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Liu L, Wang S, Blanco T, Ge H, Zhu S, Yin J, Chen Y, Dana R. Neurokinin-1 Receptor Antagonism Reduces Nonallergic Ocular Redness in a Rabbit Model. J Ocul Pharmacol Ther 2024; 40:445-451. [PMID: 38829162 DOI: 10.1089/jop.2024.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
Purpose: To evaluate the therapeutic efficacy of topical application of a neurokinin-1 receptor (NK1R) antagonist in a rabbit model of nonallergic ocular redness. Methods: Nonallergic ocular redness was induced in rabbits by a single, topical application of dapiparzole hydrochloride eye drops (0.5%, 1%, 2%, or 5%). The NK1R antagonist L-703,606 was topically applied to the eye at the same time of induction or 20 min after induction, and phosphate buffered saline (PBS) treatment served as the control. Superior bulbar conjunctival images were taken every 30 s for the first 2 min, followed by every 4 min for 8 min, and then every 10 min until 1 h. The severity of ocular redness was evaluated on the images using ImageJ-based ocular redness index (ORI) calculations. Results: The ORI scores were significantly increased after the application of 0.5%, 1%, 2%, or 5% dapiparzole at each time point evaluated, with the most severe redness induced by the 5% dapiprazole that led to a maximal mean increase in ORI score of 14 at 20 min post-induction and thus used for subsequent evaluation of therapeutic efficacy of NK1R antagonism. Topical L-703,606, when applied at the same time as dapiprazole induction, significantly suppressed the increase of ORI scores at all time points (∼40% decrease). Furthermore, when applied at 20 min after dapiprazole induction, L-703,606 rapidly and effectively suppressed the increase of ORI scores at 30, 40, 50, and 60 min (∼30% decrease). Conclusions: Topical blockade of NK1R effectively prevents and alleviates nonallergic ocular redness in a novel animal model.
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Affiliation(s)
- Lingjia Liu
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin, China
| | - Shudan Wang
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tomas Blanco
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Hongyan Ge
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shuyan Zhu
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Jia Yin
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Yihe Chen
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Reza Dana
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
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Cai Y, Wu Z, Yuan R, Wang P, Xu H, Xu Y, Yao X, Wang H, Zou J. Alterations in Macular Microvasculature in Pterygium Patients Measured by OCT Angiography. Diagnostics (Basel) 2023; 13:diagnostics13091603. [PMID: 37174994 PMCID: PMC10177751 DOI: 10.3390/diagnostics13091603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/20/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
Previous studies have reported an association between pterygia and maculopathy, yet the underlying mechanisms and alterations to the macular microvasculature in pterygium patients have yet to be fully elucidated. Our study conducted an analysis of macular superficial vessel length density (VLD) and vessel perfusion density (VPD) to establish associations between the conjunctival and macular microvasculature in patients with unilateral and bilateral pterygia. We revealed a loss of macular microvasculature in the outer nasal (ON) region in both unilateral and bilateral pterygium patients. VLD was significantly decreased in both pterygium groups in the ON region, and VPD was notably lower in bilateral pterygium patients in the same area. Furthermore, in unilateral pterygium patients, the vessel percent pixel coverage (PPC) of the pterygium and the area of the pterygium exhibited a negative correlation with VLD in the ON region. Multiple stepwise linear regression models indicated that the PPC could best predict VLP in the ON region. Taken together, our findings suggest that patients with pterygia may be more susceptible to macular diseases, and this may be due to a compensatory increase in blood perfusion via the anterior ciliary artery. These results underscore the importance of managing maculopathy in patients with pterygia.
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Affiliation(s)
- Yingjun Cai
- Eye Center of Xiangya Hospital, Hunan Key Laboratory of Ophthalmology, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zhenkai Wu
- The First People's Hospital of Changde, Changde 415000, China
| | - Ruolan Yuan
- Eye Center of Xiangya Hospital, Hunan Key Laboratory of Ophthalmology, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Pingbao Wang
- Eye Center of Xiangya Hospital, Hunan Key Laboratory of Ophthalmology, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Huizhuo Xu
- Eye Center of Xiangya Hospital, Hunan Key Laboratory of Ophthalmology, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Yi Xu
- Eye Center of Xiangya Hospital, Hunan Key Laboratory of Ophthalmology, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xueyan Yao
- Eye Center of Xiangya Hospital, Hunan Key Laboratory of Ophthalmology, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Hua Wang
- Eye Center of Xiangya Hospital, Hunan Key Laboratory of Ophthalmology, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Jing Zou
- Eye Center of Xiangya Hospital, Hunan Key Laboratory of Ophthalmology, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
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Wang S, Liu L, Blanco T, Ge H, Xia Y, Pang K, Chen Y, Dana R. Therapeutic efficacy of topical blockade of substance P in experimental allergic red eye. Ocul Surf 2022; 26:184-190. [PMID: 36067981 DOI: 10.1016/j.jtos.2022.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE Allergic conjunctivitis is the most common cause leading to ocular redness (OR). Herein, using an animal model of allergic OR, we evaluated the therapeutic efficacy of topical blockade of substance P (SP) in treating red eye. METHODS Allergic OR was induced in guinea pigs with topical histamine. Ocular SP was blocked using a specific SP receptor (neurokinin-1 receptor, NK1R) antagonist, L-703,606, via topical application 10 min before or 10 min after histamine instillation. Animal eyes were examined and a series of images were taken for up to 60 min post-OR induction. The severity of redness was analyzed using the quantitative ocular redness index (ORI). At the end of clinical examination, conjunctival tissues were collected for histological examination of conjunctival blood vessels and infiltrating eosinophils and neutrophils. In addition, SP concentration was quantified in the tear fluid and expression levels of inflammatory cytokines were assessed in the conjunctival tissues. RESULTS Topical histamine application successfully induced red eye, evidenced by the significantly increased ORI during the observation period, with peak values at 10 min, along with significantly increased levels of SP in the tears. Topical treatment with L-703,606, either before histamine application or at the time of peak ORI, effectively reduced ORI and suppressed conjunctival blood vessel dilation, along with decreased eosinophil and neutrophil infiltration, and inflammatory cytokine expression in the conjunctiva, as well as reduced SP levels in the tears. CONCLUSIONS Topical blockade of SP effectively prevents and treats allergy-related ocular redness by suppressing blood vessel dilation and allergic inflammation.
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Affiliation(s)
- Shudan Wang
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Lingjia Liu
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Tomas Blanco
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Hongyan Ge
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Yutong Xia
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Kunpeng Pang
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Yihe Chen
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Reza Dana
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA.
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Mochizuki H, Suyama S, Cha JY, Ho PS, Shimoi A. Optimization of a histamine-induced allergic conjunctivitis model in Guinea pigs. J Pharmacol Toxicol Methods 2021; 113:107133. [PMID: 34798284 DOI: 10.1016/j.vascn.2021.107133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 11/29/2022]
Abstract
Allergic conjunctivitis is one of the most common immune diseases in the field of ophthalmology. The number of patients suffering from allergic conjunctivitis has been increasing, and there is still a strong need for development of therapeutic agents for this disease. In drug development, the utmost important point to improve the success probability is to accurately single out good compounds in the early stage of drug development. Therefore, drug efficacy evaluations in the nonclinical stage should be conducted with high reliability and accuracy. However, there are no literatures investigating the preparation and evaluation methods of animal models of conjunctivitis in details nor the standardized criteria. In this study, we verified the reproducibility of an animal model in the previous report and made improvements in test methods focusing on a guinea pig model of histamine-induced allergic conjunctivitis. Furthermore, the drug efficacy evaluation was conducted using a commercially available antihistamine drug, levocabastine hydrochloride, to judge the suitability of the improved model. As a result, the dose level of histamine needed to be increased to use the existing model for drug efficacy evaluation, but allergic-like symptoms were induced very easily and stably in this model. For observations of symptoms of conjunctivitis, we eliminated ambiguity of evaluation by adopting the Draize scale and ensured a higher objectivity on the evaluation method. The drug efficacy evaluation of levocabastine hydrochloride in the prepared model revealed that drug efficacy of the antihistamine drug was captured according to the standardized test method and highly-reproducible results were obtained.
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Affiliation(s)
- Hidemi Mochizuki
- Ina Research Inc., 2148-188 Nishiminowa, Ina, Nagano 399-4501, Japan.
| | - Susumu Suyama
- Ina Research Inc., 2148-188 Nishiminowa, Ina, Nagano 399-4501, Japan.
| | - Joo Young Cha
- JW Pharmaceutical Corporation, 2477, Nambusunhwan-ro, Seocho-gu, Seoul 137-864, Republic of Korea.
| | - Pil-Su Ho
- JW Pharmaceutical Corporation, 2477, Nambusunhwan-ro, Seocho-gu, Seoul 137-864, Republic of Korea.
| | - Akihito Shimoi
- Ina Research Inc., 2148-188 Nishiminowa, Ina, Nagano 399-4501, Japan.
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Singh RB, Liu L, Yung A, Anchouche S, Mittal SK, Blanco T, Dohlman TH, Yin J, Dana R. Ocular redness - II: Progress in development of therapeutics for the management of conjunctival hyperemia. Ocul Surf 2021; 21:66-77. [PMID: 34000363 DOI: 10.1016/j.jtos.2021.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 11/30/2022]
Abstract
Conjunctival hyperemia is one of the most common causes for visits to primary care physicians, optometrists, ophthalmologists, and emergency rooms. Despite its high incidence, the treatment options for patients with conjunctival hyperemia are restricted to over-the-counter drugs that provide symptomatic relief due to short duration of action, tachyphylaxis and rebound redness. As our understanding of the immunopathological pathways causing conjunctival hyperemia expands, newer therapeutic targets are being discovered. These insights have also contributed to the development of animal models for mimicking the pathogenic changes in microvasculature causing hyperemia. Furthermore, this progress has catalyzed the development of novel therapeutics that provide efficacious, long-term relief from conjunctival hyperemia with minimal adverse effects.
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Affiliation(s)
- Rohan Bir Singh
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Lingjia Liu
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Ann Yung
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Sonia Anchouche
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sharad K Mittal
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Tomas Blanco
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Thomas H Dohlman
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Jia Yin
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Reza Dana
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
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6
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Aicher N, Nagahori K, Inoue M, Itoh Y, Hirakata A. Vascular Density of the Anterior Segment of the Eye Determined by Optical Coherence Tomography Angiography and Slit-Lamp Photography. Ophthalmic Res 2020; 63:572-579. [DOI: 10.1159/000506953] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/02/2020] [Indexed: 11/19/2022]
Abstract
<b><i>Objective:</i></b> To determine the vascular density of the anterior segment (AS) of the eye from optical coherence tomography angiography (OCTA) images and slit-lamp photographs. <b><i>Methods:</i></b> A swept-source OCTA (Plex Elite 9000; Carl Zeiss) device modified with a +10-diopter lens was used to record the vasculature of the AS. Twenty eyes, including 4 eyes of 4 healthy subjects and 16 eyes of 12 patients scheduled for cataract surgery or combined vitrectomy and cataract surgery, were studied. The slit-lamp photographs of the AS were acquired concurrently with the AS-OCTA images. The vascular density was measured preoperatively and postoperatively in the nasal, temporal, superior, and inferior quadrants after binarization with ImageJ software. <b><i>Results:</i></b> Acceptable AS-OCTA images were obtained of 65% (superior), 80% (nasal), 70% (inferior), and 80% (temporal) of the eyes. The percentage of acceptable images was significantly lower in the superior quadrant among the AS-OCTA images than among the AS photographs (100%; <i>p</i> = 0.004). The vascular density determined by AS-OCTA was higher than that determined in the AS photographs in all quadrants (<i>p</i> = 0.011 to <0.001). The AS-OCTA B-mode images showed that vascular flow was identified mainly between the conjunctiva and sclera but not in the ciliary body. The vascular density increased significantly after cataract surgery in the superior quadrant, which was significantly correlated with the location of the surgical incision (<i>p</i> = 0.03). <b><i>Conclusion:</i></b> AS-OCTA can obtain images with higher vascular density of the conjunctiva and sclera than slit-lamp photographs, and AS-OCTA images can show a postoperative increase in vascular density.
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Yoneda T, Sumi T, Hoshikawa Y, Kobayashi M, Fukushima A. Hyperemia Analysis Software for Assessment of Conjunctival Hyperemia Severity. Curr Eye Res 2018; 44:376-380. [DOI: 10.1080/02713683.2018.1554153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Tsuyoshi Yoneda
- Department of Sensory Science, Kawasaki University of Medical Welfare, Okayama, Japan
- Department of Ophthalmology, Kochi Medical School, Nankoku-city, Kochi, Japan
| | - Tamaki Sumi
- Department of Ophthalmology, Kochi Medical School, Nankoku-city, Kochi, Japan
| | | | | | - Atsuki Fukushima
- Department of Ophthalmology, Kochi Medical School, Nankoku-city, Kochi, Japan
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Banaee T, Pourreza H, Doosti H, Abrishami M, Ehsaei A, Basiry M, Pourreza R. Distribution of Different Sized Ocular Surface Vessels in Diabetics and Normal Individuals. J Ophthalmic Vis Res 2017; 12:361-367. [PMID: 29090043 PMCID: PMC5644400 DOI: 10.4103/jovr.jovr_238_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose: To compare the distribution of different sized vessels using digital photographs of the ocular surface of diabetic and normal individuals. Methods: In this cross-sectional study, red-free conjunctival photographs of diabetic and normal individuals, aged 30-60 years, were taken under defined conditions and analyzed using a Radon transform-based algorithm for vascular segmentation. The image areas occupied by vessels (AOV) of different diameters were calculated. The main outcome measure was the distribution curve of mean AOV of different sized vessels. Secondary outcome measures included total AOV and standard deviation (SD) of AOV of different sized vessels. Results: Two hundred and sixty-eight diabetic patients and 297 normal (control) individuals were included, differing in age (45.50 ± 5.19 vs. 40.38 ± 6.19 years, P < 0.001), systolic (126.37 ± 20.25 vs. 119.21 ± 15.81 mmHg, P < 0.001) and diastolic (78.14 ± 14.21 vs. 67.54 ± 11.46 mmHg, P < 0.001) blood pressures. The distribution curves of mean AOV differed between patients and controls (smaller AOV for larger vessels in patients; P < 0.001) as well as between patients without retinopathy and those with non-proliferative diabetic retinopathy (NPDR); with larger AOV for smaller vessels in NPDR (P < 0.001). Controlling for the effect of confounders, patients had a smaller total AOV, larger total SD of AOV, and a more skewed distribution curve of vessels compared to controls. Conclusion: Presence of diabetes mellitus is associated with contraction of larger vessels in the conjunctiva. Smaller vessels dilate with diabetic retinopathy. These findings may be useful in the photographic screening of diabetes mellitus and retinopathy.
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Affiliation(s)
- Touka Banaee
- Retina Research Center, Mashhad University of Medical Sciences, Mashhad, Irna.,Department of Ophthalmology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Pourreza
- Computer Engineering Department, School of Engineering, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Hassan Doosti
- Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Abrishami
- Retina Research Center, Mashhad University of Medical Sciences, Mashhad, Irna
| | - Asieh Ehsaei
- Refractive Error Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Basiry
- Retina Research Center, Mashhad University of Medical Sciences, Mashhad, Irna
| | - Reza Pourreza
- Department of Electrical Engineering, University of Texas at Dallas, Richardson, USA
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Kim SY, Chun BY. Effects of Corneal Toxicity and Conjunctival Injection of Preservative-free 0.1% Fluorometholone after Pediatric Strabismus Surgery. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.7.846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Su Yeon Kim
- Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Bo Young Chun
- Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea
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Stuebiger N, Smiddy W, Wang J, Jiang H, DeBuc DC. Assesment of Conjunctival Microangiopathy in a Patient with Diabetes Mellitus Using the Retinal Function Imager. ACTA ACUST UNITED AC 2015; 6. [PMID: 26301125 PMCID: PMC4541803 DOI: 10.4172/2155-9570.1000400] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Diabetes mellitus (DM) is notorious for causing retinal microangiopathy, but bulbar conjunctival microangiopathy (CM) mirroring the established retinal vessel changes, has also been observed. Recent studies suggest that CM occurs in all DM patients in various degrees depending on disease severity and occur even before non-proliferative retinopathy develops. Thus, CM might provide a means of early detection or even form a basis for early intervention of disease progression in DM patients. Herein we present - to our knowledge for the first time-the feasibility and applicability in diagnostic imaging of CM in a diabetic patient using a commercially available Retinal Function Imager (RFI, Optical Imaging Ltd, Rehovot, Israel).
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Affiliation(s)
- Nicole Stuebiger
- Bascom Palmer Eye Institute, University of Miami, 900 NW 17th Street, Miami, Florida, 33136, USA ; Charite, Universitaetsmedizin Berlin, Campus Benjamin Franklin, University Eye Hospital, Hindenburgdamm 30, 12200 Berlin, Germany
| | - William Smiddy
- Bascom Palmer Eye Institute, University of Miami, 900 NW 17th Street, Miami, Florida, 33136, USA
| | - Jianhua Wang
- Bascom Palmer Eye Institute, University of Miami, 900 NW 17th Street, Miami, Florida, 33136, USA
| | - Hong Jiang
- Bascom Palmer Eye Institute, University of Miami, 900 NW 17th Street, Miami, Florida, 33136, USA
| | - Delia Cabrera DeBuc
- Bascom Palmer Eye Institute, University of Miami, 900 NW 17th Street, Miami, Florida, 33136, USA
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11
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Banaee T. Comment on 'Distribution of normal superficial ocular vessels in digital images'. Cont Lens Anterior Eye 2014; 37:473. [PMID: 25439760 DOI: 10.1016/j.clae.2014.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 09/11/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Touka Banaee
- Retina Research Center, Mashhad University of Medical Sciences, Iran.
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Abstract
Conjunctival hyperemia is observed in a variety of ocular inflammatory conditions. The evaluation of hyperemia is indispensable for the treatment of patients with ocular inflammation. However, the major methods currently available for evaluation are based on nonquantitative and subjective methods. Therefore, we developed novel software to evaluate bulbar hyperemia quantitatively and objectively. First, we investigated whether the histamine-induced hyperemia of guinea pigs could be quantified by image analysis. Bulbar conjunctival images were taken by means of a digital camera, followed by the binarization of the images and the selection of regions of interest (ROIs) for evaluation. The ROIs were evaluated by counting the number of absolute pixel values. Pixel values peaked significantly 1 minute after histamine challenge was performed and were still increased after 5 minutes. Second, we applied the same method to antigen (ovalbumin)-induced hyperemia of sensitized guinea pigs, acquiring similar results except for the substantial upregulation in the first 5 minutes after challenge. Finally, we analyzed human bulbar hyperemia using the new software we developed especially for human usage. The new software allows the automatic calculation of pixel values once the ROIs have been selected. In our clinical trials, the percentage of blood vessel coverage of ROIs was significantly higher in the images of hyperemia caused by allergic conjunctival diseases and hyperemia induced by Bimatoprost, compared with those of healthy volunteers. We propose that this newly developed automated hyperemia analysis software will be an objective clinical tool for the evaluation of ocular hyperemia.
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13
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Zhao WJ, Duan F, Li ZT, Yang HJ, Huang Q, Wu KL. Evaluation of regional bulbar redness using an image-based objective method. Int J Ophthalmol 2014; 7:71-6. [PMID: 24634867 DOI: 10.3980/j.issn.2222-3959.2014.01.13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/25/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To develop an image-based objective method to precisely evaluate regional ocular bulbar injection. METHODS Six healthy adult volunteers were photographed in four orientations (superior, inferior, nasal and temporal sides) with and without stimulating eye drops. Six line segments (covering 30°) were drawn 4mm away from the limbus on each image using ImageJ software. The graph peaks, which were derived from the areas under the line segments and corresponded to the cross-sectional grey-level of the vessels, were analyzed to obtain peak area, peak height/width (PH/PW), and peak numbers. Different-sized areas were selected to calculate the pixels based on the edge-detection algorithm. Also, conjunctival and superficial scleral vessels were analyzed separately. RESULTS This method had a smaller coefficient of variation, especially for PH/PW, in all four orientations. Hyperaemia parameters changed the least after challenging in the superior region. Moreover, 95% of the PH/PW ratios were greater than 0.87 in conjunctival vessels and less than 1.00 in superficial scleral vessels. PH/PW significantly increased in conjunctival vessels and changed less in superficial scleral vessels. CONCLUSION A new method of objectively assessing bulbar injection based on ocular surface images was developed. This method can be used to quantify ocular regional injection and to distinguish the superficial scleral and conjunctival vessels.
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Affiliation(s)
- Wen-Juan Zhao
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Fang Duan
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Zhong-Ting Li
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Hua-Jun Yang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Qiang Huang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Kai-Li Wu
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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Sárándi I, Claßen DP, Astvatsatourov A, Pfaar O, Klimek L, Mösges R, Deserno TM. Quantitative Conjunctival Provocation Test for Controlled Clinical Trials. Methods Inf Med 2014; 53:238-244. [DOI: 10.3414/me13-12-0142] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
SummaryBackground: The conjunctival provocation test (CPT) is a diagnostic procedure for the assessment of allergic diseases. Photographs are taken before and after provocation increasing the redness of the conjunctiva due to hyperemia.Objective: We propose and evaluate an automatic image processing pipeline for objective and quantitative CPT.Method: After scale normalization based on intrinsic image features, the conjunctiva region of interest (ROI) is segmented combining thresholding, edge detection and Hough transform. Redness of the ROI is measured from 0 to 1 by the average pixel redness, which is defined by truncated projection in HSV space. In total, 92 images from an observational diagnostic study are processed for evaluation. The database contains images from two visits for assessment of the test- retest reliability (46 images per visit).Result: All images were successfully processed by the algorithm. The relative redness increment correlates between the two visits with Pearson’s r = 0.672 (p < .001). Linear correlation of the automatic measure is larger than the manual measure (r = 0.59). This indicates a higher reproducibility and stability of the automatic method.Conclusion: We presented a robust and effective way to objectify CPT. The algorithm operates on low resolution, is fast and requires no manual input. Quantitative CPT measures can now be established as surrogate endpoint in controlled clinical trials.
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Dogan S, Astvatsatourov A, Deserno TM, Bock F, Shah-Hosseini K, Michels A, Mösges R. Objectifying the conjunctival provocation test: photography-based rating and digital analysis. Int Arch Allergy Immunol 2013; 163:59-68. [PMID: 24248100 DOI: 10.1159/000355333] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 08/28/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Patients with allergic rhinoconjunctivitis are susceptible to both nasal and ocular symptoms. The conjunctival provocation test (CPT) is an established diagnostic procedure used in allergic rhinoconjunctivitis, particularly to document a patient's current reactivity to allergens. To date, there are no international guidelines defining the CPT. No approved evaluation method exists for interpreting CPT results. This paper aims to establish the digital analysis of macroimages as an objective, validated and standardized method for interpreting CPT results. METHODS In a clinical immunotherapy trial with 155 patients, treatment progress was documented based on the CPT. Local investigators used a symptom score to grade tearing, reddening and the patients' subjective perception of symptoms (mucosal irritation). A central observer rated conjunctival hyperemia via digital photography. Digital image analysis software was utilized to determine conjunctival hyperemia. RESULTS Spearman's correlation between the local investigators' and the central observer's ratings was r = 0.729 (p < 0.001); the percentage of total agreement was 48% (based on 739 photos). Digital image analysis (based on 48 photos) had a high percentage of total agreement with the central observer's ratings (69%) but a low percentage of total agreement with the investigators' ratings (38%). The corresponding correlations were r = 0.264 and 0.064, respectively. CONCLUSION Photography-based rating by a central observer may represent a valuable supplement to the local investigator's assessment for making an objective evaluation of CPT results. Digital image analysis possesses the potential of being an objective evaluation method compared to the wide-spread subjective evaluation by the investigators.
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Affiliation(s)
- S Dogan
- Institute of Medical Statistics, Informatics and Epidemiology, University Hospital Cologne, Cologne, Germany
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Banaee T, Ehsaei A, Pourreza H, Khajedaluee M, Abrishami M, Basiri M, Daneshvar Kakhki R, Pourreza R. Distribution of normal superficial ocular vessels in digital images. Cont Lens Anterior Eye 2013; 37:11-5. [PMID: 23962767 DOI: 10.1016/j.clae.2013.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 07/11/2013] [Accepted: 07/12/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE To investigate the distribution of different-sized vessels in the digital images of the ocular surface, an endeavor which may provide useful information for future studies. METHODS This study included 295 healthy individuals. From each participant, four digital photographs of the superior and inferior conjunctivae of both eyes, with a fixed succession of photography (right upper, right lower, left upper, left lower), were taken with a slit lamp mounted camera. Photographs were then analyzed by a previously described algorithm for vessel detection in the digital images. The area (of the image) occupied by vessels (AOV) of different sizes was measured. Height, weight, fasting blood sugar (FBS) and hemoglobin levels were also measured and the relationship between these parameters and the AOV was investigated. RESULTS These findings indicated a statistically significant difference in the distribution of the AOV among the four conjunctival areas. No significant correlations were noted between the AOV of each conjunctival area and the different demographic and biometric factors. Medium-sized vessels were the most abundant vessels in the photographs of the four investigated conjunctival areas. The AOV of the different sizes of vessels follows a normal distribution curve in the four areas of the conjunctiva. The distribution of the vessels in successive photographs changes in a specific manner, with the mean AOV becoming larger as the photos were taken from the right upper to the left lower area. CONCLUSIONS The AOV of vessel sizes has a normal distribution curve and medium-sized vessels occupy the largest area of the photograph.
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Affiliation(s)
- Touka Banaee
- Retina Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Asieh Ehsaei
- Refractive Error Research Centre, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Pourreza
- Computer Engineering Department, Faculty of Engineering, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Mohammad Khajedaluee
- Department of Social Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Abrishami
- Retina Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Basiri
- Retina Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Reza Pourreza
- Computer Engineering Department, Faculty of Engineering, Ferdowsi University of Mashhad, Mashhad, Iran
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Automated hyperemia analysis software: reliability and reproducibility in healthy subjects. Jpn J Ophthalmol 2011; 56:1-7. [PMID: 22130522 DOI: 10.1007/s10384-011-0107-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 10/05/2011] [Indexed: 10/15/2022]
Abstract
PURPOSE To evaluate the reliability and reproducibility of automated software to analyze human bulbar hyperemia. METHODS We enrolled 89 healthy volunteers in this study. A slit lamp was used to take pictures of the conjunctiva on the temporal side of each subject's right eye. Photographic conditions were standardized by using a single photographer. Images were transferred to software for automatic pixel value calculation in the green channel of the region of interest (ROI). We investigated optimal ROI size, mean ROI pixel frequency, percentage ROI blood vessel coverage, and data reproducibility. We also used this software to evaluate bimatoprost-induced hyperemia and hyperemia in allergic conjunctival diseases. RESULTS The optimal ROI was found to be 400 vertical pixels by 300 horizontal pixels. Mean ROI pixel frequency was 5305 and % coverage was 4.4%. We confirmed the reproducibility of the analysis by comparing two images (r (2) = 0.7, P < 0.0001). Percentage blood vessel coverage increased in images of bimatoprost-induced hyperemia and hyperemia in allergic conjunctival diseases compared to the data from healthy volunteers. CONCLUSIONS The software was simple to use and provided reproducible data. We established standard settings for the operation of the software. The use of our software will improve hyperemia evaluation, which is presently done using nonquantitative methods.
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Papathanassiou M, Giannoulaki V, Zampeli E, Tiligada E. Effect of aminoguanidine on the conjunctival histamine and nitrite levels in experimental conjunctivitis. J Ocul Pharmacol Ther 2011; 27:137-42. [PMID: 21500983 DOI: 10.1089/jop.2010.0147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Histamine and nitric oxide (NO) play pivotal roles in ocular surface hypersensitivity reactions, whereas the activity of their metabolic enzymes diamine oxidase (DAO) and NO synthase (NOS) may affect their function. This study aimed at investigating the effects of ocular administration of aminoguanidine (AMG), a multiple action DAO and NOS inhibitor, on the conjunctival histamine and nitrite levels in a model of experimental conjunctivitis. METHODS AMG, at 0.81, 81 or 81×10(3) μM, was instilled into the lower conjunctival fornix of normal and compound 48/80 (C48/80)-challenged eyes of male Wistar rats in the absence or presence of 40 mg/mL disodium cromoglycate. Histamine and nitrite were quantified in the conjunctival homogenate and lavage fluid 45 min and 6 h postchallenge, respectively. RESULTS AMG induced no significant alterations in basal histamine and nitrite levels in the normal rat eye. In experimental conjunctivitis, AMG failed to modify the reduction in histamine content and partially circumvented the increases in nitrite levels observed during the early and late phase reactions, respectively. In the presence of disodium cromoglycate, AMG significantly increased the levels of both proinflammatory mediators in the normal rat eye. CONCLUSIONS The data suggested that DAO may not be the main route of in situ histamine catabolism in the normal and C48/80-challenged rat conjunctiva, whereas NOS contributes to the phenotypic alterations observed in mast cell-dependent conjunctivitis. Mast cell stabilizing agents and AMG-modulated systems seem to interact through yet undefined mechanisms in the different phases of ocular hypersensitivity reactions.
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Fukushima A, Tomita T. Image analyses of conjunctival hyperemia in guinea pig allergic conjunctivitis. Graefes Arch Clin Exp Ophthalmol 2009; 247:1571-2. [PMID: 19544064 DOI: 10.1007/s00417-009-1123-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Revised: 06/02/2009] [Accepted: 06/03/2009] [Indexed: 11/28/2022] Open
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