohort suggest that a macular dysfunction, detectable by mfERG recordings, may occur in the overt disorder, and unexpectedly in the stage of the disease in which there is still an absence of neurological signs. In NSC, an exclusive dysfunction of preganglionic macular elements can be observed, and this is associated with both normal RGCs function and neural conduction along the visual pathways.
Collapse
|
4
|
Nicoară SD, Brie I, Jurj A, Sorițău O. The Future of Stem Cells and Their Derivates in the Treatment of Glaucoma. A Critical Point of View. Int J Mol Sci 2021; 22:ijms222011077. [PMID: 34681739 PMCID: PMC8540760 DOI: 10.3390/ijms222011077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/07/2021] [Accepted: 10/09/2021] [Indexed: 12/24/2022] Open
Abstract
This review focuses on the clinical translation of preclinical studies, especially those that have used stem cells in the treatment of glaucoma, with an emphasis on optic nerve regeneration. The studies referred to in the review aim to treat optic nerve atrophy, while cell therapies targeting other sites in the eye, such as the trabecular meshwork, have not been addressed. Such complex and varied pathophysiological mechanisms that lead to glaucoma may explain the fact that although stem cells have a high capacity of neuronal regeneration, the treatments performed did not have the expected results and the promise offered by animal studies was not achieved. By analyzing the facts associated with failure, important lessons are to be learned: the type of stem cells that are used, the route of administration, the selection of patients eligible for these treatments, additional therapies that support stem cells transplantation and their mode of action, methods of avoiding the host’s immune response. Many of these problems could be solved using exosomes (EV), but also miRNA, which allows more targeted approaches with minimal side effects.
Collapse
Affiliation(s)
- Simona Delia Nicoară
- Department of Ophthalmology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 8 Victor Babeș Street, 400012 Cluj-Napoca, Romania
- Clinic of Ophthalmology, Emergency County Hospital, 3–5 Clinicilor Street, 40006 Cluj-Napoca, Romania
- Correspondence: or ; Tel.: +40-264592771
| | - Ioana Brie
- “Ion Chiricuță” Institute of Oncology, Laboratory of Cell Biology and Radiobiology, 34–36 Republicii Street, 400010 Cluj-Napoca, Romania; (I.B.); (O.S.)
| | - Ancuța Jurj
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 8 Victor Babeș Street, 400012 Cluj-Napoca, Romania;
| | - Olga Sorițău
- “Ion Chiricuță” Institute of Oncology, Laboratory of Cell Biology and Radiobiology, 34–36 Republicii Street, 400010 Cluj-Napoca, Romania; (I.B.); (O.S.)
| |
Collapse
|
5
|
Sharif NA. Therapeutic Drugs and Devices for Tackling Ocular Hypertension and Glaucoma, and Need for Neuroprotection and Cytoprotective Therapies. Front Pharmacol 2021; 12:729249. [PMID: 34603044 PMCID: PMC8484316 DOI: 10.3389/fphar.2021.729249] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/18/2021] [Indexed: 12/11/2022] Open
Abstract
Damage to the optic nerve and the death of associated retinal ganglion cells (RGCs) by elevated intraocular pressure (IOP), also known as glaucoma, is responsible for visual impairment and blindness in millions of people worldwide. The ocular hypertension (OHT) and the deleterious mechanical forces it exerts at the back of the eye, at the level of the optic nerve head/optic disc and lamina cribosa, is the only modifiable risk factor associated with glaucoma that can be treated. The elevated IOP occurs due to the inability of accumulated aqueous humor (AQH) to egress from the anterior chamber of the eye due to occlusion of the major outflow pathway, the trabecular meshwork (TM) and Schlemm’s canal (SC). Several different classes of pharmaceutical agents, surgical techniques and implantable devices have been developed to lower and control IOP. First-line drugs to promote AQH outflow via the uveoscleral outflow pathway include FP-receptor prostaglandin (PG) agonists (e.g., latanoprost, travoprost and tafluprost) and a novel non-PG EP2-receptor agonist (omidenepag isopropyl, Eybelis®). TM/SC outflow enhancing drugs are also effective ocular hypotensive agents (e.g., rho kinase inhibitors like ripasudil and netarsudil; and latanoprostene bunod, a conjugate of a nitric oxide donor and latanoprost). One of the most effective anterior chamber AQH microshunt devices is the Preserflo® microshunt which can lower IOP down to 10–13 mmHg. Other IOP-lowering drugs and devices on the horizon will be also discussed. Additionally, since elevated IOP is only one of many risk factors for development of glaucomatous optic neuropathy, a treatise of the role of inflammatory neurodegeneration of the optic nerve and retinal ganglion cells and appropriate neuroprotective strategies to mitigate this disease will also be reviewed and discussed.
Collapse
Affiliation(s)
- Najam A Sharif
- Global Alliances and External Research, Ophthalmology Innovation Center, Santen Inc., Emeryville, CA, United States
| |
Collapse
|
6
|
Mehmood A, Ali W, Song S, Din ZU, Guo RY, Shah W, Ilahi I, Yin B, Yan H, Zhang L, Khan M, Ali W, Zeb L, Safari H, Li B. Optical coherence tomography monitoring and diagnosing retinal changes in multiple sclerosis. Brain Behav 2021; 11:e2302. [PMID: 34520634 PMCID: PMC8553325 DOI: 10.1002/brb3.2302] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/22/2021] [Accepted: 07/12/2021] [Indexed: 12/14/2022] Open
Abstract
This study explores the use of optical coherence tomography (OCT) to monitor and diagnose multiple sclerosis (MS). The analysis of reduced total macular volume and peripapillary retinal nerve fiber layer thinning are shown. The severity of these defects increases as MS progresses, reflecting the progressive degeneration of nerve fibers and retinal ganglion cells. The OCT parameters are noninvasive, sensitive indicators that can be used to assess the progression of neurodegeneration and inflammation in MS.
Collapse
Affiliation(s)
- Arshad Mehmood
- Department of Neurology, The Second Hospital of Hebei Medical University, City Shijiazhuang, Hebei Province, P. R. China.,Key Laboratory of Neurology of Hebei Province, City Shijiazhuang, Hebei Province, P. R. China
| | - Wajid Ali
- Key Laboratory of Functional Inorganic Materials Chemistry, School of Chemistry and Materials Science, Heilongjiang University, Harbin, P. R. China
| | - Shuang Song
- Department of Neurology, The Second Hospital of Hebei Medical University, City Shijiazhuang, Hebei Province, P. R. China.,Key Laboratory of Neurology of Hebei Province, City Shijiazhuang, Hebei Province, P. R. China
| | - Zaheer Ud Din
- Institute of Cancer Stem Cell, Dalian Medical University, Liaoning Province, P. R. China
| | - Ruo-Yi Guo
- Department of Neurology, The Second Hospital of Hebei Medical University, City Shijiazhuang, Hebei Province, P. R. China.,Key Laboratory of Neurology of Hebei Province, City Shijiazhuang, Hebei Province, P. R. China
| | - Wahid Shah
- Department of Physiology, Hebei Medical University, Shijiazhuang, Hebei, P. R. China
| | - Ikram Ilahi
- Department of Zoology, University of Malakand, Chakdara, Khyber Pakhtunkhwa, Pakistan
| | - Bowen Yin
- Department of Neurology, The Second Hospital of Hebei Medical University, City Shijiazhuang, Hebei Province, P. R. China.,Key Laboratory of Neurology of Hebei Province, City Shijiazhuang, Hebei Province, P. R. China.,Department of Neurology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, P. R. China
| | - Hongjing Yan
- Department of Neurology, The Second Hospital of Hebei Medical University, City Shijiazhuang, Hebei Province, P. R. China.,Key Laboratory of Neurology of Hebei Province, City Shijiazhuang, Hebei Province, P. R. China
| | - Lu Zhang
- Department of Neurology, The Second Hospital of Hebei Medical University, City Shijiazhuang, Hebei Province, P. R. China.,Key Laboratory of Neurology of Hebei Province, City Shijiazhuang, Hebei Province, P. R. China
| | - Murad Khan
- Department of Genetics, Hebei Key Lab of Laboratory Animal, Hebei Medical University, Shijiazhuang, Hebei Province, P. R. China
| | - Wajid Ali
- Green and Environmental Chemistry, Ecotoxicology and Ecology Laboratory, Department of Zoology, University of Malakand, Chakdara, Khyber Pakhtunkhwa, Pakistan
| | - Liaqat Zeb
- School of Bioengineering, Dalian University of Technology, Dalian, Liaoning, P.R. China
| | - Hamidreza Safari
- Department of Immunology, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Bin Li
- Department of Neurology, The Second Hospital of Hebei Medical University, City Shijiazhuang, Hebei Province, P. R. China.,Key Laboratory of Neurology of Hebei Province, City Shijiazhuang, Hebei Province, P. R. China
| |
Collapse
|
7
|
Majeed A, Marwick B, Yu H, Fadavi H, Tavakoli M. Ophthalmic Biomarkers for Alzheimer's Disease: A Review. Front Aging Neurosci 2021; 13:720167. [PMID: 34566623 PMCID: PMC8461312 DOI: 10.3389/fnagi.2021.720167] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/11/2021] [Indexed: 11/13/2022] Open
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by neuronal loss, extracellular amyloid-β (Aβ) plaques, and intracellular neurofibrillary tau tangles. A diagnosis is currently made from the presenting symptoms, and the only definitive diagnosis can be done post-mortem. Over recent years, significant advances have been made in using ocular biomarkers to diagnose various neurodegenerative diseases, including AD. As the eye is an extension of the central nervous system (CNS), reviewing changes in the eye's biology could lead to developing a series of non-invasive, differential diagnostic tests for AD that could be further applied to other diseases. Significant changes have been identified in the retinal nerve fiber layer (RNFL), cornea, ocular vasculature, and retina. In the present paper, we review current research and assess some ocular biomarkers' accuracy and reliability that could potentially be used for diagnostic purposes. Additionally, we review the various imaging techniques used in the measurement of these biomarkers.
Collapse
Affiliation(s)
- Ayesha Majeed
- Medical School, University of Exeter, Exeter, United Kingdom
| | - Ben Marwick
- Medical School, University of Exeter, Exeter, United Kingdom
| | - Haoqing Yu
- Medical School, University of Exeter, Exeter, United Kingdom
| | | | - Mitra Tavakoli
- Medical School, University of Exeter, Exeter, United Kingdom
- Exeter Centre of Excellence for Diabetes Research, University of Exeter, Exeter, United Kingdom
- National Institute for Health Research, Exeter Clinical Research Facility, Exeter, United Kingdom
| |
Collapse
|
8
|
Parisi V, Ziccardi L, Tanga L, Roberti G, Barbano L, Carnevale C, Manni G, Oddone F. Neural Conduction Along Postretinal Visual Pathways in Glaucoma. Front Aging Neurosci 2021; 13:697425. [PMID: 34408643 PMCID: PMC8365149 DOI: 10.3389/fnagi.2021.697425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study was conducted in order to evaluate retinal ganglion cell (RCG) function and the neural conduction along the postretinal large and small axons and its correlation with retinal nerve fiber layer thickness (RNFL-T) in open-angle glaucoma (OAG) eyes. Methods: Thirty-seven OAG patients (mean age: 51.68 ± 9.83 years) with 24-2 Humphrey mean deviation (MD) between -2.5 and -20 dB and IOP <21 mmHg on pharmacological treatment (OAG group) and 20 age-matched controls (control group) were enrolled. In both groups, simultaneous pattern electroretinograms (PERG) and visual evoked potentials (VEP), in response to checks stimulating macular or extramacular areas (the check edge subtended 15' and 60' of visual arc, respectively), and RNFL-T (measured in superior, inferior, nasal, and temporal quadrants) were assessed. Results: In the OAG group, a significant (ANOVA, p < 0.01) reduction of 60' and 15' PERG P50-N95 and VEP N75-P100 amplitudes and of RNFL-T [overall (average of all quadrants) or temporal] with respect to controls was found; the values of 60' and 15' PERG P50 and VEP P100 implicit times and of retinocortical time (RCT; difference between VEP P100 and PERG P50 implicit times) were significantly (p < 0.01) increased with respect to control ones. The observed increased RCTs were significantly linearly correlated (Pearson's test, p < 0.01) with the reduced PERG amplitude and MD values, whereas no significant linear correlation (p < 0.01) with RNFL-T (overall or temporal) values was detected. Conclusions: In OAG, there is an impaired postretinal neural conduction along both large and small axons (increased 60' and 15' RCTs) that is related to RGC dysfunction, but independent from the RNFL morphology. This implies that, in OAG, the impairment of postretinal neural structures can be electrophysiologically identified and may contribute to the visual field defects, as suggested by the linear correlation between the increase of RCT and MD reduction.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Gianluca Manni
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | | |
Collapse
|
9
|
Mendez-Martinez S, Martínez-Rincón T, Subias M, Pablo LE, García-Herranz D, Feijoo JG, Bravo-Osuna I, Herrero-Vanrell R, Garcia-Martin E, Rodrigo MJ. Influence of Chronic Ocular Hypertension on Emmetropia: Refractive, Structural and Functional Study in Two Rat Models. J Clin Med 2021; 10:jcm10163697. [PMID: 34441992 PMCID: PMC8397123 DOI: 10.3390/jcm10163697] [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: 07/19/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 12/29/2022] Open
Abstract
Chronic ocular hypertension (OHT) influences on refraction in youth and causes glaucoma in adulthood. However, the origin of the responsible mechanism is unclear. This study analyzes the effect of mild-moderate chronic OHT on refraction and neuroretina (structure and function) in young-adult Long-Evans rats using optical coherence tomography and electroretinography over 24 weeks. Data from 260 eyes were retrospectively analyzed in two cohorts: an ocular normotension (ONT) cohort (<20 mmHg) and an OHT cohort (>20 mmHg), in which OHT was induced either by sclerosing the episcleral veins (ES group) or by injecting microspheres into the anterior chamber. A trend toward emmetropia was found in both cohorts over time, though it was more pronounced in the OHT cohort (p < 0.001), especially in the ES group (p = 0.001) and males. IOP and refraction were negatively correlated at week 24 (p = 0.010). The OHT cohort showed early thickening in outer retinal sectors (p < 0.050) and the retinal nerve fiber layer, which later thinned. Electroretinography demonstrated early supranormal amplitudes and faster latencies that later declined. Chronic OHT accelerates emmetropia in Long–Evans rat eyes towards slowly progressive myopia, with an initial increase in structure and function that reversed over time.
Collapse
Affiliation(s)
- Silvia Mendez-Martinez
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (T.M.-R.); (M.S.); (L.E.P.); (E.G.-M.); (M.J.R.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
- Correspondence: ; Tel.: +34-9-7676-5558
| | - Teresa Martínez-Rincón
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (T.M.-R.); (M.S.); (L.E.P.); (E.G.-M.); (M.J.R.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
| | - Manuel Subias
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (T.M.-R.); (M.S.); (L.E.P.); (E.G.-M.); (M.J.R.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
| | - Luis E. Pablo
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (T.M.-R.); (M.S.); (L.E.P.); (E.G.-M.); (M.J.R.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain; (J.G.F.); (I.B.-O.); (R.H.-V.)
| | - David García-Herranz
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415 Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain;
- Health Research Institute, San Carlos Clinical Hospital (IdISSC), 28040 Madrid, Spain
- University Institute for Industrial Pharmacy (IUFI), School of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Julian García Feijoo
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain; (J.G.F.); (I.B.-O.); (R.H.-V.)
- Department of Ophthalmology, San Carlos Clinical Hospital (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain
| | - Irene Bravo-Osuna
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain; (J.G.F.); (I.B.-O.); (R.H.-V.)
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415 Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain;
- Health Research Institute, San Carlos Clinical Hospital (IdISSC), 28040 Madrid, Spain
| | - Rocío Herrero-Vanrell
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain; (J.G.F.); (I.B.-O.); (R.H.-V.)
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415 Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain;
- Health Research Institute, San Carlos Clinical Hospital (IdISSC), 28040 Madrid, Spain
| | - Elena Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (T.M.-R.); (M.S.); (L.E.P.); (E.G.-M.); (M.J.R.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain; (J.G.F.); (I.B.-O.); (R.H.-V.)
| | - María J. Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (T.M.-R.); (M.S.); (L.E.P.); (E.G.-M.); (M.J.R.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain; (J.G.F.); (I.B.-O.); (R.H.-V.)
| |
Collapse
|
10
|
Liao C, Xu J, Chen Y, Ip NY. Retinal Dysfunction in Alzheimer's Disease and Implications for Biomarkers. Biomolecules 2021; 11:biom11081215. [PMID: 34439882 PMCID: PMC8394950 DOI: 10.3390/biom11081215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 02/08/2023] Open
Abstract
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that manifests as cognitive deficits and memory decline, especially in old age. Several biomarkers have been developed to monitor AD progression. Given that the retina and brain share some similarities including features related to anatomical composition and neurological functions, the retina is closely associated with the progression of AD. Herein, we review the evidence of retinal dysfunction in AD, particularly at the early stage, together with the underlying molecular mechanisms. Furthermore, we compared the retinal pathologies of AD and other ophthalmological diseases and summarized potential retinal biomarkers measurable by existing technologies for detecting AD, providing insights for the future development of diagnostic tools.
Collapse
Affiliation(s)
- Chunyan Liao
- Chinese Academy of Sciences Key Laboratory of Brain Connectome and Manipulation, Shenzhen Key Laboratory of Translational Research for Brain Diseases, The Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science—Shenzhen Fundamental Research Institutions, Shenzhen 518055, China; (C.L.); (J.X.)
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen 518057, China
| | - Jinying Xu
- Chinese Academy of Sciences Key Laboratory of Brain Connectome and Manipulation, Shenzhen Key Laboratory of Translational Research for Brain Diseases, The Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science—Shenzhen Fundamental Research Institutions, Shenzhen 518055, China; (C.L.); (J.X.)
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen 518057, China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yu Chen
- Chinese Academy of Sciences Key Laboratory of Brain Connectome and Manipulation, Shenzhen Key Laboratory of Translational Research for Brain Diseases, The Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science—Shenzhen Fundamental Research Institutions, Shenzhen 518055, China; (C.L.); (J.X.)
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen 518057, China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Correspondence: (Y.C.); (N.Y.I.); Tel.: +86-755-2692-5498 (Y.C.); +852-2358-6161 (N.Y.I.)
| | - Nancy Y. Ip
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, Shenzhen-Hong Kong Institute of Brain Science, HKUST Shenzhen Research Institute, Shenzhen 518057, China
- Division of Life Science, Molecular Neuroscience Center, and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Hong Kong 999077, China
- Correspondence: (Y.C.); (N.Y.I.); Tel.: +86-755-2692-5498 (Y.C.); +852-2358-6161 (N.Y.I.)
| |
Collapse
|
11
|
Karaca U, Dagli O, Ozge G, Mumcuoglu T, Bayer A. Comparison of structural and functional tests in primary open angle glaucoma. Indian J Ophthalmol 2021; 68:805-811. [PMID: 32317450 PMCID: PMC7350476 DOI: 10.4103/ijo.ijo_921_19] [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] [Indexed: 11/10/2022] Open
Abstract
Purpose: To comparatively analyze the structural and functional tests used in the diagnosis and follow-up of glaucoma. Methods: Eighty eyes of 40 patients with primary open angle glaucoma (POAG) and 46 eyes of 23 healthy individuals were included in the study. Transient pattern electroretinography (PERG), steady-state PERG (ssPERG), computerized visual field (VF) screening, and examination of retinal nerve fiber layer (RNFL) and macular thickness on optical coherence tomography (OCT) were undertaken. The results were compared between the groups. Results: 80 eyes belonging to 40 patients with a diagnosis of POAG (23 female, 17 male) (18 mild 22 moderate POAG) with a mean of 57.37 (±8.6) years, and 46 eyes of 23 healthy individuals (14 female, 9 male) with a mean age of 55.30 (±8.09) years were included in the study. PERG P50 and N95 and ssPERG latency revealed a significant delay in the POAG group. When the wave amplitudes were examined, they were found to be significantly lower in both PERG and sSPERG tests for the POAG group, but the results were more pronounced in ssPERG. The latency values of PERG and ssPERG tests were not significantly correlated with any of the parameters of the remaining tests. However, the amplitude values of these tests had a positive correlation with the mean deviation value and negative correlation with the pattern standard deviation value of VF. All associated parameters were significant for the amplitude value of the ssPERG test. Conclusion: For the proper management of glaucoma, rather than approaching damage simply as the loss of retinal ganglion cells or the neuroretinal rim, it is necessary to focus on the ongoing anatomical and functional relationship and evaluate structural and functional tests together. In addition, ssPERG test, which is not widely adopted in routine practice, provides valuable information and is significantly correlated with OCT parameters.
Collapse
Affiliation(s)
- Umut Karaca
- Isparta Suleyman Demirel University Faculty of Medicine Department of Ophthalmology Isparta, Turkey
| | - Ozan Dagli
- Katip Celebi University Department of Ophthalmology Izmir, Turkey
| | - Gokhan Ozge
- University of Medical Sciences, Gulhane Education and Research Hospital, Department of Ophthalmology, Ankara, Turkey
| | - Tarkan Mumcuoglu
- TOBB ETU University Faculty of Medicine Department of Ophthalmology Ankara, Ankara, Turkey
| | | |
Collapse
|
12
|
Asefy Z, Hoseinnejhad S, Ceferov Z. Nanoparticles approaches in neurodegenerative diseases diagnosis and treatment. Neurol Sci 2021; 42:2653-2660. [PMID: 33846881 DOI: 10.1007/s10072-021-05234-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/07/2021] [Indexed: 01/16/2023]
Abstract
The World Health Organization (WHO) has declared that neurodegenerative diseases will be the biggest health issues of the twenty-first century. Among these, Alzheimer's and Parkinson's diseases can be considered as the most acute incurable neurological diseases. Researchers are studying and developing a new treatment approach that uses nanotechnology to diagnosis and treatment neurodegenerative diseases. This treatment strategy will be used to regress neurodegenerative diseases such as Alzheimer's disease. Alzheimer's disease (AD) is one of the most common forms of reduced brain function, which causes many devastating complications. Current neurodegenerative diseases treatment protocols only help to treat symptoms nevertheless with nanotechnology approaches, can regress nerve cells apoptosis, reduce inflammation, and improve brain drug delivery. In this paper, new nanotechnology methods such as nanobodies, nano-antibodies, and lipid nanoparticles have been investigated. Correspondingly blood-brain barrier drug delivery improvement methods have been suggested.
Collapse
Affiliation(s)
- Zahra Asefy
- School of Nursing and Allied Medical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran.
| | - Sirus Hoseinnejhad
- School of Nursing and Allied Medical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | | |
Collapse
|
13
|
Candadai AA, Liu F, Fouda AY, Alfarhan M, Palani CD, Xu Z, Caldwell RB, Narayanan SP. Deletion of arginase 2 attenuates neuroinflammation in an experimental model of optic neuritis. PLoS One 2021; 16:e0247901. [PMID: 33735314 PMCID: PMC7971528 DOI: 10.1371/journal.pone.0247901] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 02/16/2021] [Indexed: 12/11/2022] Open
Abstract
Vision impairment due to optic neuritis (ON) is one of the major clinical presentations in Multiple Sclerosis (MS) and is characterized by inflammation and degeneration of the optic nerve and retina. Currently available treatments are only partially effective and have a limited impact on the neuroinflammatory pathology of the disease. A recent study from our laboratory highlighted the beneficial effect of arginase 2 (A2) deletion in suppressing retinal neurodegeneration and inflammation in an experimental model of MS. Utilizing the same model, the present study investigated the impact of A2 deficiency on MS-induced optic neuritis. Experimental autoimmune encephalomyelitis (EAE) was induced in wild-type (WT) and A2 knockout (A2-/-) mice. EAE-induced cellular infiltration, as well as activation of microglia and macrophages, were reduced in A2-/- optic nerves. Axonal degeneration and demyelination seen in EAE optic nerves were observed to be reduced with A2 deletion. Further, the lack of A2 significantly ameliorated astrogliosis induced by EAE. In conclusion, our findings demonstrate a critical involvement of arginase 2 in mediating neuroinflammation in optic neuritis and suggest the potential of A2 blockade as a targeted therapy for MS-induced optic neuritis.
Collapse
Affiliation(s)
- Amritha A. Candadai
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, GA, United States of America
- Culver Vision Discovery Institute, Augusta University, Augusta, GA, United States of America
- Charlie Norwood VA Medical Center, Augusta, GA, United States of America
| | - Fang Liu
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, GA, United States of America
- Culver Vision Discovery Institute, Augusta University, Augusta, GA, United States of America
- Charlie Norwood VA Medical Center, Augusta, GA, United States of America
- Vascular Biology Center, Augusta University, Augusta, GA, United States of America
| | - Abdelrahman Y. Fouda
- Culver Vision Discovery Institute, Augusta University, Augusta, GA, United States of America
- Charlie Norwood VA Medical Center, Augusta, GA, United States of America
- Vascular Biology Center, Augusta University, Augusta, GA, United States of America
| | - Moaddey Alfarhan
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, GA, United States of America
- Culver Vision Discovery Institute, Augusta University, Augusta, GA, United States of America
- Charlie Norwood VA Medical Center, Augusta, GA, United States of America
| | - Chithra D. Palani
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, GA, United States of America
- Culver Vision Discovery Institute, Augusta University, Augusta, GA, United States of America
- Vascular Biology Center, Augusta University, Augusta, GA, United States of America
| | - Zhimin Xu
- Culver Vision Discovery Institute, Augusta University, Augusta, GA, United States of America
- Vascular Biology Center, Augusta University, Augusta, GA, United States of America
| | - Ruth B. Caldwell
- Culver Vision Discovery Institute, Augusta University, Augusta, GA, United States of America
- Vascular Biology Center, Augusta University, Augusta, GA, United States of America
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, United States of America
| | - S. Priya Narayanan
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, GA, United States of America
- Culver Vision Discovery Institute, Augusta University, Augusta, GA, United States of America
- Charlie Norwood VA Medical Center, Augusta, GA, United States of America
- Vascular Biology Center, Augusta University, Augusta, GA, United States of America
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, United States of America
| |
Collapse
|
14
|
Clarkson-Townsend DA, Douglass AJ, Singh A, Allen RS, Uwaifo IN, Pardue MT. Impacts of high fat diet on ocular outcomes in rodent models of visual disease. Exp Eye Res 2021; 204:108440. [PMID: 33444582 PMCID: PMC7946735 DOI: 10.1016/j.exer.2021.108440] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/23/2020] [Accepted: 01/05/2021] [Indexed: 02/08/2023]
Abstract
High fat diets (HFD) have been utilized in rodent models of visual disease for over 50 years to model the effects of lipids, metabolic dysfunction, and diet-induced obesity on vision and ocular health. HFD treatment can recapitulate the pathologies of some of the leading causes of blindness, such as age-related macular degeneration (AMD) and diabetic retinopathy (DR) in rodent models of visual disease. However, there are many important factors to consider when using and interpreting these models. To synthesize our current understanding of the importance of lipid signaling, metabolism, and inflammation in HFD-driven visual disease processes, we systematically review the use of HFD in mouse and rat models of visual disease. The resulting literature is grouped into three clusters: models that solely focus on HFD treatment, models of diabetes that utilize both HFD and streptozotocin (STZ), and models of AMD that utilize both HFD and genetic models and/or other exposures. Our findings show that HFD profoundly affects vision, retinal function, many different ocular tissues, and multiple cell types through a variety of mechanisms. We delineate how HFD affects the cornea, lens, uvea, vitreous humor, retina, retinal pigmented epithelium (RPE), and Bruch's membrane (BM). Furthermore, we highlight how HFD impairs several retinal cell types, including glia (microglia), retinal ganglion cells, bipolar cells, photoreceptors, and vascular support cells (endothelial cells and pericytes). However, there are a number of gaps, limitations, and biases in the current literature. We highlight these gaps and discuss experimental design to help guide future studies. Very little is known about how HFD impacts the lens, ciliary bodies, and specific neuronal populations, such as rods, cones, bipolar cells, amacrine cells, and retinal ganglion cells. Additionally, sex bias is an important limitation in the current literature, with few HFD studies utilizing female rodents. Future studies should use ingredient-matched control diets (IMCD), include both sexes in experiments to evaluate sex-specific outcomes, conduct longitudinal metabolic and visual measurements, and capture acute outcomes. In conclusion, HFD is a systemic exposure with profound systemic effects, and rodent models are invaluable in understanding the impacts on visual and ocular disease.
Collapse
Affiliation(s)
- Danielle A Clarkson-Townsend
- Gangarosa Department of Environmental Health, Emory University, Atlanta, GA, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA, USA
| | - Amber J Douglass
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA, USA
| | - Anayesha Singh
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA, USA; Emory Center for Ethics, Emory University, Atlanta, GA, USA
| | - Rachael S Allen
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA, USA; Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Ivie N Uwaifo
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA, USA; Department of Neuroscience, Emory University, Atlanta, GA, USA
| | - Machelle T Pardue
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA, USA; Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
| |
Collapse
|
15
|
Barbano L, Ziccardi L, Parisi V. Correlations between visual morphological, electrophysiological, and acuity changes in chronic non-arteritic ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol 2021; 259:1297-1308. [PMID: 33415352 DOI: 10.1007/s00417-020-05023-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/09/2020] [Accepted: 11/19/2020] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To study whether there is a correlation between the macular and optic nerve morphological condition and the retinal ganglion cells (RGCs) and visual pathways' function, and to investigate whether visual acuity (VA) changes might be related to the morpho-functional findings in chronic non-arteritic ischemic optic neuropathy (NAION). METHODS In this retrospective study, 22 patients (mean age 62.12 ± 6.87) with chronic unilateral NAION providing 22 affected and 22 fellow eyes without NAION (NAION-FE), and 20 (mean age 61.20 ± 7.32) healthy control subjects were studied by spectral domain optical coherence tomography (Sd-OCT) for investigating macular thickness (MT) and volume (MV) of the whole (WR), inner (IR) and outer retina (OR), and the peripapillary retinal nerve fiber layer thickness (RNFL-T) measured overall and for all quadrants. Also, simultaneous 60' and 15' pattern electroretinogram (PERG) and visual evoked potentials (VEP) and VA were assessed. Differences of MT and MV of WR, IR, OR, and RNFL-T overall and for all quadrants, PERG amplitude (A), VEP implicit time (IT), and A and VA values between NAION eyes and controls were assessed by one-way analysis of variance. Pearson's test was used for regression analysis. A p value < 0.01 was considered as significant. RESULTS In NAION eyes as compared to NAION-FE eyes and controls, significant (p < 0.01) changes of MT, MV of WR and IR, RNFL-T, 60' and 15' PERG A, VEP IT and A, and VA were found. No significant (p > 0.01) OR changes were observed between groups. In NAION eyes, significant (p < 0.01) correlations between MV of WR and IR and 15' PERG A were found. Overall, RNFL-T values were significantly correlated (p < 0.01) with those of 60' PERG A and VEP IT and A; temporal RNFL-T values were correlated (p < 0.01) with 15' PERG A and VEP IT and A ones. Temporal RNFL-T, MV-IR, and 15' PERG A as well as VEP IT were significantly (p < 0.01) correlated with VA. Significant (p < 0.01) linear correlations between 60' and 15' PERG A findings and the corresponding values of 60' and 15' VEP A were also found. CONCLUSION Our findings suggest that in chronic NAION, there is a morpho-functional impairment of the IR, with OR structural sparing. VA changes are related to the impaired morphology and function of IR, to the temporal RNFL-T reduction and to the dysfunction of both large and small axons forming the visual pathway.
Collapse
Affiliation(s)
- Lucilla Barbano
- Visual Neurophysiology and Neurophthalmology Unit, IRCCS - Fondazione Bietti, Via Livenza 1, 00198, Rome, Italy
| | - Lucia Ziccardi
- Visual Neurophysiology and Neurophthalmology Unit, IRCCS - Fondazione Bietti, Via Livenza 1, 00198, Rome, Italy.
| | - Vincenzo Parisi
- Visual Neurophysiology and Neurophthalmology Unit, IRCCS - Fondazione Bietti, Via Livenza 1, 00198, Rome, Italy
| |
Collapse
|
16
|
The Retinal Inner Plexiform Synaptic Layer Mirrors Grey Matter Thickness of Primary Visual Cortex with Increased Amyloid β Load in Early Alzheimer's Disease. Neural Plast 2020; 2020:8826087. [PMID: 33014034 PMCID: PMC7525303 DOI: 10.1155/2020/8826087] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 11/17/2022] Open
Abstract
The retina may serve as putative window into neuropathology of synaptic loss in Alzheimer's disease (AD). Here, we investigated synapse-rich layers versus layers composed by nuclei/cell bodies in an early stage of AD. In addition, we examined the associations between retinal changes and molecular and structural markers of cortical damage. We recruited 20 AD patients and 17 healthy controls (HC). Combining optical coherence tomography (OCT), magnetic resonance (MR), and positron emission tomography (PET) imaging, we measured retinal and primary visual cortex (V1) thicknesses, along with V1 amyloid β (Aβ) retention ([11C]-PiB PET tracer) and neuroinflammation ([11C]-PK11195 PET tracer). We found that V1 showed increased amyloid-binding potential, in the absence of neuroinflammation. Although thickness changes were still absent, we identified a positive association between the synapse-rich inner plexiform layer (IPL) and V1 in AD. This retinocortical interplay might reflect changes in synaptic function resulting from Aβ deposition, contributing to early visual loss.
Collapse
|
17
|
Sen S, Saxena R, Tripathi M, Vibha D, Dhiman R. Neurodegeneration in Alzheimer's disease and glaucoma: overlaps and missing links. Eye (Lond) 2020; 34:1546-1553. [PMID: 32152519 PMCID: PMC7608361 DOI: 10.1038/s41433-020-0836-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 12/17/2019] [Accepted: 02/17/2020] [Indexed: 12/18/2022] Open
Abstract
The eye is said to be the window into the brain. Alzheimer’s disease (AD) and glaucoma both being diseases of the elderly, have several epidemiological and histological overlaps in pathogenesis. Both these diseases are neurodegenerative conditions. Over the years, a consensus has developed that both may be two ends of a singular spectrum of diseases. Epidemiological studies have shown that more Alzheimer’s patients may be suffering from glaucoma than general healthy population. Retinal ganglion cell damage is a characteristic of both diseases, along with discovery of amyloid-β and tau protein deposition in the retina and aqueous humor of eye. The latter two proteins are known to be pathognomonic of AD. Other pathways such as the insulin receptor pathway also seem to be affected in both diseases similarly. In spite of these overlaps, there are few missing links which still need more evidence, namely, intraocular pressure mechanisms, cerebrospinal fluid pressure and trans-lamina cribrosa pressure gradients, vascular autoregulation factors, etc. Several factors point towards a common pathogenesis at some level for both diseases and prospective studies are necessary to study the natural course of both diseases.
Collapse
Affiliation(s)
- Sagnik Sen
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Saxena
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rebika Dhiman
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
18
|
Ngoo QZ, Wan Hitam WH, Ab Razak A. Evaluation of Retinal Nerve Fiber Layer Thickness, Electroretinogram and Visual Evoked Potential in Patients with Alzheimer's Disease. J Ophthalmol 2019; 2019:6248185. [PMID: 31949951 PMCID: PMC6948353 DOI: 10.1155/2019/6248185] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 12/08/2019] [Accepted: 12/09/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To study the retinal nerve fibre layer (RNFL) thickness and visual electrophysiology testing in patients with Alzheimer's disease (AD). METHODS A cross-sectional, hospital-based study: 25 AD subjects and 25 controls were recruited. Candidates who fulfil the criteria with normal ocular examinations were made to proceed with scanning laser polarimetry, pattern electroretinogram (PERG), and pattern visual evoked potential (PVEP) examinations of the right eye. RNFL thickness, PERG, and PVEP readings were evaluated. RESULTS In AD, the mean of average RNFL thickness was 45.28 μm, SD = 3.61, P < 0.001 (P < 0.05), while the superior RNFL thickness was 54.44 μm, SD = 2.85, P < 0.001 (P < 0.05) and inferior RNFL thickness was 47.11 μm, SD = 4.52, P < 0.001 (P < 0.05). For PERG, the mean P50 latency was 63.88 ms, SD = 7.94, P < 0.001 (P < 0.05) and the mean amplitudes of P50 waves were 1.79 μV, SD = 0.64, P < 0.001 (P < 0.05) and N95 waves were 2.43 μV, SD = 0.90, P < 0.001 (P < 0.05). For PVEP, the mean latency of P100 was 119.00 ms, SD = 9.07, P < 0.001 (P < 0.05), while the mean latency of N135 was 145.20 ms, SD = 8.53, P < 0.001 (P < 0.05). The mean amplitude of P100 waves was 3.71 μV, SD = 1.60, P < 0.001 (P < 0.05), whereas the mean amplitude of N135 waves was 3.67 μV, SD = 2.02, P < 0.001 (P < 0.05). RNFL thickness strongly correlates with PERG readings, with P50 latency R = 0.582, R2 = 0.339, P=0.002 (P < 0.05), amplitude of P50 wave at R = 0.749, R2 = 0.561, P ≤ 0.001 (P < 0.05), and amplitude of N95 wave at R = 0.500, R2 = 0.250, P=0.011 (P < 0.05). No significant difference and correlation were observed on PVEP readings. CONCLUSION The mean of the average, superior and inferior RNFL thickness were significantly lower in the AD group compared with control. There is also significant difference of PERG and PVEP parameters between AD and controls. Regression analysis showed average RNFL thickness having significantly linear relationship with the PERG parameters.
Collapse
Affiliation(s)
- Qi Zhe Ngoo
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Wan Hazabbah Wan Hitam
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Asrenee Ab Razak
- Department of Psychiatry, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| |
Collapse
|
19
|
Yap TE, Balendra SI, Almonte MT, Cordeiro MF. Retinal correlates of neurological disorders. Ther Adv Chronic Dis 2019; 10:2040622319882205. [PMID: 31832125 PMCID: PMC6887800 DOI: 10.1177/2040622319882205] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 09/20/2019] [Indexed: 12/11/2022] Open
Abstract
Considering the retina as an extension of the brain provides a platform from which to study diseases of the nervous system. Taking advantage of the clear optical media of the eye and ever-increasing resolution of modern imaging techniques, retinal morphology can now be visualized at a cellular level in vivo. This has provided a multitude of possible biomarkers and investigative surrogates that may be used to identify, monitor and study diseases until now limited to the brain. In many neurodegenerative conditions, early diagnosis is often very challenging due to the lack of tests with high sensitivity and specificity, but, once made, opens the door to patients accessing the correct treatment that can potentially improve functional outcomes. Using retinal biomarkers in vivo as an additional diagnostic tool may help overcome the need for invasive tests and histological specimens, and offers the opportunity to longitudinally monitor individuals over time. This review aims to summarise retinal biomarkers associated with a range of neurological conditions including Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS) and prion diseases from a clinical perspective. By comparing their similarities and differences according to primary pathological processes, we hope to show how retinal correlates can aid clinical decisions, and accelerate the study of this rapidly developing area of research.
Collapse
Affiliation(s)
- Timothy E. Yap
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
| | - Shiama I. Balendra
- Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London, UK
| | - Melanie T. Almonte
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
| | - M. Francesca Cordeiro
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, NW1 5QH, UK
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College, London, NW1 5QH, UK
- Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, 11–43 Bath Street, London, EC1V 9EL UK
| |
Collapse
|
20
|
Chiquita S, Campos EJ, Castelhano J, Ribeiro M, Sereno J, Moreira PI, Castelo-Branco M, Ambrósio AF. Retinal thinning of inner sub-layers is associated with cortical atrophy in a mouse model of Alzheimer's disease: a longitudinal multimodal in vivo study. ALZHEIMERS RESEARCH & THERAPY 2019; 11:90. [PMID: 31722748 PMCID: PMC6854691 DOI: 10.1186/s13195-019-0542-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/22/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND It has been claimed that the retina can be used as a window to study brain disorders. However, concerning Alzheimer's disease (AD), it still remains controversial whether changes occurring in the brain and retina are associated. We aim to understand when changes start appearing in the retina and brain, how changes progress, and if they are correlated. METHODS We carried out a unique longitudinal study, at 4, 8, 12, and 16 months of age, in a triple transgenic mouse model of AD (3×Tg-AD), which mimics pathological and neurobehavioral features of AD, as we have already shown. Retinal structure and physiology were evaluated in vivo using optical coherence tomography and electroretinography. Brain visual cortex structure was evaluated in vivo using magnetic resonance imaging. RESULTS The retinal thickness of 3×Tg-AD decreased, at all time points, except for the outer nuclear layer, where the opposite alteration was observed. Amplitudes in scotopic and photopic responses were increased throughout the study. Similarly, higher amplitude and lower phase values were observed in the photopic flicker response. No differences were found in the activity of retinal ganglion cells. Visual cortex gray matter volume was significantly reduced. CONCLUSIONS Our results show that this animal model shows similar neural changes in the retina and brain visual cortex, i.e., retinal and brain thinning. Moreover, since similar changes occur in the retina and brain visual cortex, these observations support the possibility of using the eye as an additional tool (noninvasive) for early AD diagnosis and therapeutic monitoring.
Collapse
Affiliation(s)
- Samuel Chiquita
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548, Coimbra, Portugal.,CNC.IBILI Consortium, University of Coimbra, 3004-504, Coimbra, Portugal
| | - Elisa J Campos
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548, Coimbra, Portugal.,CNC.IBILI Consortium, University of Coimbra, 3004-504, Coimbra, Portugal
| | - João Castelhano
- CNC.IBILI Consortium, University of Coimbra, 3004-504, Coimbra, Portugal.,Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, 3000-548, Coimbra, Portugal.,Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548, Coimbra, Portugal
| | - Mário Ribeiro
- CNC.IBILI Consortium, University of Coimbra, 3004-504, Coimbra, Portugal.,Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, 3000-548, Coimbra, Portugal.,Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548, Coimbra, Portugal
| | - José Sereno
- CNC.IBILI Consortium, University of Coimbra, 3004-504, Coimbra, Portugal.,Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, 3000-548, Coimbra, Portugal.,Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548, Coimbra, Portugal
| | - Paula I Moreira
- CNC.IBILI Consortium, University of Coimbra, 3004-504, Coimbra, Portugal.,Center for Neuroscience and Cell Biology (CNC), University of Coimbra, 3004-517, Coimbra, Portugal.,Institute of Physiology, Faculty of Medicine, University of Coimbra, 3004-517, Coimbra, Portugal
| | - Miguel Castelo-Branco
- CNC.IBILI Consortium, University of Coimbra, 3004-504, Coimbra, Portugal. .,Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, 3000-548, Coimbra, Portugal. .,Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548, Coimbra, Portugal.
| | - António Francisco Ambrósio
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548, Coimbra, Portugal. .,CNC.IBILI Consortium, University of Coimbra, 3004-504, Coimbra, Portugal.
| |
Collapse
|
21
|
Chan VTT, Sun Z, Tang S, Chen LJ, Wong A, Tham CC, Wong TY, Chen C, Ikram MK, Whitson HE, Lad EM, Mok VCT, Cheung CY. Spectral-Domain OCT Measurements in Alzheimer's Disease: A Systematic Review and Meta-analysis. Ophthalmology 2019; 126:497-510. [PMID: 30114417 PMCID: PMC6424641 DOI: 10.1016/j.ophtha.2018.08.009] [Citation(s) in RCA: 214] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 08/02/2018] [Accepted: 08/06/2018] [Indexed: 02/07/2023] Open
Abstract
TOPIC OCT is a noninvasive tool to measure specific retinal layers in the eye. The relationship of retinal spectral-domain (SD) OCT measurements with Alzheimer's disease (AD) and mild cognitive impairment (MCI) remains unclear. Hence, we conducted a systematic review and meta-analysis to examine the SD OCT measurements in AD and MCI. CLINICAL RELEVANCE Current methods of diagnosing early AD are expensive and invasive. Retinal measurements of SD OCT, which are noninvasive, technically simple, and inexpensive, are potential biomarkers of AD. METHODS We conducted a literature search in PubMed and Excerpta Medica Database to identify studies published before December 31, 2017, that assessed the associations between AD, MCI, and measurements of SD OCT: ganglion cell-inner plexiform layer (GC-IPL), ganglion cell complex (GCC), macular volume, and choroidal thickness, in addition to retinal nerve fiber layer (RNFL) and macular thickness. We used a random-effects model to examine these relationships. We also conducted meta-regression and assessed heterogeneity, publication bias, and study quality. RESULTS We identified 30 eligible studies, involving 1257 AD patients, 305 MCI patients, and 1460 controls, all of which were cross-sectional studies. In terms of the macular structure, AD patients showed significant differences in GC-IPL thickness (standardized mean difference [SMD], -0.46; 95% confidence interval [CI], -0.80 to -0.11; I2 = 71%), GCC thickness (SMD, -0.84; 95% CI, -1.10 to -0.57; I2 = 0%), macular volume (SMD, -0.58; 95% CI, -1.03 to -0.14; I2 = 80%), and macular thickness of all inner and outer sectors (SMD range, -0.52 to -0.74; all P < 0.001) when compared with controls. Peripapillary RNFL thickness (SMD, -0.67; 95% CI, -0.95 to -0.38; I2 = 89%) and choroidal thickness (SMD range, -0.88 to -1.03; all P < 0.001) also were thinner in AD patients. CONCLUSIONS Our results confirmed the associations between retinal measurements of SD OCT and AD, highlighting the potential usefulness of SD OCT measurements as biomarkers of AD.
Collapse
Affiliation(s)
- Victor T T Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Zihan Sun
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Shumin Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Adrian Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Duke-NUS Medical School, National University of Singapore, Singapore, Republic of Singapore
| | - Christopher Chen
- Memory Aging and Cognition Centre, National University Health System, Singapore, Republic of Singapore; Department of Pharmacology, National University of Singapore, Singapore, Republic of Singapore
| | - M Kamran Ikram
- Departments of Neurology and Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Heather E Whitson
- Duke University Medical Center, Durham, North Carolina; Geriatrics Research Education and Clinical Center (GRECC), Durham VA Medical Center, Durham, North Carolina
| | | | - Vincent C T Mok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Therese Pei Fong Chow Research Centre for Prevention of Dementia, The Chinese University of Hong Kong, Hong Kong, China
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
| |
Collapse
|
22
|
Mukherjee C, Al-Fahad Q, Elsherbiny S. The role of optical coherence tomography in therapeutics and conditions, which primarily have systemic manifestations: a narrative review. Ther Adv Ophthalmol 2019; 11:2515841419831155. [PMID: 30923793 PMCID: PMC6431765 DOI: 10.1177/2515841419831155] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 01/22/2019] [Indexed: 12/22/2022] Open
Abstract
Optical coherence tomography is designed to evaluate in vivo qualitative and quantitative changes of the anterior segment, optic nerve and the retina. Initial applications of this technology were confined mainly to ophthalmic diseases. However recently, numerous studies have evaluated its use in systemic conditions and in therapeutics where, optic nerve and retinal architecture can be assessed to monitor progression of systemic conditions and its response to treatment. This is a narrative review aimed at evaluating the debate surrounding the role of spectral domain optical coherence tomography, in systemic conditions where optic nerve affection can be measured and be used in the diagnosis, monitoring and assessment of treatment effect as a non-invasive, quick, novel technique.
Collapse
Affiliation(s)
| | - Qusay Al-Fahad
- Birmingham Midland Eye Centre, Birmingham, UK; Machen Eye Unit, South Warwickshire Foundation Trust, Warwick, UK
| | - Samer Elsherbiny
- Birmingham Midland Eye Centre, Birmingham, UK; Machen Eye Unit, South Warwickshire Foundation Trust, Warwick, UK
| |
Collapse
|
23
|
Parisi V, Oddone F, Ziccardi L, Roberti G, Coppola G, Manni G. Citicoline and Retinal Ganglion Cells: Effects on Morphology and Function. Curr Neuropharmacol 2018; 16:919-932. [PMID: 28676014 PMCID: PMC6120106 DOI: 10.2174/1570159x15666170703111729] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/07/2017] [Accepted: 06/22/2017] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Retinal ganglion cells (RGCs) are the nervous retinal elements which connect the visual receptors to the brain forming the nervous visual system. Functional and/or morphological involvement of RGCs occurs in several ocular and neurological disorders and therefore these cells are targeted in neuroprotective strategies. Cytidine 5-diphosphocholine or Citicoline is an endogenous compound that acts in the biosynthesis of phospholipids of cell membranes and increases neurotransmitters' levels in the Central Nervous System. Experimental studies suggested the neuromodulator effect and the protective role of Citicoline on RGCs. This review aims to present evidence of the effects of Citicoline in experimental models of RGCs degeneration and in human neurodegenerative disorders involving RGCs. METHODS All published papers containing experimental or clinical studies about the effects of Citicoline on RGCs morphology and function were reviewed. RESULTS In rodent retinal cultures and animal models, Citicoline induces antiapoptotic effects, increases the dopamine retinal level, and counteracts retinal nerve fibers layer thinning. Human studies in neurodegenerative visual pathologies such as glaucoma or non-arteritic ischemic neuropathy showed a reduction of the RGCs impairment after Citicoline administration. By reducing the RGCs' dysfunction, a better neural conduction along the post-retinal visual pathways with an improvement of the visual field defects was observed. CONCLUSION Citicoline, with a solid history of experimental and clinical studies, could be considered a very promising molecule for neuroprotective strategies in those pathologies (i.e. Glaucoma) in which morpho-functional changes of RGCc occurs.
Collapse
Affiliation(s)
- Vincenzo Parisi
- IRCCS-Fondazione GB Bietti, Via Livenza, 3, 00198 Rome, Italy
| | | | - Lucia Ziccardi
- IRCCS-Fondazione GB Bietti, Via Livenza, 3, 00198 Rome, Italy
| | - Gloria Roberti
- IRCCS-Fondazione GB Bietti, Via Livenza, 3, 00198 Rome, Italy
| | | | - Gianluca Manni
- IRCCS-Fondazione GB Bietti, Via Livenza, 3, 00198 Rome, Italy.,DSCMT, Università di Roma Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| |
Collapse
|
24
|
Rodriguez L, Mdzomba JB, Joly S, Boudreau-Laprise M, Planel E, Pernet V. Human Tau Expression Does Not Induce Mouse Retina Neurodegeneration, Suggesting Differential Toxicity of Tau in Brain vs. Retinal Neurons. Front Mol Neurosci 2018; 11:293. [PMID: 30197586 PMCID: PMC6117378 DOI: 10.3389/fnmol.2018.00293] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 08/03/2018] [Indexed: 02/03/2023] Open
Abstract
The implication of the microtubule-associated protein (MAP) Tau in the ocular manifestations of Alzheimer’s disease (AD) is elusive due to the lack of relevant animal model. However, signs of AD have been reported in the brain of transgenic mice expressing human Tau (hTau). To assess whether hTau is sufficient to induce AD pathogenesis in the retina as well, in the present study, we compared the retinal structure and function of KO mice deprived of Tau (mTKO) with those of transgenic mice expressing hTau. Our results revealed that hTau is particularly abundant in the inner nuclear layer (INL) cells of the retina. By electroretinogram (ERG) recording, light-induced retinal cell activation was not altered in hTau compared with mTKO littermates. Surprisingly, the ERG response mediated by cone photoreceptor stimulation was even stronger in hTau than in mTKO retinae. Immunofluorescent analysis of retinal sections allowed us to observe thicker inner retina in hTau than in mTKO eyes. By Western Blotting (WB), the upregulation of mTOR that was found in hTau mice may underlie retinal structure and function increases. Taken together, our results not only indicate that hTau expression is not toxic for retinal cells but they also suggest that it may play a positive role in visual physiology. The use of hTau may be envisaged to improve visual recovery in ocular diseases affecting the retinal function such as glaucoma or diabetic retinopathy.
Collapse
Affiliation(s)
- Léa Rodriguez
- CUO-Recherche, Centre de Recherche du CHU de Québec, Quebec, QC, Canada.,Département d'ophtalmologie, Faculté de Médecine, Université Laval, Quebec, QC, Canada
| | - Julius Baya Mdzomba
- CUO-Recherche, Centre de Recherche du CHU de Québec, Quebec, QC, Canada.,Département d'ophtalmologie, Faculté de Médecine, Université Laval, Quebec, QC, Canada
| | - Sandrine Joly
- CUO-Recherche, Centre de Recherche du CHU de Québec, Quebec, QC, Canada.,Département d'ophtalmologie, Faculté de Médecine, Université Laval, Quebec, QC, Canada
| | - Mélissa Boudreau-Laprise
- CUO-Recherche, Centre de Recherche du CHU de Québec, Quebec, QC, Canada.,Département d'ophtalmologie, Faculté de Médecine, Université Laval, Quebec, QC, Canada
| | - Emmanuel Planel
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Quebec, QC, Canada.,Département de Psychiatrie et de Neurosciences, Faculté de Médecine, Université Laval, Quebec, QC, Canada
| | - Vincent Pernet
- CUO-Recherche, Centre de Recherche du CHU de Québec, Quebec, QC, Canada.,Département d'ophtalmologie, Faculté de Médecine, Université Laval, Quebec, QC, Canada
| |
Collapse
|
25
|
Liao H, Zhu Z, Peng Y. Potential Utility of Retinal Imaging for Alzheimer's Disease: A Review. Front Aging Neurosci 2018; 10:188. [PMID: 29988470 PMCID: PMC6024140 DOI: 10.3389/fnagi.2018.00188] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 06/05/2018] [Indexed: 01/18/2023] Open
Abstract
The ensuing upward shift in demographic distribution due to the increase in life expectancy has resulted in a rising prevalence of Alzheimer's disease (AD). The heavy public burden of AD, along with the urgent to prevent and treat the disease before the irreversible damage to the brain, calls for a sensitive and specific screening technology to identify high-risk individuals before cognitive symptoms arise. Even though current modalities, such as positron emission tomography (PET) and cerebrospinal fluid (CSF) biomarker, showed their potential clinical uses in early detection of AD, the high cost, narrow isotope availability of PET probes and invasive characteristics of CSF biomarker limited their broad utility. Therefore, additional tools for detection of AD are needed. As a projection of the central nervous system (CNS), the retina has been described as a "window to the brain" and a novel marker for AD. Low cost, easy accessibility and non-invasive features make retina tests suitable for large-scale population screening and investigations of preclinical AD. Furthermore, a number of novel approaches in retina imaging, such as optical coherence tomography (OCT), have been developed and made it possible to visualize changes in the retina at a very fine resolution. In this review, we outline the background for AD to accelerate the adoption of retina imaging for the diagnosis and management of AD in clinical practice. Then, we focus on recent findings on the application of retina imaging to investigate AD and provide suggestions for future research directions.
Collapse
Affiliation(s)
- Huan Liao
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ying Peng
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
26
|
Doustar J, Torbati T, Black KL, Koronyo Y, Koronyo-Hamaoui M. Optical Coherence Tomography in Alzheimer's Disease and Other Neurodegenerative Diseases. Front Neurol 2017; 8:701. [PMID: 29312125 PMCID: PMC5742098 DOI: 10.3389/fneur.2017.00701] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 12/06/2017] [Indexed: 12/19/2022] Open
Abstract
Over the past decade, a surge of evidence has documented various pathological processes in the retina of patients suffering from mild cognitive impairment, Alzheimer's disease (AD), Parkinson's disease (PD), and other neurodegenerative diseases. Numerous studies have shown that the retina, a central nervous system tissue formed as a developmental outgrowth of the brain, is profoundly affected by AD. Harboring the earliest detectable disease-specific signs, amyloid β-protein (Aβ) plaques, the retina of AD patients undergoes substantial ganglion cell degeneration, thinning of the retinal nerve fiber layer, and loss of axonal projections in the optic nerve, among other abnormalities. More recent investigations described Aβ plaques in the retina located within sites of neuronal degeneration and occurring in clusters in the mid- and far-periphery of the superior and inferior quadrants, regions that had been previously overlooked. Diverse structural and/or disease-specific changes were also identified in the retina of PD, Huntington's disease, and multiple sclerosis patients. The pathological relationship between the retina and brain prompted the development of imaging tools designed to noninvasively detect and monitor these signs in living patients. One such tool is optical coherence tomography (OCT), uniquely providing high-resolution two-dimensional cross-sectional imaging and three-dimensional volumetric measurements. As such, OCT emerged as a prominent approach for assessing retinal abnormalities in vivo, and indeed provided multiple parameters that allowed for the distinction between normal aged individuals and patients with neurodegenerative diseases. Beyond the use of retinal optical fundus imaging, which recently allowed for the detection and quantification of amyloid plaques in living AD patients via a wide-field view of the peripheral retina, a major advantage of OCT has been the ability to measure the volumetric changes in specified retinal layers. OCT has proven to be particularly useful in analyzing retinal structural abnormalities consistent with disease pathogenesis. In this review, we provide a summary of OCT findings in the retina of patients with AD and other neurodegenerative diseases. Future studies should explore the combination of imaging early hallmark signs together with structural-functional biomarkers in the accessible retina as a practical means of assessing risk, disease progression, and therapeutic efficacy in these patients.
Collapse
Affiliation(s)
- Jonah Doustar
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Tania Torbati
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States.,College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, United States
| | - Keith L Black
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Yosef Koronyo
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Maya Koronyo-Hamaoui
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States.,Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| |
Collapse
|
27
|
Jamal S, Goyal S, Shanker A, Grover A. Predicting neurological Adverse Drug Reactions based on biological, chemical and phenotypic properties of drugs using machine learning models. Sci Rep 2017; 7:872. [PMID: 28408735 PMCID: PMC5429831 DOI: 10.1038/s41598-017-00908-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/16/2017] [Indexed: 02/07/2023] Open
Abstract
Adverse drug reactions (ADRs) have become one of the primary reasons for the failure of drugs and a leading cause of deaths. Owing to the severe effects of ADRs, there is an urgent need for the generation of effective models which can accurately predict ADRs during early stages of drug development based on integration of various features of drugs. In the current study, we have focused on neurological ADRs and have used various properties of drugs that include biological properties (targets, transporters and enzymes), chemical properties (substructure fingerprints), phenotypic properties (side effects (SE) and therapeutic indications) and a combinations of the two and three levels of features. We employed relief-based feature selection technique to identify relevant properties and used machine learning approach to generated learned model systems which would predict neurological ADRs prior to preclinical testing. Additionally, in order to explain the efficiency and applicability of the models, we tested them to predict the ADRs for already existing anti-Alzheimer drugs and uncharacterized drugs, respectively in side effect resource (SIDER) database. The generated models were highly accurate and our results showed that the models based on chemical (accuracy 93.20%), phenotypic (accuracy 92.41%) and combination of three properties (accuracy 94.18%) were highly accurate while the models based on biological properties (accuracy 82.11%) were highly informative.
Collapse
Affiliation(s)
- Salma Jamal
- Department of Bioscience and Biotechnology, Banasthali University, Tonk, Rajasthan, India
| | - Sukriti Goyal
- Department of Bioscience and Biotechnology, Banasthali University, Tonk, Rajasthan, India
| | - Asheesh Shanker
- Department of Bioscience and Biotechnology, Banasthali University, Tonk, Rajasthan, India.,Bioinformatics Programme, Centre for Biological Sciences, Central University of South Bihar, BIT Campus, Patna, Bihar, India
| | - Abhinav Grover
- School of Biotechnology, Jawaharlal Nehru University, New Delhi, India.
| |
Collapse
|
28
|
Hart NJ, Koronyo Y, Black KL, Koronyo-Hamaoui M. Ocular indicators of Alzheimer's: exploring disease in the retina. Acta Neuropathol 2016; 132:767-787. [PMID: 27645291 PMCID: PMC5106496 DOI: 10.1007/s00401-016-1613-6] [Citation(s) in RCA: 173] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/29/2016] [Accepted: 09/01/2016] [Indexed: 12/11/2022]
Abstract
Although historically perceived as a disorder confined to the brain, our understanding of Alzheimer's disease (AD) has expanded to include extra-cerebral manifestation, with mounting evidence of abnormalities in the eye. Among ocular tissues, the retina, a developmental outgrowth of the brain, is marked by an array of pathologies in patients suffering from AD, including nerve fiber layer thinning, degeneration of retinal ganglion cells, and changes to vascular parameters. While the hallmark pathological signs of AD, amyloid β-protein (Aβ) plaques and neurofibrillary tangles (NFT) comprising hyperphosphorylated tau (pTau) protein, have long been described in the brain, identification of these characteristic biomarkers in the retina has only recently been reported. In particular, Aβ deposits were discovered in post-mortem retinas of advanced and early stage cases of AD, in stark contrast to non-AD controls. Subsequent studies have reported elevated Aβ42/40 peptides, morphologically diverse Aβ plaques, and pTau in the retina. In line with the above findings, animal model studies have reported retinal Aβ deposits and tauopathy, often correlated with local inflammation, retinal ganglion cell degeneration, and functional deficits. This review highlights the converging evidence that AD manifests in the eye, especially in the retina, which can be imaged directly and non-invasively. Visual dysfunction in AD patients, traditionally attributed to well-documented cerebral pathology, can now be reexamined as a direct outcome of retinal abnormalities. As we continue to study the disease in the brain, the emerging field of ocular AD warrants further investigation of how the retina may faithfully reflect the neurological disease. Indeed, detection of retinal AD pathology, particularly the early presenting amyloid biomarkers, using advanced high-resolution imaging techniques may allow large-scale screening and monitoring of at-risk populations.
Collapse
Affiliation(s)
- Nadav J Hart
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Los Angeles, 90048, CA, USA
| | - Yosef Koronyo
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Los Angeles, 90048, CA, USA
| | - Keith L Black
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Los Angeles, 90048, CA, USA
| | - Maya Koronyo-Hamaoui
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Los Angeles, 90048, CA, USA.
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 110 George Burns Rd., Los Angeles, CA, 90048, USA.
| |
Collapse
|
29
|
Cunha LP, Almeida ALM, Costa-Cunha LVF, Costa CF, Monteiro MLR. The role of optical coherence tomography in Alzheimer's disease. Int J Retina Vitreous 2016; 2:24. [PMID: 27847642 PMCID: PMC5088456 DOI: 10.1186/s40942-016-0049-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 10/04/2016] [Indexed: 01/20/2023] Open
Abstract
Background Alzheimer’s disease (AD) is the most common cause of dementia and its incidence is increasing worldwide along with population aging. Previous clinical and histologic studies suggest that the neurodegenerative process, which affects the brain, may also affect the retina of AD patients. Main body Optical coherence tomography (OCT) is a non-invasive technology that acquires cross-sectional images of retinal structures allowing neural fundus integrity assessment. Several previous studies demonstrated that both peripapillary retinal nerve fiber layer and macular thickness measurements assessed by OCT were able to detect neuronal loss in AD. Moreover, recent advances in OCT technology, have allowed substantial enhancement in ultrastructural evaluation of the macula, enabling the assessment not only of full-thickness retinal measurements but also of inner retinal layers, which seems to be a promising approach, mainly regarding the assessment of retinal ganglion cell layer impairment in AD patients. Furthermore, retinal neuronal loss seems to correlate with cognitive impairment in AD, reinforcing the promising role of OCT in the clinical evaluation of these patients. Conclusion The purpose of this article is to review the main findings on OCT in AD patients, to discuss the role of this important diagnostic tool in these patients and how OCT technology may be useful in understanding morphological retinal changes in AD.
Collapse
Affiliation(s)
- Leonardo Provetti Cunha
- Department of Ophthalmology, School of Medicine, Juiz de Fora Eye Hospital, Federal University of Juiz de Fora, Av. Barão do Rio Branco, 4051, Bom Pastor, Juiz de Fora, MG 36021-630 Brazil ; Juiz de Fora Eye Hospital, Juiz de Fora, MG Brazil
| | - Ana Laura Maciel Almeida
- Department of Neurology, School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | | | | | - Mário L R Monteiro
- Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| |
Collapse
|
30
|
Abstract
UNLABELLED Tauopathies are neurodegenerative diseases characterized by intraneuronal inclusions of hyperphosphorylated tau protein and abnormal expression of brain-derived neurotrophic factor (BDNF), a key modulator of neuronal survival and function. The severity of both these pathological hallmarks correlate with the degree of cognitive impairment in patients. However, how tau pathology specifically modifies BDNF signaling and affects neuronal function during early prodromal stages of tauopathy remains unclear. Here, we report that the mild tauopathy developing in retinal ganglion cells (RGCs) of the P301S tau transgenic (P301S) mouse induces functional retinal changes by disrupting BDNF signaling via the TrkB receptor. In adult P301S mice, the physiological visual response of RGCs to pattern light stimuli and retinal acuity decline significantly. As a consequence, the activity-dependent secretion of BDNF in the vitreous is impaired in P301S mice. Further, in P301S retinas, TrkB receptors are selectively upregulated, but uncoupled from downstream extracellular signal-regulated kinase (ERK) 1/2 signaling. We also show that the impairment of TrkB signaling is triggered by tau pathology and mediates the tau-induced dysfunction of visual response. Overall our results identify a neurotrophin-mediated mechanism by which tau induces neuronal dysfunction during prodromal stages of tauopathy and define tau-driven pathophysiological changes of potential value to support early diagnosis and informed therapeutic decisions. SIGNIFICANCE STATEMENT This work highlights the potential molecular mechanisms by which initial tauopathy induces neuronal dysfunction. Combining clinically used electrophysiological techniques (i.e., electroretinography) and molecular analyses, this work shows that in a relevant model of early tauopathy, the retina of the P301S mutant human tau transgenic mouse, mild tau pathology results in functional changes of neuronal activity, likely due to selective impairment of brain-derived neurotrophic factor signaling via its receptor, TrkB. These findings may have important translational implications for early diagnosis in a subset of Alzheimer's disease patients with early visual symptoms and emphasize the need to clarify the pathophysiological changes associated with distinct tauopathy stages to support informed therapeutic decisions and guide drug discovery.
Collapse
|
31
|
Chandra A, Abbas S, Raza ST, Singh L, Rizvi S, Mahdi F. Polymorphism of CYP46A1 and PPARγ2 Genes in Risk Prediction of Primary Open Angle Glaucoma Among North Indian Population. Middle East Afr J Ophthalmol 2016; 23:172-6. [PMID: 27162448 PMCID: PMC4845614 DOI: 10.4103/0974-9233.171772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Purpose: Glaucoma is the leading cause of irreversible blindness and the second most common cause of all blindness after cataracts. This study investigates the association of polymorphism in the CYP46A1 and PPARγ2 genes and primary open angle glaucoma (POAG). Materials and Methods: This study evaluated 122 POAG cases (POAG group) and 112 cases of nonglaucomatous patients (control group). Polymorphisms of the CYP46A1 gene and PPARγ2 gene were evaluated with the polymerase chain reaction-restriction fragment length polymorphism method in both groups. Results: The mean ages were 49.88 ± 12.34 years and 53.74 ± 11.87 years for the POAG group and control group, respectively. The CYP46A1 gene CC, CT, TT genotype frequencies were 13.93%, 58.2%, 27.87% in the POAG group and 19.6%, 40.19%, 40.19% in the control group, respectively. The PPARγ2 gene CC, CG, GG genotype frequencies were 16.83%, 54.45%, 28.71% in cases and 3.92%, 28.43%, 67.64% in the control group, respectively. Statistically, significant differences in the frequencies of CYP46A1 CC, CT, TT and PPARγ2 CC, CG, GG (P < 0.05) genotype were found between groups (P < 0.05, all comparisons). Conclusion: Findings of this study suggest that CYP46A1 gene and PPARγ2 gene polymorphisms can be a predictive marker for early identification of population at risk of POAG, although a larger sample size is required to determine the role of these polymorphisms in the pathogenesis and course of POAG.
Collapse
Affiliation(s)
- Anu Chandra
- Department of Biochemistry, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Shania Abbas
- Department of Biochemistry, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Syed Tasleem Raza
- Department of Biochemistry, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Luxmi Singh
- Department of Opthalmology, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Saliha Rizvi
- Department of Biochemistry, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Farzana Mahdi
- Department of Biochemistry, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
| |
Collapse
|
32
|
Lee EJ, Kim TW, Lee DS, Kim H, Park YH, Kim J, Lee JW, Kim S. Increased CSF tau level is correlated with decreased lamina cribrosa thickness. ALZHEIMERS RESEARCH & THERAPY 2016; 8:6. [PMID: 26857246 PMCID: PMC4746900 DOI: 10.1186/s13195-015-0169-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 12/31/2015] [Indexed: 01/06/2023]
Abstract
Background This study was to investigate whether the previously proposed link between Alzheimer’s disease (AD) and decreased retinal nerve fiber layer thickness could be explained by the relationship between abnormal CSF profiles and optic nerve head characteristics, focusing on the influence of CSF tau protein on the lamina cribrosa (LC) thickness (LCT). Methods A total of 44 eyes from 18 patients with AD and 26 healthy subjects were subjected to enhanced-depth-imaging volume scanning of the optic nerve using spectral-domain optical coherence tomography. The B-scan images were constructed three-dimensionally using maximum intensity projection (MIP), and the LCT was measured at three locations (superior midperipheral, midhorizontal, and inferior midperipheral) using the thin-slab MIP images. CSF levels of amyloid β 1-42 peptide, (Aβ1–42), total tau (T-tau) and tau phosphorylated at threonine 181 (P-tau181P) were measured from CSF samples of each subject. The relationship between the level of CSF proteins and the LCT was determined using linear regression and fractional polynomial analyses. Results Univariate regression analysis revealed that higher CSF levels of T-tau (P = 0.004) and P-tau181P (P = 0.027), as well as a smaller central corneal thickness (P = 0.032), were significantly associated with a smaller LCT. Multivariate analysis indicated that only CSF T-tau (P = 0.041) was significantly associated with the LCT. The relationship was well explained by both linear regression (R2 = 0.179, P = 0.004) and fractional polynomial analysis (R2 = 0.275, P = 0.001). When we performed an assessment by linear regression with an indicator, the relationship was significant both in the healthy and AD groups, with a stronger correlation found in the healthy group (regression coefficients = -1.098 vs. -0.280, P = 0.018). Conclusions An increased CSF level of T-tau was significantly associated with a thinner LCT in both the healthy and AD groups. This result suggests that LCT could serve as a potential non-invasive indicator for increased CSF tau. The clinical meaning of the higher level of CSF T-tau in axonal degeneration of the optic nerve remains to be determined.
Collapse
Affiliation(s)
- Eun Ji Lee
- Department of Ophthalmology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, 463-707, Seongnam, Gyeonggi-do, South Korea.
| | - Tae-Woo Kim
- Department of Ophthalmology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, 463-707, Seongnam, Gyeonggi-do, South Korea.
| | - Dae Seung Lee
- Department of Ophthalmology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, 463-707, Seongnam, Gyeonggi-do, South Korea.
| | - Hyunjoong Kim
- Department of Applied Statistics, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, 120-749, Seoul, South Korea.
| | - Young Ho Park
- Department of Neurology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, 463-707, Seongnam, Gyeonggi-do, South Korea.
| | - Jungeun Kim
- Department of Neurology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, 463-707, Seongnam, Gyeonggi-do, South Korea.
| | - Joon Woo Lee
- Department of Radiology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, 463-707, Seongnam, Gyeonggi-do, South Korea.
| | - SangYun Kim
- Department of Neurology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, 463-707, Seongnam, Gyeonggi-do, South Korea.
| |
Collapse
|
33
|
Coppola G, Di Renzo A, Ziccardi L, Martelli F, Fadda A, Manni G, Barboni P, Pierelli F, Sadun AA, Parisi V. Optical Coherence Tomography in Alzheimer's Disease: A Meta-Analysis. PLoS One 2015; 10:e0134750. [PMID: 26252902 PMCID: PMC4529274 DOI: 10.1371/journal.pone.0134750] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/13/2015] [Indexed: 12/24/2022] Open
Abstract
Background Alzheimer’s disease (AD) is a neurodegenerative disorder, which is likely to start as mild cognitive impairment (MCI) several years before the its full-blown clinical manifestation. Optical coherence tomography (OCT) has been used to detect a loss in peripapillary retina nerve fiber layer (RNFL) and a reduction in macular thickness and volume of people affected by MCI or AD. Here, we performed an aggregate meta-analysis combining results from different studies. Methods and Findings Data sources were case-control studies published between January 2001 and August 2014 (identified through PubMed and Google Scholar databases) that examined the RNFL thickness by means of OCT in AD and MCI patients compared with cognitively healthy controls. Results 11 studies were identified, including 380 patients with AD, 68 with MCI and 293 healthy controls (HC). The studies suggest that the mean RNFL thickness is reduced in MCI (weighted mean differences in μm, WMD = -13.39, 95% CI: -17.34 to -9.45, p = 0.031) and, even more so, in AD (WMD = -15.95, 95% CI: -21.65 to -10.21, p<0.0001) patients compared to HC. RNFL in the 4 quadrants were all significantly thinner in AD superior (superior WMD = -24.0, 95% CI: -34.9 to -13.1, p<0.0001; inferior WMD = -20.8, 95% CI: -32.0 to -9.7, p<0.0001; nasal WMD = -14.7, 95% CI: -23.9 to -5.5, p<0.0001; and temporal WMD = -10.7, 95% CI: -19.9 to -1.4, p<0.0001); the same significant reduction in quadrant RNFL was observed in MCI patients compared with HC (Inferior WMD = -20.22, 95% CI: -30.41 to -10.03, p = 0.0001; nasal WMD = -7.4, 95% CI: -10.08 to -4.7, p = 0.0000; and temporal WMD = -6.88, 95% CI: -12.62 to -1.13, p = 0.01), with the exception of superior quadrant (WMD = -19.45, 95% CI: -40.23 to 1.32, p = 0.06). Conclusion Results from the meta-analysis support the important role of OCT for RNFL analysis in monitoring the progression of AD and in assessing the effectiveness of purported AD treatments.
Collapse
Affiliation(s)
- Gianluca Coppola
- G.B. Bietti Foundation-IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Rome, Italy
- * E-mail:
| | - Antonio Di Renzo
- G.B. Bietti Foundation-IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Rome, Italy
| | - Lucia Ziccardi
- G.B. Bietti Foundation-IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Rome, Italy
| | - Francesco Martelli
- Istituto Superiore di Sanità, Dipartimento Tecnologie e Salute, Rome, Italy
| | - Antonello Fadda
- Istituto Superiore di Sanità, Dipartimento Tecnologie e Salute, Rome, Italy
| | - Gianluca Manni
- Tor Vergata University of Rome, Department of Clinical Sciences and Translation Medicine; Rome, Italy
| | - Piero Barboni
- IRCCS Istituto Scientifico San Raffaele, Milan, Italy
| | - Francesco Pierelli
- Sapienza University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
- IRCCS-Neuromed, Pozzilli (IS), Italy
| | - Alfredo A. Sadun
- Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Vincenzo Parisi
- G.B. Bietti Foundation-IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Rome, Italy
| |
Collapse
|
34
|
Kurna SA, Akar G, Altun A, Agirman Y, Gozke E, Sengor T. Confocal scanning laser tomography of the optic nerve head on the patients with Alzheimer's disease compared to glaucoma and control. Int Ophthalmol 2014; 34:1203-11. [PMID: 25284015 DOI: 10.1007/s10792-014-0004-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 09/07/2014] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to evaluate optic nerve head (ONH) differences of the patients with Alzheimer's disease (AD) measured by confocal scanning laser tomography [Heidelberg Retina Tomograph (HRT) III] and compare with glaucoma and control subjects. Eighty-four patients were enrolled into the study: 44 eyes of 24 patients with mild to moderate AD (Group 1), 68 eyes of 35 patients with glaucoma (Group 2), and 49 eyes of 25 heathy volunteers as a control (Group 3). A complete ophthalmologic examination as well as a confocal scanning laser ophthalmoscopic assessment with HRT III were performed on all patients. Mean values of the ONH topographic parameters such as rim area (RA), rim volume (RV), height variation contour, linear cup/disc ratio, cup shape measure, and retinal nerve fiber layer (RNFL) were recorded. Mean values of RNFL thickness was 0.23 ± 0.07 in AD, 0.22 ± 0.09 in glaucoma and 0.24 ± 0.07 in the control group (p = 0.323). RA and RV were significantly lower, and linear C/D ratio was significantly higher in the glaucoma group when compared to AD and control (p < 0.05). There was no statistically significant difference between AD and control for the optic disc parameters tested (p > 0.05). We observed a negative correlation of the age with RNFL in all of the groups (p < 0.005). Age was the most important parameter affecting RNFL. Our results suggest that HRT does not demonstrate ONH differences between AD and control group, while it successfully differentiates glaucoma from AD and control cases of older age.
Collapse
Affiliation(s)
- Sevda Aydin Kurna
- Ophthalmology Clinics, Fatih Sultan Mehmet Training and Research Hospital, E5 Road, İçerenköy, Ataşehir, Istanbul, 34752, Turkey,
| | | | | | | | | | | |
Collapse
|
35
|
Ascaso FJ, Cruz N, Modrego PJ, Lopez-Anton R, Santabárbara J, Pascual LF, Lobo A, Cristóbal JA. Retinal alterations in mild cognitive impairment and Alzheimer's disease: an optical coherence tomography study. J Neurol 2014; 261:1522-30. [PMID: 24846203 DOI: 10.1007/s00415-014-7374-z] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 05/12/2014] [Accepted: 05/13/2014] [Indexed: 01/16/2023]
Abstract
Retinal nerve fiber layer thickness (RNFL) measured by means of Optical Coherence Tomography (OCT) has been used as a marker not only of ophthalmologic diseases but also of neurodegenerative diseases such as Alzheimer's disease (AD) and mild cognitive impairment (MCI). The purpose of this work was to demonstrate that patients with amnestic MCI show an intermediate RNFL thickness between normality and AD, and a macular volume and thickness as well. In a cross-sectional study we consecutively recruited 18 patients with AD, 21 with MCI, and 41 healthy controls. OCT was performed in all of them to measure circumpapillary RNFL thickness in µm, as well as macular volume and thickness. In the analysis of variance we saw that RNFL was thinner in MCI patients compared with controls, and it was also thinner in AD patients compared with MCI patients and controls. With regard to the macular measurements in mm(3), MCI patients had the greatest macular volume in comparison with AD patients and controls. In turn the controls had greater macular volume than AD patients. The decreased RNFL thickness in MCI and AD patients suggests loss of retinal neurons and their axons. The increased thickness and macular volume have never been reported before in aMCI. This finding could be explained by inflammation and/or gliosis in early stages of AD. OCT could be a useful marker of AD for early detection and monitoring progression.
Collapse
Affiliation(s)
- Francisco J Ascaso
- Department of Ophthalmology, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, Spain
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Kromer R, Serbecic N, Hausner L, Froelich L, Aboul-Enein F, Beutelspacher SC. Detection of Retinal Nerve Fiber Layer Defects in Alzheimer's Disease Using SD-OCT. Front Psychiatry 2014; 5:22. [PMID: 24616709 PMCID: PMC3934110 DOI: 10.3389/fpsyt.2014.00022] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Accepted: 02/11/2014] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Our aim is to examine the clinical value of spectral-domain optical coherence tomography (Spectralis OCT) to detect retinal nerve fibre layer defects in patients with clinically defined Alzheimer's disease (AD). MATERIAL AND METHODS This cross-sectional study included 22 patients with AD (mean age: 75.9 ± 6.1 years) and 22 healthy age- and sex-matched controls. Neuro-ophthalmologic examinations and a series of high-resolution OCT examinations of the peripapillary retinal nerve fiber layer (RNFL) thickness using the Spectralis 3.5-mm circle scan protocol with ART-Modus and eye tracking were obtained, and compared to age- and sex-matched healthy control subjects. RESULTS Patients with AD showed a significant decrease in RNFL thickness in the nasal superior sector compared to the control group (101.0 ± 18.18 μm versus 122.8 ± 28.08 μm; P < 0.0001). In all other sectors, independently of disease duration, no significant difference in RNFL thickness compared to controls was detected. Using the advanced age- and gender-matched measurement model, 32 out of 42 eyes (76.19%) as pathologic with 67 abnormal sectors were detected. DISCUSSION As examined by spectral-domain OCT, patients with mild to moderate stages of AD showed a significant reduction of RNFL thickness in the nasal superior sector. Nevertheless, successive studies are needed.
Collapse
Affiliation(s)
- Robert Kromer
- Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Nermin Serbecic
- Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Lucrezia Hausner
- Division of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Lutz Froelich
- Division of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | | | - Sven C. Beutelspacher
- Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| |
Collapse
|
37
|
Hokazono K, Raza AS, Oyamada MK, Hood DC, Monteiro MLR. Pattern electroretinogram in neuromyelitis optica and multiple sclerosis with or without optic neuritis and its correlation with FD-OCT and perimetry. Doc Ophthalmol 2013; 127:201-15. [PMID: 23892551 DOI: 10.1007/s10633-013-9401-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 07/16/2013] [Indexed: 12/21/2022]
Abstract
PURPOSE To evaluate the ability of transient pattern electroretinogram (PERG) parameters to differentiate between eyes of patients with neuromyelitis optica (NMO), longitudinally extensive transverse myelitis (LETM), multiple sclerosis with optic neuritis (MS + ON), multiple sclerosis without optic neuritis (MS - ON), and controls, to compare PERG and OCT with regard to discrimination ability, and to assess the correlation between PERG, FD-OCT, and visual field measurements (VFs). METHODS Visual field measurements and full-field stimulation PERGs based on both 48- and 14-min checks were obtained from patients with MS (n = 28), NMO (n = 20), LETM (n = 18), and controls (n = 26). In addition, FD-OCT peripapillary retinal nerve fiber layer (RNFL) and segmented macular layer measurements were obtained and their correlation coefficients were determined. RESULTS Compared to controls, PERG amplitude measurements were significantly reduced in eyes with NMO and MS + ON, but not in eyes with LETM and MS - ON. PERG amplitudes were significantly smaller in NMO and MS + ON eyes than in MS - ON eyes. PERG and OCT performance was similar except in NMO eyes where macular thickness parameters were more efficient at detecting abnormalities. A significant correlation was found between N95 amplitude values and OCT-measured macular ganglion cell layer thickness, total retinal thickness, and temporal peripapillary RNFL thickness. PERG amplitude was also significantly associated with VF sensitivity loss. No statistically significant difference was observed with regard to the best-performing parameters of the two methods. CONCLUSIONS Pattern electroretinogram measurements were able to detect RNFL loss in MS + ON and NMO eyes, with a performance comparable to OCT. PERG amplitude measurements were reasonably well correlated with OCT-measured parameters.
Collapse
Affiliation(s)
- Kenzo Hokazono
- Division of Ophthalmology and Laboratory of Investigation in Ophthalmology (LIM 33), University of São Paulo Medical School, Av. Angélica 1757 conj. 61, São Paulo, SP, 01227-200, Brazil
| | | | | | | | | |
Collapse
|
38
|
Laude A, Lascaratos G, Henderson RD, Starr JM, Deary IJ, Dhillon B. Retinal nerve fiber layer thickness and cognitive ability in older people: the Lothian Birth Cohort 1936 study. BMC Ophthalmol 2013; 13:28. [PMID: 23822668 PMCID: PMC3706226 DOI: 10.1186/1471-2415-13-28] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Accepted: 06/25/2013] [Indexed: 11/20/2022] Open
Abstract
Background This study aims to examine the relationship between the retinal nerve fiber layer (RNFL) thickness as measured by optical coherence tomography (OCT) and lifetime cognitive change in healthy older people. Methods In a narrow-age sample population from the Lothian Birth Cohort 1936 who were all aged approximately 72 years when tested, participants underwent RNFL measurements using OCT. General linear modeling was used to calculate the effect of RNFL thickness on three domains; general cognitive ability (g-factor), general processing speed (g-speed) and general memory ability (g-memory) using age at time of assessment and gender as co-variates. Results Of 105 participants, 96 completed OCT scans that were of suitable quality for assessment were analyzed. Using age and gender as covariates, we found only one significant association, between the inferior area RNFL thickness and g-speed (p = 0.049, η2 = 0.045). Interestingly, when we included age 11 IQ as a covariate in addition to age and gender, there were several statistically significant associations (p = 0.029 to 0.048, η2 = 0.00 to 0.059) in a negative direction; decreasing scores on measures of g-factor and g-speed were associated with increasing RNFL thickness (r = −0.229 to −0.243, p < 0.05). No significant associations were found between RNFL thickness and g-memory ability. When we considered the number of years of education as a covariate, we found no significant associations between the RNFL thickness and cognitive scores. Conclusions In a community dwelling cohort of healthy older people, increased RNFL thickness appeared to be associated with lower general processing speed and lower general cognitive ability when age 11 IQ scores were included as a covariate.
Collapse
|
39
|
Parnell M, Guo L, Abdi M, Cordeiro MF. Ocular manifestations of Alzheimer's disease in animal models. Int J Alzheimers Dis 2012; 2012:786494. [PMID: 22666623 PMCID: PMC3362039 DOI: 10.1155/2012/786494] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Accepted: 03/11/2012] [Indexed: 12/29/2022] Open
Abstract
Alzheimer's disease (AD) is the most common form of dementia, and the pathological changes of senile plaques (SPs) and neurofibrillary tangles (NFTs) in AD brains are well described. Clinically, a diagnosis remains a postmortem one, hampering both accurate and early diagnosis as well as research into potential new treatments. Visual deficits have long been noted in AD patients, and it is becoming increasingly apparent that histopathological changes already noted in the brain also occur in an extension of the brain; the retina. Due to the optically transparent nature of the eye, it is possible to image the retina at a cellular level noninvasively and thus potentially allow an earlier diagnosis as well as a way of monitoring progression and treatment effects. Transgenic animal models expressing amyloid precursor protein (APP) presenilin (PS) and tau mutations have been used successfully to recapitulate the pathological findings of AD in the brain. This paper will cover the ocular abnormalities that have been detected in these transgenic AD animal models.
Collapse
Affiliation(s)
- Miles Parnell
- Glaucoma & Retinal Neurodegeneration Research Group, Visual Neuroscience, UCL Institute of Ophthalmology, London EC1V 9EL, UK
- Sutton Eye Unit, Epsom and St. Helier NHS Trust, Cotswold Road, Sutton, Surry, London, UK
| | - Li Guo
- Glaucoma & Retinal Neurodegeneration Research Group, Visual Neuroscience, UCL Institute of Ophthalmology, London EC1V 9EL, UK
| | - Mohamed Abdi
- St. Georges Healthcare NHS Trust, Blackshaw Road, Tooting, London, UK
| | - M. Francesca Cordeiro
- Glaucoma & Retinal Neurodegeneration Research Group, Visual Neuroscience, UCL Institute of Ophthalmology, London EC1V 9EL, UK
- Western Eye Hospital, Imperial College Healthcare Trust, London, UK
| |
Collapse
|
40
|
Kur J, Newman EA, Chan-Ling T. Cellular and physiological mechanisms underlying blood flow regulation in the retina and choroid in health and disease. Prog Retin Eye Res 2012; 31:377-406. [PMID: 22580107 DOI: 10.1016/j.preteyeres.2012.04.004] [Citation(s) in RCA: 450] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 04/17/2012] [Accepted: 04/22/2012] [Indexed: 02/06/2023]
Abstract
We review the cellular and physiological mechanisms responsible for the regulation of blood flow in the retina and choroid in health and disease. Due to the intrinsic light sensitivity of the retina and the direct visual accessibility of fundus blood vessels, the eye offers unique opportunities for the non-invasive investigation of mechanisms of blood flow regulation. The ability of the retinal vasculature to regulate its blood flow is contrasted with the far more restricted ability of the choroidal circulation to regulate its blood flow by virtue of the absence of glial cells, the markedly reduced pericyte ensheathment of the choroidal vasculature, and the lack of intermediate filaments in choroidal pericytes. We review the cellular and molecular components of the neurovascular unit in the retina and choroid, techniques for monitoring retinal and choroidal blood flow, responses of the retinal and choroidal circulation to light stimulation, the role of capillaries, astrocytes and pericytes in regulating blood flow, putative signaling mechanisms mediating neurovascular coupling in the retina, and changes that occur in the retinal and choroidal circulation during diabetic retinopathy, age-related macular degeneration, glaucoma, and Alzheimer's disease. We close by discussing issues that remain to be explored.
Collapse
Affiliation(s)
- Joanna Kur
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
| | | | | |
Collapse
|
41
|
Electroretinogram findings in unilateral optic neuritis. Doc Ophthalmol 2011; 123:173-8. [PMID: 22038575 DOI: 10.1007/s10633-011-9294-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 09/22/2011] [Indexed: 10/15/2022]
Abstract
To report the electrophysiological findings in patients with unilateral optic neuritis (ON), with particular reference to the electroretinogram (ERG). A retrospective analysis of full-field ERG, pattern ERG (PERG) and pattern visual evoked potential findings from 46 patients with clinical and electrophysiological findings in keeping with unilateral ON. ISCEV standard ERGs did not significantly differ between the optic neuritis and fellow eyes, nor between patients with and without MS. Differences were present in the N95 component of the PERG, which was significantly lower in the affected eye, and the pattern reversal visual evoked potential, which showed significantly longer peak time (latency) in the affected eye. In addition, there was a significant difference between patients with and without multiple sclerosis (MS). No significant inter-ocular asymmetry in ISCEV standard ERGs was present in these cases of unilateral optic neuritis, either as a clinically isolated syndrome or as part of multiple sclerosis. All ERGs recorded were normal.
Collapse
|
42
|
Low-density lipoprotein receptor-related protein is decreased in optic neuropathy of Alzheimer disease. J Neuroophthalmol 2011; 31:139-46. [PMID: 21593627 DOI: 10.1097/wno.0b013e31821b602c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Alzheimer disease (AD) is associated with optic nerve degeneration, yet the underlying pathophysiology of this disease and the optic nerve disorder remain poorly understood. Low-density lipoprotein receptor-related protein (LRP) is implicated in the pathogenesis of AD by mediating the transport of amyloid-β (Aβ) out of the brain into the systemic circulation. As a key player in the reaction to central nervous system injury, astrocytes associate with LRP in AD. This study investigates the role of LRP and astrocytes in the pathogenesis of AD optic neuropathy. METHODS To investigate the role of LRP and astrocytes in the pathogenesis of AD optic neuropathy, we conducted immunohistochemical studies on postmortem optic nerves in AD patients (n = 11) and age-matched controls (n = 10) to examine the presence of LRP. Quantitative analyses using imaging software were used to document the extent of LRP in neural tissues. Axonal integrity was assessed by performing immunohistochemistry on the subjects' optic nerves with an antibody to neurofilament (NF) protein. Double-immunofluorescence labeling was performed to investigate whether LRP colocalized with astrocytes, expressing glial fibrillary acidic protein. RESULTS LRP expression was decreased in AD optic nerves compared to that in controls (P < 0.001). LRP immunoreactivity was observed in the microvasculature and perivascularly in close proximity to the astrocytic processes. Colocalization of LRP in the astrocytes of optic nerves was also demonstrated. The presence of optic neuropathy was confirmed in the AD optic nerves by demonstrating greatly reduced immunostaining for NF protein as compared to controls. CONCLUSIONS The reduction of LRP in the AD degenerative optic nerves supports the hypothesis that LRP may play a role in the pathophysiology of AD optic neuropathy.
Collapse
|
43
|
Bowd C, Tafreshi A, Zangwill LM, Medeiros FA, Sample PA, Weinreb RN. Pattern electroretinogram association with spectral domain-OCT structural measurements in glaucoma. Eye (Lond) 2010; 25:224-32. [PMID: 21183943 DOI: 10.1038/eye.2010.203] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To describe the association between pattern electroretinogram (PERG) amplitude and spectral domain-optical coherence tomography (SD-OCT) macular thickness, retinal nerve fibre layer (RNFL) thickness and optic disc topography measurements. SUBJECTS AND METHODS Both eyes (n = 132) of 66 glaucoma patients (mean age = 67.9 years) enrolled in the University of California, San Diego, CA, USA, Diagnostic Innovations in Glaucoma Study (DIGS) were included. Eyes were tested with PERG (Glaid PERGLA, Lace Elettronica, Pisa, Italy), RTVue SD-OCT (Optovue Inc., Fremont, CA, USA) GCC, and NHM4 protocols on the same day. Of the 66 enrolled patients, 43 had glaucoma defined by repeated abnormal standard automated perimetry (SAP) results in at least one eye and 23 were glaucoma suspects defined by a glaucomatous-appearing optic disc by physicians' examination in at least one eye and normal SAP results in both eyes. Associations (R(2)) were determined between PERG amplitude (μV) and SD-OCT macular ganglion cell complex (GCC) thickness (μm), macular thickness (μm), macular outer retinal thickness (macular thickness minus GCC thickness) (μm), RNFL thickness (μm), neuroretinal rim area (mm(2)), and rim volume (mm(3)). RESULTS PERG amplitude was significantly associated with GCC thickness (R(2) = 0.179, P < 0.001), RNFL thickness (R(2) = 0.174, P < 0.001), and macular thickness (R(2) = 0.095, P<0.001). R(2) associations with other parameters were not significant (all P > 0.624). Significant associations remained for GCC and average RNFL thickness when age and intraocular pressure at the time of testing were included in multivariate models (both P ≤ 0.030). CONCLUSIONS PERG amplitude is significantly (but weakly) associated with macular GCC thickness, RNFL thickness, and macular thickness. The lack of association between PERG amplitude and macular outer retinal thickness supports previous results, possibly suggesting that that the PERG is driven primarily by retinal ganglion cell (inner retinal) responses.
Collapse
Affiliation(s)
- C Bowd
- Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA 92037-0946, USA.
| | | | | | | | | | | |
Collapse
|
44
|
Koronyo-Hamaoui M, Koronyo Y, Ljubimov AV, Miller CA, Ko MK, Black KL, Schwartz M, Farkas DL. Identification of amyloid plaques in retinas from Alzheimer's patients and noninvasive in vivo optical imaging of retinal plaques in a mouse model. Neuroimage 2010; 54 Suppl 1:S204-17. [PMID: 20550967 DOI: 10.1016/j.neuroimage.2010.06.020] [Citation(s) in RCA: 436] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 06/04/2010] [Accepted: 06/07/2010] [Indexed: 01/10/2023] Open
Abstract
Noninvasive monitoring of β-amyloid (Aβ) plaques, the neuropathological hallmarks of Alzheimer's disease (AD), is critical for AD diagnosis and prognosis. Current visualization of Aβ plaques in brains of live patients and animal models is limited in specificity and resolution. The retina as an extension of the brain presents an appealing target for a live, noninvasive optical imaging of AD if disease pathology is manifested there. We identified retinal Aβ plaques in postmortem eyes from AD patients (n=8) and in suspected early stage cases (n=5), consistent with brain pathology and clinical reports; plaques were undetectable in age-matched non-AD individuals (n=5). In APP(SWE)/PS1(∆E9) transgenic mice (AD-Tg; n=18) but not in non-Tg wt mice (n=10), retinal Aβ plaques were detected following systemic administration of curcumin, a safe plaque-labeling fluorochrome. Moreover, retinal plaques were detectable earlier than in the brain and accumulated with disease progression. An immune-based therapy effective in reducing brain plaques, significantly reduced retinal Aβ plaque burden in immunized versus non-immunized AD mice (n=4 mice per group). In live AD-Tg mice (n=24), systemic administration of curcumin allowed noninvasive optical imaging of retinal Aβ plaques in vivo with high resolution and specificity; plaques were undetectable in non-Tg wt mice (n=11). Our discovery of Aβ specific plaques in retinas from AD patients, and the ability to noninvasively detect individual retinal plaques in live AD mice establish the basis for developing high-resolution optical imaging for early AD diagnosis, prognosis assessment and response to therapies.
Collapse
Affiliation(s)
- Maya Koronyo-Hamaoui
- Department of Neurosurgery and Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Relationship between pattern electroretinogram, standard automated perimetry, and optic nerve structural assessments. J Glaucoma 2009; 18:608-17. [PMID: 19826390 DOI: 10.1097/ijg.0b013e31819afb5c] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine the relationship between retinal ganglion cell function measured using pattern electroretinogram optimized for glaucoma screening (PERGLA), retinal nerve fiber layer (RNFL) thickness, and optic nerve head topography. METHODS Twenty-nine normal, 28 glaucoma, and 37 glaucoma suspect volunteers were enrolled. All participants were age similar. One randomly selected eye underwent complete eye examination, standard automated perimetry (SAP), scanning laser polarimetry with enhanced corneal compensation (GDxECC), optical coherence tomography, Heidelberg retina tomograph (HRT), and PERGLA measurements. PERGLA amplitude (microV) was converted to dB for comparison with SAP mean deviation (MD) and pattern SD. The correlation between PERGLA amplitude in dB and the average of sensitivity values for 16 central test locations of SAP were calculated. Analysis of variance, Pearson and Spearman rank correlations, coefficient of variation, and intraclass correlation coefficients were calculated. RESULTS PERGLA amplitude in glaucomatous eyes was significantly lower than normal eyes (0.47+/-0.20 vs. 0.70+/-0.28 microV, P<0.001) but not glaucoma suspects (0.54+/-0.21 microV, P=0.84). PERGLA amplitude was inversely correlated with age (r=-0.31, P=0.002). PERGLA amplitude (in dB) was associated with the sensitivity values of the SAP central 16 test locations (r=0.40, P<0001) across the entire cohort, GDxECC superior RNFL thickness (r=0.38, P<0.001), and HRT Moorfields regression analysis classification (rho=-0.34, P=0.001). The coefficient of variation and intraclass correlation coefficients were 14.5% and 0.89 for PERGLA amplitude, 2.4% and 0.98 for optical coherence tomography average RNFL, 2.2% and 0.97 for GDxECC temporal superior nasal inferior temporal average, and 6.3% and 0.94 for HRT rim area. CONCLUSIONS Retinal ganglion cell function measured using PERGLA is reduced in glaucoma and demonstrates modest correlations with central SAP sensitivity values and structural measures of optic nerve topography and RNFL thickness.
Collapse
|
46
|
Picciani R, Desai K, Guduric-Fuchs J, Cogliati T, Morton CC, Bhattacharya SK. Cochlin in the eye: functional implications. Prog Retin Eye Res 2007; 26:453-69. [PMID: 17662637 PMCID: PMC2064858 DOI: 10.1016/j.preteyeres.2007.06.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Aqueous humor is actively produced in the ciliary epithelium of the anterior chamber and has important functions for the eye. Under normal physiological conditions, the inflow and outflow of the aqueous humor are tightly regulated, but in the pathologic state this balance is lost. Aqueous outflow involves structures of the anterior chamber and experiences most resistance at the level of the trabecular meshwork (TM) that acts as a filter. The modulation of the TM structure regulates the filter and its mechanism remains poorly understood. Proteomic analyses have identified cochlin, a protein of poorly understood function, in the glaucomatous TM but not in healthy control TM from human cadaver eyes. The presence of cochlin has subsequently been confirmed by Western and immunohistochemical analyses. Functionally, cochlin undergoes multimerization induced by shear stress and other changes in the microenvironment. Cochlin along with mucopolysaccharide deposits has been found in the TM of glaucoma patients and in the inner ear of subjects affected by the hearing disorder DNFA9, a late-onset, progressive disease that also involves alterations in fluid shear regimes. In vitro, cochlin induces aggregation of primary TM cells suggesting a role in cell adhesion, possibly in mechanosensation, and in modulation of the TM filter.
Collapse
Affiliation(s)
- Renata Picciani
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, 33136
| | - Kavita Desai
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, 33136
| | - Jasenka Guduric-Fuchs
- Centre for Vision Sciences, Queen's University School of Biomedical Sciences, BELFAST BT12 6BA, UK
| | - Tiziana Cogliati
- Centre for Vision Sciences, Queen's University School of Biomedical Sciences, BELFAST BT12 6BA, UK
| | - Cynthia C. Morton
- Harvard Medical School, Brigham and Women's Hospital New Research Building, Room 160D, 77 Avenue Louis Pasteur, Boston, MA 02115
| | | |
Collapse
|
47
|
Parisi V. Electrophysiological assessment of glaucomatous visual dysfunction during treatment with cytidine-5'-diphosphocholine (citicoline): a study of 8 years of follow-up. Doc Ophthalmol 2006; 110:91-102. [PMID: 16249960 DOI: 10.1007/s10633-005-7348-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In this study we assessed, by simultaneous recordings of visual evoked potentials (VEPs) and pattern-electroretinograms (PERGs), the effects cytidine-5'-diphosphocholine (citicoline) on retinal function and/or visual cortical responses in glaucoma patients. Thirty glaucoma patients were randomly divided into two age-matched groups: patients in group GC (15 patients) were treated with citicoline (1,000 mg/die intramuscularly) for 2 months; patients in group GP (15 patients) were treated with placebo for 2 months. After 4 months of wash-out (month 6), GC patients underwent a further 2-month period of citicoline treatment (months 7-8) followed by another 4-month period of wash-out (months 9-12). In GP patients the wash-out was extended for a further 6 months (months 7-12). During the following 13-96 months, GC patients received additional 2-month periods of treatment with citicoline (each period followed by 4 months of wash-out) for a total of 16 periods in 8 years. GP patients were also examined at months 24, 26, 48, 60, 72, 84 and 96. In GC patients the first two treatments with citicoline induced a significant (p <0.01) improvement of VEP and PERG parameters with respect to pre-treatment conditions. VEPs and PERGs recorded in GC patients after the first wash-out revealed that, although there was a worsening trend, the electrophysiological improvement was still maintained with respect to baseline conditions. The additional periods of citicoline treatment in GC patients during the subsequent 13-96 months induced a greater (p <0.01) improvement of VEP and PERG parameters with respect to pre-treatment conditions and when compared to GP patients. Thus, we observed that citicoline significantly improves retinal and cortical bioelectrical responses in glaucoma patients, suggesting a potential use of this substance in the medical treatment of glaucoma, as a complement to hypotensive therapy.
Collapse
Affiliation(s)
- Vincenzo Parisi
- Fondazione per l'Oftalmologia G.B. Bietti-ONLUS, Via Santa Maria Goretti 66, 00199, Roma, Italy.
| |
Collapse
|
48
|
Bhattacharya SK, Peachey NS, Crabb JW. Cochlin and glaucoma: a mini-review. Vis Neurosci 2006; 22:605-13. [PMID: 16332271 PMCID: PMC1483214 DOI: 10.1017/s0952523805225099] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2005] [Accepted: 07/12/2005] [Indexed: 11/07/2022]
Abstract
Primary open angle glaucoma (POAG) is a leading cause of late onset, progressive, irreversible blindness and, although its etiology is poorly understood, elevated intraocular pressure (IOP) often appears to be a contributory factor. Proteomic and Western analyses of trabecular meshwork (TM) from patients with POAG and age-matched controls originally implicated cochlin as possibly contributing to glaucoma pathogenesis. Cochlin deposits were subsequently detected in glaucomatous but not in control TM and older glaucomatous TM was found to contain higher levels of cochlin and significantly lower amounts of collagen type II. More recently, similar results were reported in DBA/2J mice, which at older ages develop elevated IOP, retinal ganglion cell degeneration, and optic nerve damage. Notably, cochlin was absent in TM from C57BL/6J, CD1, and BALBc/ByJ mice, which do not exhibit elevated IOP or glaucoma. Cochlin was found in the TM of very young DBA/2J mice, prior to elevated IOP, suggesting that over time the protein may contribute to the events leading to increased IOP and optic nerve damage. Here we review these findings and describe how future studies in DBA/2J mice can help resolve whether cochlin plays a causal role in mechanisms of POAG and elevated IOP.
Collapse
|