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Manners S, Morgan W, Morlet N, Meuleners L, Liu W, Morlet H, Ng JQ. Epidemiology of Field of Vision Disorders (eFOVID) study, Western Australia, 1988-2022. Report 1: Data collection and aggregation protocol. Clin Exp Ophthalmol 2024. [PMID: 39073299 DOI: 10.1111/ceo.14422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 07/04/2024] [Accepted: 07/08/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Computerised static visual field testing using dedicated machines such as the Humphrey Field Analyzer (HFA) can assess and track changes in visual field sensitivity. The use of retrospective visual field databases is a novel undertaking, with no studies published utilising large scale population-level data. This study phase developed a method to extract HFA data into a large standardised population-based database including point sensitivity data with additional derived variables. METHODS Retrospective, longitudinal, population study of visual field data from people who attended an ophthalmology service and had a HFA field test, in Western Australia, between 1988 and 2022. Raw test data included patient demographic fields, sensitivity readings and test parameters. Calculated fields included reliability scores, and a novel combined reliability score. RESULTS There were 606 230 tests for 92 215 study individuals, from 22 ophthalmology practices in metropolitan Perth and three public hospital eye clinics, representing around 85% of the field tests performed by ophthalmologists each year. Raw sensitivity values were available for all tests, and additional descriptors were available for most tests (97.5%-100% of tests) with the exception of data variables retired by the manufacturer. CONCLUSIONS Visual field data from 606 230 tests were collated into a single dataset, which is highly representative over a long period of time, for a defined population. This dataset has been linked to other administrative datasets to allow for epidemiological investigation of field of vision disorders.
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Affiliation(s)
- Siobhan Manners
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - William Morgan
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Nigel Morlet
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Lynn Meuleners
- Western Australian Centre for Road Safety, School of Psychology, The University of Western Australia, Perth, Western Australia, Australia
| | - Wei Liu
- School of Physics, Mathematics and Computing, The University of Western Australia, Perth, Western Australia, Australia
| | - Hector Morlet
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Jonathon Q Ng
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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Cifuentes-González C, Rojas-Carabali W, Mejía Salgado G, Pineda-Sierra JS, Polania D, Garzón-Dangond JM, Orozco JS, Soto-Ariño J, Lesley-Cruz D, de-la-Torre A. Colombian ocular diseases epidemiology study (CODES): glaucoma incidence and sociodemographic characterisation 2015-2020. Clin Exp Optom 2024:1-7. [PMID: 39048299 DOI: 10.1080/08164622.2024.2377386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 06/25/2024] [Accepted: 07/02/2024] [Indexed: 07/27/2024] Open
Abstract
CLINICAL RELEVANCE Glaucoma encompasses a group of eye diseases that progressively damage the optic nerve, leading to vision loss and blindness. Understanding the incidence and demographic distribution is vital for public health planning and patient care. BACKGROUND Previous small-scale studies in Colombia have reported the prevalence of glaucoma in individuals over 40 years between 1.1% and 5.29%. These data may not fully capture the true extent of the disease. Furthermore, with the ageing population, the incidence of glaucoma is likely to increase, highlighting the need for up-to-date incidence data to guide healthcare planning. METHODS Data were obtained from the Social Protection Information System, the primary health record repository of Colombia, using the International Classification of Disease 10 for glaucoma. Crude incidence rates were calculated and adjusted for sex, age, and gender. The 2020 incidence was compared with estimated rates from previous years to assess the impact of the coronavirus disease 2019 lockdown. A standardised morbidity map was created to show regional variations. RESULTS The average incidence of glaucoma in Colombia was 17.36 per 1,000 inhabitants, increasing from 12.29 in 2015 to 24.22 in 2019. Of the 212,700 reported cases, 60.75% were females. Primary open-angle glaucoma was the most prevalent type, with significant incidence in the elderly over 70 years of age, irrespective of sex. Bogotá, Antioquia, and Valle del Cauca had the highest numbers of new cases. CONCLUSION The increasing incidence of glaucoma and its demographic and geographical variations necessitate the awareness of ophthalmologists and optometrists. This study emphasises the need for continuous monitoring, effective interventions, and developing healthcare strategies to address the escalating challenge of glaucoma in Colombia.
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Affiliation(s)
- Carlos Cifuentes-González
- Neuroscience (NEUROS) Research Group, NeuroVitae Centre for Neuroscience, Institute of Translational Medicine (IMT), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - William Rojas-Carabali
- Neuroscience (NEUROS) Research Group, NeuroVitae Centre for Neuroscience, Institute of Translational Medicine (IMT), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Germán Mejía Salgado
- Neuroscience (NEUROS) Research Group, NeuroVitae Centre for Neuroscience, Institute of Translational Medicine (IMT), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Juan Sebastián Pineda-Sierra
- Ophthalmology Interest Group Universidad del Rosario (OIG UR), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Diego Polania
- Ophthalmology Interest Group Universidad del Rosario (OIG UR), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Juan Manuel Garzón-Dangond
- Ophthalmology Interest Group Universidad del Rosario (OIG UR), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Juan Sebastian Orozco
- Ophthalmology Interest Group Universidad del Rosario (OIG UR), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Jaime Soto-Ariño
- Ophthalmology Interest Group Universidad del Rosario (OIG UR), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Danna Lesley-Cruz
- Clinical Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Alejandra de-la-Torre
- Neuroscience (NEUROS) Research Group, NeuroVitae Centre for Neuroscience, Institute of Translational Medicine (IMT), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
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Wu JH, Halfpenny W, Bu J, Brar M, Weinreb RN, Baxter SL. Social factors associated with the risk of glaucoma suspect conversion to glaucoma: analysis of the nationwide All of Us Program. Ophthalmol Glaucoma 2024:S2589-4196(24)00102-9. [PMID: 38959998 DOI: 10.1016/j.ogla.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/13/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024]
Abstract
PURPOSE To examine social factors associated with the 5-year risk of glaucoma suspects (GS) converting to open-angle glaucoma (OAG). DESIGN Retrospective cohort analysis. SUBJECTS We screened for participants diagnosed with GS in the All of Us database. Cases that converted to OAG within 5 years of GS diagnosis (the "conversion group") were compared with control cases that did not convert. METHODS Demographic, socioeconomic and healthcare utilization data of the cases were extracted and compared between the conversion group and the control group. Multivariable Cox proportional hazards modeling was used to identify potential factors associated with the risk of conversion. MAIN OUTCOME MEASURES Hazard ratios (HRs) of significant factors associated with the risk of conversion. RESULTS A total of 5274 GS participants were identified, and 786 (15%) cases converted to OAG within 5-year follow-up. The two groups showed significant differences in age, race, gender, employment status, income/education level, history of intra-ocular surgery, and healthcare utilization patterns. In the multivariable model, African American/Black race (HR [95% confidence interval] =1.70 [1.44-2.00]), older age at GS diagnosis (1.17 [1.09-1.25]), male gender (1.30 [1.13-1.50], no history of recreational drug use (1.23 [1.07-1.42]), history of intra-ocular surgery (1.60 [1.02-1.53]) and having more reasons for delayed healthcare access (2.27 [1.23-4.18]) were associated with a greater hazard of conversion, while being employed (0.71 [0.60-0.86]) was associated with a smaller hazard of conversion (P<0.05 for all). CONCLUSIONS Several social factors were associated with the conversion from GS to OAG, which may help to identify patients at higher risk of disease progression. Future studies are needed to examine the basis for these findings and the potential interventions that could address them.
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Affiliation(s)
- Jo-Hsuan Wu
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California; Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Willam Halfpenny
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Jennifer Bu
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Manreet Brar
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Robert N Weinreb
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Sally L Baxter
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California; Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States.
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Hou J, Wen Y, Gao S, Jiang Z, Tao L. Association of dietary intake of B vitamins with glaucoma. Sci Rep 2024; 14:8539. [PMID: 38609427 PMCID: PMC11014949 DOI: 10.1038/s41598-024-58526-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
This cross-sectional study investigated the association between glaucoma and B vitamin dietary intake. A total of 5025 enrolled individuals participated in self-reported glaucoma questionnaire and 3264 participated in International Society Geographical and Epidemiological Ophthalmology (ISGEO) criteria. In self-reported glaucoma, the risk of having self-reported glaucoma was lower in the third quartile of vitamin B1 intake (odds ratio [odds ratio [OR] 0.63, 95% confidence interval [CI] 0.40-0.97), and P trend (P trend = 0.004) for vitamin B12 was significant; in males, the third quartile of vitamin B1 intake (OR 0.44, 95% CI 0.24-0.83) and the fourth quartile of vitamin B2 intake (OR 0.39, 95% CI 0.17-0.89) were associated with a lower risk. In glaucoma based on ISGEO criteria, the increase of niacin intake (OR 0.94, 95% CI 0.89-0.99) was negatively associated with the odds of self-reported glaucoma. After sex-stratified analysis, the third quartile of vitamin B6 intake (OR 0.21, 95% CI 0.08-0.60) in males were associated with reduced odds of glaucoma. The restricted cubic spline analysis revealed a nonlinear association of vitamin B2 (p for nonlinearity = 0.04) and B9 (p for nonlinearity = 0.024) intake with glaucoma diagnosed by ISGEO criteria in females.
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Affiliation(s)
- Jingjing Hou
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Yu Wen
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Sijia Gao
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Zhengxuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, China
| | - Liming Tao
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, China.
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Golshan-Tafti A, Bahrami M, Mohsenzadeh-Yazdi R, Dastgheib SA, Aghasipour M, Shiri A, Alijanpour K, Asadian F, Aghili K, Manzourolhojeh M, Neamatzadeh H. Consolidating data on the association of IL-6 and IL-10 polymorphisms with the development of glaucoma: a meta-analysis. Ophthalmic Genet 2024:1-11. [PMID: 38602069 DOI: 10.1080/13816810.2024.2336964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/26/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND The study aimed to investigate the association of IL-6 and IL-10 polymorphisms with susceptibility to glaucoma by analyzing all relevant individual studies. MATERIALS AND METHODS Relevant articles were gathered from PubMed, Web of Science, Embase, WanFang, and CNKI databases up to 15 October 2023. Odds ratios (ORs) were used to evaluate the association strengths, along with 95% confidence intervals (CIs). RESULTS Seven case-control studies involving 1408 cases and 1789 controls on the IL-6 -174 G>C polymorphism, and three studies with 675 cases and 1100 controls on the IL-6 -572 G>C were included. Moreover, three separate studies, each comprising 442 cases and 672 controls, investigated the IL-10 -592C>A, -819T>C, and -1082A>G polymorphisms. The combined data indicated a significant association between -592C>A, -819T>C, and -1082A>G at IL-10 gene and IL-6 -572 G>C with glaucoma susceptibility, with no correlation found for IL-6 -174 G>C. CONCLUSIONS The study found that IL-10 -592C>A, -819T>C, -1082A>G, and IL-6 -572 G>C polymorphisms were linked to glaucoma risk. However, no significant association was observed for IL-6 -174 G>C. These findings imply a possible connection between genetic variations in these genes and glaucoma risk. Further research is crucial to fully understand the underlying mechanisms and their significance in managing and preventing glaucoma.
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Affiliation(s)
- Ahmadreza Golshan-Tafti
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Bahrami
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reyhaneh Mohsenzadeh-Yazdi
- Department of Engineering and Public Policy, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Seyed Alireza Dastgheib
- Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Aghasipour
- Department of Cancer Biology, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Amirmasoud Shiri
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Alijanpour
- General Practitioner, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Asadian
- Department of Medical Laboratory Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kazem Aghili
- Department of Radiology, Shahid Rahnemoun Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Manzourolhojeh
- Mother and Newborn Health Research Center, Shahid Sadoughi Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Neamatzadeh
- Mother and Newborn Health Research Center, Shahid Sadoughi Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Cobbs LV, Mahmoudzadeh R, Salabati M, Hamati J, Yonekawa Y, Russ Soares R. Trends in Geographic Distribution of Visual Disability - United States, 2010-2019. Semin Ophthalmol 2024; 39:209-216. [PMID: 37876215 DOI: 10.1080/08820538.2023.2273855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023]
Abstract
PURPOSE We aimed to describe changes in the geographic distribution of self-reported visual impairment (VI) over the last decade (2010-2019) in the U.S. METHODS Our study was an analysis of publicly available data collected between 2010 and 2019 from the Census Bureau American Community Survey. RESULTS The mean overall prevalence of self-reported VI from 2010 to 2019 was 2.31% in the United States, and there was a significant increase in VI over the past decade from 2.25% in 2010-2014 to 2.37% in 2015-2019 (p < .001). VI was significantly higher in rural counties (3.58%), compared to urban (3.10%) or metropolitan counties (2.18%) (p < .001). In terms of geographic region, the South of the United States had the highest rate of VI (2.63%) (p < .001). For age groups > 17-years-old in the 2010-2019 data, women had higher rates of VI compared to men. CONCLUSIONS Prevalence of self-reported visual impairment has risen and disproportionately affects certain communities. This includes individuals living in the South, in rural counties, and women.
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Affiliation(s)
- Lucy V Cobbs
- Mid Atlantic Retina, Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA
| | - Raziyeh Mahmoudzadeh
- Mid Atlantic Retina, Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA
| | - Mirataollah Salabati
- Mid Atlantic Retina, Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA
| | - Jacquelyn Hamati
- Mid Atlantic Retina, Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA
| | - Yoshihiro Yonekawa
- Mid Atlantic Retina, Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA
| | - Rebecca Russ Soares
- Mid Atlantic Retina, Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA
- Retina Service, Ophthalmic Consultants of Boston, Boston, USA
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Acuff K, Wu JH, Varkhedi V, Baxter SL. Social determinants of health and health disparities in glaucoma: A review. Clin Exp Ophthalmol 2024; 52:276-293. [PMID: 38385607 PMCID: PMC11038416 DOI: 10.1111/ceo.14367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/23/2024]
Abstract
Social determinants of health and barriers to care can significantly impact patients' access to glaucoma care and treatment, resulting in disparities within disease presentation, progression, management, and treatment outcomes. The widespread adoption of electronic health record systems has allowed researchers and clinicians to further explore these relationships, identifying factors such as race, ethnicity, and socioeconomic status to be risk factors for more severe disease and lower treatment adherence. These disparities highlight potential targets for interventions to combat these disparities and improve overall patient outcomes. This article provides a summary of the available data on health disparities within glaucoma disease presentation, progression, management, treatment, and outcomes and discusses interventions to improve care delivery and outcomes among patients with glaucoma.
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Affiliation(s)
- Kaela Acuff
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Jo-Hsuan Wu
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Varsha Varkhedi
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
| | - Sally L. Baxter
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
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Mannaf SMA, Islam MS, Islam MN, Rahman MM, Parvin S, Rahman S, Sarker BKD. Population-based survey of the prevalence and types of glaucoma in Bangladesh. BMJ Open Ophthalmol 2024; 9:e001609. [PMID: 38538147 PMCID: PMC10982763 DOI: 10.1136/bmjophth-2023-001609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND To delineate the epidemiological landscape of glaucoma using a population-based sample representative of Bangladesh. METHODS Using multistage stratified cluster random sampling, households were selected to identify individuals ≥35 years across all 8 divisions of Bangladesh. Sampling frames were derived from the 2011 national census. Fifty-eight study examination sites were set up for comprehensive eye evaluations, including intraocular pressure, gonioscopy and visual field testing when indicated. International Society for Geographic and Epidemiological Ophthalmology definitions were used to define glaucoma and glaucoma suspect cases. RESULTS One hundred forty clusters (89 rural and 51 urban) were randomly selected, and 13 791 residential households were visited. We invited 17 002 individuals ≥35 years for on-site examination, of which 12 000 (71%) complied, with a male-to-female ratio of 1:1. The prevalence of glaucoma was 3.2% (95% CI 2.79% to 3.64%), and glaucoma suspect was 10.1% (95% CI 9.05% to 11.12%). The majority (78%) had primary open-angle glaucoma (POAG), while angle closure was seen in 16%. Of the POAG, 83% (n=251) were normal-tension glaucoma. Multivariable logistic regression showed increasing age (OR=1.01 for every 5-year increment, 95% CI 1 to 1.01) and male gender (OR=1.43, 95% CI 1.15 to 1.77) to be associated with an increased risk of glaucoma. CONCLUSIONS The prevalence of glaucoma in Bangladesh is 3.2% in ≥35-year-old individuals with older men most at risk. Extrapolating the results, we estimate about 2 million patients with glaucoma. Though normal-tension variety was the most common type, caution should be exercised in generalising these results to other populations.
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Affiliation(s)
- Sheikh M A Mannaf
- Ophthalmology, BIRDEM, Dhaka, Bangladesh
- Harun Eye Hospital, Dhaka, Bangladesh
| | | | - M Nazrul Islam
- Ophthalmology, BIRDEM, Dhaka, Bangladesh
- Glaucoma, Bangladesh Eye Hospital & Institute, Dhaka, Bangladesh
| | - Md Mizanur Rahman
- Ophthalmology, Bangladesh Medical College, Dhaka, Dhaka District, Bangladesh
| | - Salma Parvin
- Ophthalmology, Green Life Medical College and Hospital, Dhanmondi, Dhaka, Bangladesh
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Tseng VL, Kitayama K, Yu F, Coleman AL. Prevalence and Severity of Glaucoma in the California Medicare Population. Am J Ophthalmol 2024; 259:25-34. [PMID: 37898281 DOI: 10.1016/j.ajo.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE To examine the prevalence of glaucoma by type and severity in the 2019 California (CA) Medicare population, and to identify associated demographic and systemic factors. DESIGN Retrospective cross-sectional design. METHODS The study population included all 2019 CA Medicare beneficiaries ≥65 years of age with Part A and Part B coverage. Outcomes included prevalence of any glaucoma, primary open angle glaucoma (POAG), secondary open angle glaucoma (SOAG), and angle closure glaucoma (ACG). Covariates included age, sex, race and ethnicity, Charlson Comorbidity Index (CCI) score, pseudophakia, and age-related macular degeneration. Logistic regression modeling was used to examine multivariable predictors of each type of glaucoma. RESULTS Of 5,856,491 beneficiaries in the 2019 California Medicare population, there were 220,662 (3.8%) with any glaucoma, 171,988 (2.9%) with POAG, 8,827 (0.2%) with SOAG, and 12,978 (0.2%) with ACG. The largest proportion of beneficiaries had moderate to severe glaucoma (68,553 of 220,662 [31.0%] for any glaucoma moderate stage, 3,168 of 12,978 [24.4%] for ACG severe stage). Multivariable predictors of any glaucoma included age ≥85 years vs 65 to 69 years (adjusted odds ratio [aOR] = 2.03, 95% CI = 2.00, 2.06), female vs male sex (aOR = 1.03, 95% CI = 1.02, 1.04), Black vs non-Hispanic White race and ethnicity (aOR = 1.70, 95% CI = 1.67, 1.73), and CCI ≥5 vs 0 (aOR = 5.59, 95% = 5.51, 5.67). CONCLUSIONS In the 2019 CA Medicare population, multiple demographic and systemic factors were associated with increased likelihood of glaucoma, and beneficiaries with glaucoma had a high prevalence of moderate to severe disease. Strategies are needed to improve early screening and diagnosis for elderly individuals at risk for glaucoma in California.
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Affiliation(s)
- Victoria L Tseng
- From the Department of Ophthalmology (V.L.T., K.K., F.Y., A.L.C.), Stein and Doheny Eye Institutes, University of California, Los Angeles, Los Angeles, California, USA
| | - Ken Kitayama
- From the Department of Ophthalmology (V.L.T., K.K., F.Y., A.L.C.), Stein and Doheny Eye Institutes, University of California, Los Angeles, Los Angeles, California, USA; Department of Epidemiology (K.K., A.L.C.), Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Fei Yu
- From the Department of Ophthalmology (V.L.T., K.K., F.Y., A.L.C.), Stein and Doheny Eye Institutes, University of California, Los Angeles, Los Angeles, California, USA; Department of Biostatistics (F.Y.), Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Anne L Coleman
- From the Department of Ophthalmology (V.L.T., K.K., F.Y., A.L.C.), Stein and Doheny Eye Institutes, University of California, Los Angeles, Los Angeles, California, USA; Department of Epidemiology (K.K., A.L.C.), Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.
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Zhang Y, Wei Y, Lee CHC, Or PW, Karunaratne IK, Deng M, Yang W, Chong IT, Yang Y, Chen Z, Fan Y, Lam DCC, Yu M. Continuous 24-hour intraocular pressure monitoring in normal Chinese adults using a novel contact lens sensor system. Br J Ophthalmol 2024:bjo-2023-323361. [PMID: 38365429 DOI: 10.1136/bjo-2023-323361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 01/29/2024] [Indexed: 02/18/2024]
Abstract
AIMS To investigate the physiological nyctohemeral intraocular pressure (IOP) rhythms of normal Chinese adults using a novel contact lens sensor system (CLS) that can output IOP in millimetres of mercury (mm Hg) continuously. METHODS Fifty-nine eyes of 59 normal Chinese adults completed 24-hour IOP monitoring using the novel CLS. A descriptive analysis was conducted on the 24-hour IOP mean, peak and acrophase, trough and bathyphase, fluctuation, and mean amplitude of intraocular pressure excursion (MAPE). The continuous data were analysed at several periods (diurnal period, 08:00-20:00 hours; nocturnal period, 22:00-06:00 hours; sleep time, 0:00-06:00 hours), and compared between right and left eyes, males and females, and different age ranges (<30, and ≥30), respectively. RESULTS Normal adults had a lower peak, higher trough, smaller fluctuation and smaller MAPE (p<0.05 for all comparisons) but non-significantly different mean (p=0.695) in the nocturnal period or sleep time compared with the diurnal period. The 24-hour IOP peak and trough showed the frequency of occurrence ranging from 1.69% to 15.25% at an interval of 2 hours. No IOP parameter showed significant difference between right and left eyes (p>0.1 for all comparisons). The male group had larger 24-hour and diurnal IOP fluctuation and MAPE (p<0.05 for all comparisons). Subjects aged 30 or over had higher 24-hour and diurnal mean, higher peak, and larger MAPE (p<0.05 for all comparisons). CONCLUSION Continuous 24-hour IOP output from the CLS in normal Chinese was stable with a comparable mean level between day and night, as well as scattered acrophase and bathyphase. The 24-hour IOP mean increased with age, and IOP variations were positively correlated to age and male sex.
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Affiliation(s)
- Yuning Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yifan Wei
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Ching Hymn Christopher Lee
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Ping Wai Or
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Isuru Kaweendra Karunaratne
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Mingjie Deng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Wenxin Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Iok Tong Chong
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Yangfan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Zidong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yanmei Fan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - David C C Lam
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Minbin Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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11
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Husain KA, Alaali H, Alarayedh GG. Prevalence and Characteristics of Glaucoma Among Patients Presenting to Ophthalmology Clinics in a Tertiary Hospital in the Kingdom of Bahrain. Cureus 2024; 16:e54129. [PMID: 38487113 PMCID: PMC10939155 DOI: 10.7759/cureus.54129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/17/2024] Open
Abstract
Introduction The aim of this study was to determine the prevalence and characteristics of glaucoma in patients presenting to the ophthalmology department in a tertiary hospital in Bahrain for the first time. Methods A retrospective study was conducted at the Salmaniya Medical Complex, Manama, Bahrain. The medical records of all patients who presented for the first time to an eye clinic between January and December 2019 were reviewed. Patients who were diagnosed with glaucoma were included in this study. Data regarding age, sex, ethnicity, type of glaucoma, previous treatment, best corrected visual acuity, cup-to-disc ratio, intraocular pressure, central corneal thickness, optical coherence tomography (OCT) retinal nerve fiber layer (RNFL), and visual field findings were collected. Results Of a total of 18,238 new patients in 2019, 173 patients (0.97%) had glaucoma. The mean age of patients with glaucoma was 59.6 ± 11.3 years and approximately 60% of them were males (n=103, 59.5%). In 93% of the cases, glaucoma involved both eyes (n=161). Primary open-angle glaucoma (n=97, 56.1%), normal tension glaucoma (n=28, 16.2%), and chronic angle closure glaucoma (n=15, 8.7%) were the most frequently encountered types of glaucoma. Approximately 16.76% (n=29) of the patients were blind in one or two eyes at the time of presentation. Conclusion There seems to be a low prevalence of glaucoma among the encountered cases on the first visit to ophthalmology clinics in Bahrain, with primary open-angle glaucoma being the most common type.
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Affiliation(s)
- Khatoon A Husain
- Ophthalmology Department, Salmaniya Medical Complex, Manama, BHR
| | - Haneen Alaali
- Ophthalmology Department, Salmaniya Medical Complex, Manama, BHR
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12
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Rodrigo MJ, Martinez-Rincon T, Subias M, Mendez-Martinez S, Garcia-Herranz D, Garcia-Feijoo J, Herrero-Vanrell R, Pablo L, Bravo-Osuna I, Munuera I, Garcia-Martin E. Influence of sex on chronic steroid-induced glaucoma: 24-Weeks follow-up study in rats. Exp Eye Res 2024; 238:109736. [PMID: 38036216 DOI: 10.1016/j.exer.2023.109736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
The objective was to evaluate ocular changes based on sex in steroid-induced glaucoma models in rats comparing healthy controls, over 24 weeks follow-up. Eighty-nine Long-Evans rats (38 males and 51 females) with steroid-induced glaucoma were analysed. Two steroid-induced glaucoma models were generated by injecting poly-co-lactic-glycolic acid microspheres loaded with dexamethasone (MMDEX model) and dexamethasone-fibronectin (MMDEXAFIBRO model) into the ocular anterior chamber. Intraocular pressure was measured by rebound tonometer Tonolab®. Neuroretinal function was analysed using dark- and light-adapted electroretinography (Roland consult® RETIanimal ERG), and structure was analysed using optical coherence tomography (OCT Spectralis, Heidelberg® Engineering) using Retina Posterior Pole, Retinal Nerve Fibre Layer and Ganglion Cell Layer protocols over 24 weeks. Males showed statistically (p < 0.05) higher intraocular pressure measurements. In both sexes and models neuroretinal thickness tended to decrease over time. In the MMDEX model, males showed higher IOP values and greatest percentage thickness loss in the Ganglion Cell Layer (p = 0.015). Females receiving MMDEXAFIBRO experienced large fluctuations in thickness, a higher percentage loss (on average) in Retina Posterior Pole (p = 0.035), Retinal Nerve Fibre Layer and Ganglion Cell Layer than aged-matched males, and the highest thickness loss rate by mmHg. Although no difference was found by sex in dark- and light-adapted electroretinography, increased amplitude in photopic negative response was found in MMDEX males and MMDEXAFIBRO females at 12 weeks. Although both glaucoma models used dexamethasone, different intraocular pressure and neuroretinal changes were observed depending on sex and other influential cofactors (fibronectin). Both sex and the induced glaucoma model influenced neuroretinal degeneration.
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Affiliation(s)
- M J Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain; National Ocular Researcha Network RD21/0002/0050. RICORS Red de Enfermedades Inflamatorias (RD21/0002). Carlos III Health Institute, Spain
| | - T Martinez-Rincon
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain
| | - M Subias
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain
| | - S Mendez-Martinez
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain
| | - D Garcia-Herranz
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Spain; Ophthalmology Innovation, Therapy and Pharmaceutical Development (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain
| | - J Garcia-Feijoo
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Spain; Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain; Department of Ophthalmology, San Carlos Clinical Hospital, Complutense University of Madrid, Spain
| | - R Herrero-Vanrell
- National Ocular Researcha Network RD21/0002/0050. RICORS Red de Enfermedades Inflamatorias (RD21/0002). Carlos III Health Institute, Spain; Ophthalmology Innovation, Therapy and Pharmaceutical Development (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain; Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain; University Institute for Industrial Pharmacy (IUFI), School of Pharmacy, Complutense University of Madrid, Spain
| | - L Pablo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain; National Ocular Researcha Network RD21/0002/0050. RICORS Red de Enfermedades Inflamatorias (RD21/0002). Carlos III Health Institute, Spain; Biotech Vision, Instituto Oftalmologico Quiron, Zaragoza, Spain
| | - I Bravo-Osuna
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, Spain; Ophthalmology Innovation, Therapy and Pharmaceutical Development (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Spain; Health Research Institute, San Carlos Clinical Hospital (IdISSC), Madrid, Spain; University Institute for Industrial Pharmacy (IUFI), School of Pharmacy, Complutense University of Madrid, Spain
| | - I Munuera
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain
| | - E Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Spain; National Ocular Researcha Network RD21/0002/0050. RICORS Red de Enfermedades Inflamatorias (RD21/0002). Carlos III Health Institute, Spain.
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Thakur N, Pandey RK, Mannan R, Pruthi A, Mehrotra S. Genetic association of IL1B gene variants with primary glaucoma in a North Indian Punjabi cohort: An original study and meta-analysis. Exp Eye Res 2024; 238:109720. [PMID: 37952723 DOI: 10.1016/j.exer.2023.109720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 10/04/2023] [Accepted: 11/07/2023] [Indexed: 11/14/2023]
Abstract
Interleukin (IL) 1B is an important candidate gene in glaucoma pathogenesis as it affects the survival of retinal ganglion cells (RGCs). In the present study, -511T/C and +3953C/T polymorphisms in the IL1B were assessed as genetic risk factors for primary open angle (POAG) and angle closure glaucoma (PACG) in a North Indian Punjabi cohort comprising 867 samples (POAG cases = 307; PACG cases = 133 and controls = 427). Genetic association, diplotype and linkage disequilibrium (LD) analyses were performed. Corrections for confounding variables and multiple testing were applied. An updated meta-analysis was also performed. Pooled OR with 95% CI was calculated for dominant, over dominant, and recessive models. Level of heterozygosity among studies was tested using I2 statistic with fixed or random effect model based on the extent of heterogeneity. For -511T > C polymorphism, a positive association was observed with PACG under dominant (p = 0.038; OR = 0.65; pcorr = 0.011; OR = 0.55) and over dominant models (p = 0.010; OR = 0.59; pcorr = 0.001; OR = 0.46). Significant association of +3953C > T was also observed with POAG under dominant (p = 0.011; OR = 1.46; pcorr = 0.018; OR = 1.48) and PACG under recessive models (p < 0.0001; OR = 4.47; pcorr<0.0001; OR = 4.06). While C-C diplotype provided protection against primary glaucoma (0.67-fold; p = 0.0004), T-T and T-C diplotypes predisposed individuals to higher risk (1.31-fold; p = 0.030 and 1.36-fold; p = 0.022 respectively). In meta-analysis, a significant association between +3453 C>T and POAG was observed under dominant (pooled OR = 1.33, p = 0.0046) and over dominant (pooled OR = 1.25; p = 0.0269) models with overall heterogeneity of 15% and 0% respectively. The study provides strong evidence of IL1B variants in modifying genetic susceptibility to primary glaucoma in the targeted North Indian Punjabi population. Replication of the present findings in other populations, and functional studies are warranted to further assess the relevance of IL1B variants in the pathogenesis of primary glaucoma.
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Affiliation(s)
- Nanamika Thakur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, India; Department of Biotechnology, University Institute of Biotechnology, Chandigarh University, Mohali, Punjab, India
| | | | - Rashim Mannan
- All India Institute of Medical Sciences, New Delhi, India
| | - Archna Pruthi
- All India Institute of Medical Sciences, New Delhi, India
| | - Sanjana Mehrotra
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, India.
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14
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Munuera I, Aragon-Navas A, Villacampa P, Gonzalez-Cela MA, Subías M, Pablo LE, Garcia-Feijoo J, Herrero-Vanrell R, Garcia-Martin E, Bravo-Osuna I, Rodrigo MJ. Chronic Glaucoma Induced in Rats by a Single Injection of Fibronectin-Loaded PLGA Microspheres: IOP-Dependent and IOP-Independent Neurodegeneration. Int J Mol Sci 2023; 25:9. [PMID: 38203183 PMCID: PMC10779403 DOI: 10.3390/ijms25010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 11/30/2023] [Accepted: 12/10/2023] [Indexed: 01/12/2024] Open
Abstract
To evaluate a new animal model of chronic glaucoma induced using a single injection of fibronectin-loaded biodegradable PLGA microspheres (Ms) to test prolonged therapies. 30 rats received a single injection of fibronectin-PLGA-Ms suspension (MsF) in the right eye, 10 received non-loaded PLGA-Ms suspension (Control), and 17 were non-injected (Healthy). Follow-up was performed (24 weeks), evaluating intraocular pressure (IOP), optical coherence tomography (OCT), histology and electroretinography. The right eyes underwent a progressive increase in IOP, but only induced cohorts reached hypertensive values. The three cohorts presented a progressive decrease in ganglion cell layer (GCL) thickness, corroborating physiological age-related loss of ganglion cells. Injected cohorts (MsF > Control) presented greater final GCL thickness. Histological exams explain this paradox: the MsF cohort showed lower ganglion cell counts but higher astrogliosis and immune response. A sequential trend of functional damage was recorded using scotopic electroretinography (MsF > Control > Healthy). It seems to be a function-structure correlation: in significant astrogliosis, early functional damage can be detected by electroretinography, and structural damage can be detected by histological exams but not by OCT. Males presented higher IOP and retinal and GCL thicknesses and lower electroretinography. A minimally invasive chronic glaucoma model was induced by a single injection of biodegradable Ms.
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Affiliation(s)
- Ines Munuera
- Department of Ophthalmology, Miguel Servet University Hospital, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain; (I.M.); (M.S.); (L.E.P.); (M.J.R.)
| | - Alba Aragon-Navas
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (A.A.-N.); (M.A.G.-C.); (R.H.-V.); (I.B.-O.)
| | - Pilar Villacampa
- Department of Physiological Sciences, Faculty of Medicine and Health Sciences, University of Barcelona and Bellvitge Biomedical Research Institute (IDIBELL), Feixa Llarga s/n, 08907 l’Hospitalet de Llobregat, Spain;
| | - Miriam A. Gonzalez-Cela
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (A.A.-N.); (M.A.G.-C.); (R.H.-V.); (I.B.-O.)
| | - Manuel Subías
- Department of Ophthalmology, Miguel Servet University Hospital, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain; (I.M.); (M.S.); (L.E.P.); (M.J.R.)
- Biotech Vision SLP (Spin-Off Company), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain
| | - Luis E. Pablo
- Department of Ophthalmology, Miguel Servet University Hospital, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain; (I.M.); (M.S.); (L.E.P.); (M.J.R.)
- Biotech Vision SLP (Spin-Off Company), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain
- Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, 28040 Madrid, Spain;
| | - Julian Garcia-Feijoo
- Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, 28040 Madrid, Spain;
- Department of Ophthalmology, San Carlos Clinical Hospital, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), 28040 Madrid, Spain
| | - Rocio Herrero-Vanrell
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (A.A.-N.); (M.A.G.-C.); (R.H.-V.); (I.B.-O.)
- Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, 28040 Madrid, Spain;
| | - Elena Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain; (I.M.); (M.S.); (L.E.P.); (M.J.R.)
- Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, 28040 Madrid, Spain;
| | - Irene Bravo-Osuna
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (A.A.-N.); (M.A.G.-C.); (R.H.-V.); (I.B.-O.)
- Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, 28040 Madrid, Spain;
| | - Maria J. Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 50009 Zaragoza, Spain; (I.M.); (M.S.); (L.E.P.); (M.J.R.)
- Thematic Research Network in Ophthalmology (Oftared), Carlos III National Institute of Health, 28040 Madrid, Spain;
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Young SL, Cheng KKW, O' Connell N, Sanders R, Agarwal PK. PACS plus criteria: a retrospective cohort review of 612 consecutive patients treated with bilateral YAG peripheral iridotomies. Eye (Lond) 2023; 37:3834-3838. [PMID: 37340048 PMCID: PMC10698168 DOI: 10.1038/s41433-023-02626-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 05/28/2023] [Accepted: 06/06/2023] [Indexed: 06/22/2023] Open
Abstract
INTRODUCTION With an ageing population and better life expectancy, the prevalence of angle closure disease is expected to increase by 20% per decade. In 2022, the Royal College of Ophthalmologists (RCOphth) issued a guideline on managing angle closure disease. Hospital eye service (HES) referral and prophylactic treatment are recommended only for primary angle closure suspect (PACS) with "Plus" features only. We aimed to examine patients previously treated with YAG peripheral iridotomies (YAG PI) for the presence of "PACS Plus" features. METHODS A retrospective cohort study of consecutive patients treated with YAG PI between 2015 and 2019 at a tertiary referral NHS eye centre was reviewed. Cases were examined to identify and classify patients into Primary Angle Closure (PAC), PACS, and Primary Angle Closure Glaucoma (PACG). Patients with PACS were studied for "Plus" features. RESULTS Six hundred twelve patients with gonioscopy-confirmed angle closure (defined as a minimum 180 degrees iridotrabecular contact) treated with YAG PI from years 2015 to 2019 were included in the analysis. The mean age of patients presenting with angle closure disease was 68.5 years (SD 11.3). There were 390 (63.7%) patients with PACS, 102 (16.6%) with PAC and 120 (19.7%) with PACG. Of the PACS patients, 159(40.8%) patients had no "Plus" features. 181 (40.2%) patients had 1 "Plus" feature, 37 (9.5%) had 2 "Plus" features and 13 (3.3%) patients had 3 "Plus" features. CONCLUSION In our cohort, a considerable proportion (40.8%) of PACS patients treated with YAG PI did not have Plus features and therefore that would not meet the proposed criteria for HES referral and YAG PI. With the proposed guidance, we expect a considerable reduction in HES referrals. Nonetheless, community optometry services should be supported and trained to provide monitoring for patients with PACS not referred to the HES.
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Affiliation(s)
- Su Ling Young
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK.
- Department of Ophthalmology, University of Edinburgh, Edinburgh, UK.
| | - Kelvin K W Cheng
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
- Department of Ophthalmology, University of Edinburgh, Edinburgh, UK
| | | | - Roshini Sanders
- Department of Ophthalmology, University of Edinburgh, Edinburgh, UK
- Queen Margaret Hospital, NHS Fife, Dunfermline, UK
| | - Pankaj K Agarwal
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
- Department of Ophthalmology, University of Edinburgh, Edinburgh, UK
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Delavar A, Bu JJ, Radha Saseendrakumar B, Weinreb RN, Baxter SL. Gender Disparities in Depression, Stress, and Social Support Among Glaucoma Patients. Transl Vis Sci Technol 2023; 12:23. [PMID: 38149963 PMCID: PMC10755593 DOI: 10.1167/tvst.12.12.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 12/14/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose To understand differences in measures of depression, stress, and social support by gender among those diagnosed with glaucoma. Methods We obtained a cohort of glaucoma patients (any type) ages 18 years and over who answered the COVID-19 Participant Experience (COPE) survey of the NIH All of Us Research Program. We analyzed several measures of depression, stress, and social support by gender. Logistic regression was used to evaluate the association among reported stress associated with social distancing, depression (using Patient Health Questionnaire-9 [PHQ-9] scores), and measures of social support by self-reported gender, with men as the reference group. Multivariable models were adjusted for age, race and ethnicity, health insurance status, education, and income. Results Of 3633 glaucoma patients, 56.8% were women. Many patients had a PHQ-9 score > 4 (33.3%), indicating mild, moderate, or severe depression. In multivariable models, women were significantly more likely to report a PHQ-9 score > 4 (odds ratio [OR] = 1.40; 95% confidence interval [CI], 1.20-1.62; P < 0.001) and some or a lot of stress (OR = 1.34; 95% CI, 1.14-1.57; P < 0.001) compared with men. Further, women were significantly less likely to report having help all or most of the time if they needed someone to prepare meals (OR = 0.78; 95% CI, 0.67-0.92; P = 0.002) or perform daily chores (OR = 0.79; 95% CI, 0.67-0.91; P = 0.003) than men. Conclusions Women with glaucoma were more likely to experience depression and stress and were less likely to have social support on some measures than men. Translational Relevance The disproportionate burden of psychosocial factors among women may complicate glaucoma management.
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Affiliation(s)
- Arash Delavar
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA
| | - Jennifer J. Bu
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Bharanidharan Radha Saseendrakumar
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Robert N. Weinreb
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Sally L. Baxter
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
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Kim DK, Yu H. Incidence Rates and Risk Ratios of Normal Tension Glaucoma in Patients with Chronic Rhinosinusitis: A Population-Based Longitudinal Follow-Up Study. Life (Basel) 2023; 13:2238. [PMID: 38137840 PMCID: PMC10745065 DOI: 10.3390/life13122238] [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: 10/25/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
Several studies have investigated the association between chronic rhinosinusitis (CRS) and ophthalmological complications. However, it remains uncertain whether CRS is independently associated with the development of normal tension glaucoma (NTG). Therefore, this retrospective cohort study aimed to investigate the prospective association between CRS and the increased incidence and risk of NTG using a representative population-based dataset. The selection of both the CRS and comparison groups was meticulously conducted through the propensity scoring method. The incidence and risk ratios of NTG were measured using person-years at risk and a weighted Cox proportional hazards model. We enrolled 30,284 individuals without CRS (comparison group) and 15,142 individuals with CRS. The NTG incidence rates were 1.19 and 0.81 in the CRS and comparison groups, respectively. The CRS group showed a significantly increased risk of subsequent development for NTG (adjusted hazard ratio = 1.41, 95% confidence interval = 1.16-1.72), regardless of the CRS subtype. Additionally, the risk of developing NTG was relatively higher in the first 2 years after CRS diagnosis. Moreover, a subgroup analysis revealed a higher risk of NTG in elderly female individuals with CRS. The present findings underscore the importance of monitoring and managing NTG risk in individuals with CRS, especially in elderly female patients.
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Affiliation(s)
- Dong-Kyu Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24252, Republic of Korea
- Institute of New Frontier Research, Division of Big Data and Artificial Intelligence, Hallym University College of Medicine, Chuncheon 24252, Republic of Korea
| | - Hyunjae Yu
- Institute of New Frontier Research, Division of Big Data and Artificial Intelligence, Hallym University College of Medicine, Chuncheon 24252, Republic of Korea
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18
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Wolfram C, Vu TPL, Klemm M, Spitzer M, Beuse A, Grohmann C. [Use of antiglaucomatous drugs in the urban adult population : New Insights into the prevalence of glaucoma from the Hamburg City Health Study]. DIE OPHTHALMOLOGIE 2023; 120:1098-1106. [PMID: 37874364 DOI: 10.1007/s00347-023-01942-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Glaucoma is a widespread ophthalmological disease. Knowledge about the spread of the disease in the population is necessary with respect to further questions on comorbidities, risk factors and the provision of care. OBJECTIVE An analysis of the use of glaucoma medications and the prevalence of glaucoma in an urban adult population was carried out. MATERIAL AND METHODS The Hamburg City Health Study (HCHS) is a prospective, long-term, population-based cohort study that includes a random sample of 45,000 participants aged between 45 and 79 years from the general population of Hamburg, Germany. Apart from various medical parameters, data include premedication and the medical history of the participants. The use of antiglaucomatous medication among the first 10,000 study participants was analyzed and the prevalence of glaucoma was estimated according to the use of medications as well as by the self-reported history of glaucoma. Descriptive analysis and logistic regression analysis were performed to analyze the data and to calculate correlations by age and gender. RESULTS In the study population 319 persons were on medication to lower the intraocular pressure (IOP, mean age 67.1 years, SD = 7.57 years), which is equivalent to an estimated prevalence of 3.35% (95% confidence interval, CI 3.00-3.70%). A positive correlation was observed between age and the use of IOP-lowering medication, which is statistically highly significant (p = < 0.001). The analysis by gender showed a slightly higher prevalence among women, which was not statistically significant. The estimated prevalence according to glaucoma medication and history were only partly congruent. DISCUSSION This estimated prevalence of glaucoma is comparable to other epidemiological studies. The study results cover not only patients with manifest glaucoma but also persons who were treated for ocular hypertension. The inconsistency between the prevalence of glaucoma medication and the diagnosis of glaucoma can be explained by different treatment strategies and also by information deficits.
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Affiliation(s)
- Christian Wolfram
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
| | - Tran Phuong Linh Vu
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - Maren Klemm
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - Martin Spitzer
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - Ansgar Beuse
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - Carsten Grohmann
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
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19
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Kicińska AK, Rękas M. Safety and Efficacy of Three Modifications of Canaloplasty to Treat Open-Angle Glaucoma: 3-Year Outcomes. J Clin Med 2023; 12:6475. [PMID: 37892612 PMCID: PMC10607351 DOI: 10.3390/jcm12206475] [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: 09/24/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND This is a report of 3-year results of a prospective assessment of three modifications of canaloplasty (C): ab externo (ABeC), mini-canaloplasty (miniABeC), and ab interno (ABiC) performed concomitantly with cataract removal in subjects suffering from primary open-angle glaucoma (POAG). METHODS Forty-eight individuals were randomized for one of the surgeries: ABeC, miniABeC, or ABiC and cataract removal-16 eyes for each group. Follow-up examinations were carried out on the day of the surgery, on days 1 and 7, after 1, 3, 6 months, and at 1, 2, and 3 years. Complete and qualified success was an IOP ≤ 15 mmHg without or with antiglaucoma eye drops, respectively. The IOP reduction of 20% or more was considered an additional success criterion. RESULTS Within three years the probability of qualified success was ABiC and miniABeC-94%, ABeC-100%, and of complete success ABiC-75%, miniABeC-100%. At the 3-year follow-up, the median IOP decreased from 22 to 15 mmHg in the ABeC group (p = 0.001), from 22 to 15 mmHg in the miniABeC group 15 (p < 0.001), and from 21 to 15 mmHg in the ABiC group (p = 0.001) compared to the post-washout stage. The IOP dropped by 20% or more without medications in 56.2% of patients post ABiC, 68.8% post miniABeC and 75% post ABeC. The median number of antiglaucoma medications dropped in all three groups; at the 3-year follow-up, only one patient following ABeC and four subjects following miniABeC required treatment. One patient required reoperation and further intensification of topical treatment-post miniABeC. The levels of IOP, CDVA, and success probability at the 36-month follow-up showed no significant difference for individual groups. CONCLUSIONS ABeC, miniABeC, and ABiC have significant IOP-lowering potential in individuals diagnosed with POAG at a mild to moderate stage and no history of IOP ≥ 30 mmHg with a good safety profile.
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Affiliation(s)
- Aleksandra K. Kicińska
- Ophthalmology Department, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland;
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20
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Davuluru SS, Jess AT, Kim JSB, Yoo K, Nguyen V, Xu BY. Identifying, Understanding, and Addressing Disparities in Glaucoma Care in the United States. Transl Vis Sci Technol 2023; 12:18. [PMID: 37889504 PMCID: PMC10617640 DOI: 10.1167/tvst.12.10.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
Glaucoma is the leading cause of irreversible blindness worldwide, currently affecting around 80 million people. Glaucoma prevalence is rapidly rising in the United States due to an aging population. Despite recent advances in the diagnosis and treatment of glaucoma, significant disparities persist in disease detection, management, and outcomes among the diverse patient populations of the United States. Research on disparities is critical to identifying, understanding, and addressing societal and healthcare inequalities. Disparities research is especially important and impactful in the context of irreversible diseases such as glaucoma, where earlier detection and intervention are the primary approach to improving patient outcomes. In this article, we first review recent studies identifying disparities in glaucoma care that affect patient populations based on race, age, and gender. We then review studies elucidating and furthering our understanding of modifiable factors that contribute to these inequities, including socioeconomic status (particularly age and education), insurance product, and geographic region. Finally, we present work proposing potential strategies addressing disparities in glaucoma care, including teleophthalmology and artificial intelligence. We also discuss the presence of non-modifiable factors that contribute to differences in glaucoma burden and can confound the detection of glaucoma disparities. Translational Relevance By recognizing underlying causes and proposing potential solutions, healthcare providers, policymakers, and other stakeholders can work collaboratively to reduce the burden of glaucoma and improve visual health and clinical outcomes in vulnerable patient populations.
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Affiliation(s)
- Shaili S. Davuluru
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alison T. Jess
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Kristy Yoo
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Van Nguyen
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Benjamin Y. Xu
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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21
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Tanner A, Haddad F, Fajardo-Sanchez J, Nguyen E, Thong KX, Ah-Moye S, Perl N, Abu-Bakra M, Kulkarni A, Trikha S, Lascaratos G, Parnell M, Kailani O, King AJ, Agrawal P, Stead R, Giannouladis K, Rodrigues I, Goyal S, Hysi PG, Lim S, Yu-Wai-Man C. One-year surgical outcomes of the PreserFlo MicroShunt in glaucoma: a multicentre analysis. Br J Ophthalmol 2023; 107:1104-1111. [PMID: 35365491 PMCID: PMC10359526 DOI: 10.1136/bjophthalmol-2021-320631] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/13/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To evaluate the efficacy and safety of the PreserFlo MicroShunt glaucoma device in a multicentre cohort study. METHODS All consecutive patients who received the microshunt with mitomycin-C (MMC) 0.4 mg/mL from May 2019 to September 2020 in three UK tertiary centres. Primary outcome at 1 year was a complete success, with failure defined as intraocular pressure (IOP) >21 mmHg or <20% reduction, IOP≤5 mmHg with any decreased vision on two consecutive visits, reoperation or loss of light perception vision. Secondary outcomes were IOP, best-corrected visual acuity, medications, complications, interventions and reoperations. We also performed subgroup analyses for severe glaucoma and assessed risk factors for failure. RESULTS 104 eyes had 1-year follow-up. Complete and qualified success at 1 year were achieved in 51.9% (N=54) and 16.4% (N=17), respectively, and failure occurred in 31.7% (N=33). There was a significant reduction in IOP (mmHg) from preoperatively (23.4±0.8, N=104) to 12 months (14.7±0.6, N=104) (p<0.0001). Antiglaucoma medications also decreased from preoperatively (3.4±0.1, N=104) to 12 months (0.7±0.1, N=104) (p<0.0001). Multivariate analyses showed an association between higher mean deviation and failure (HR 1.055, 95% CI 1.0075 to 1.11, p=0.0227). Complications were hypotony (19.2%; N=20), choroidal detachments (10.6%; N=11), hyphaema (5.8%; N=6) and bleb leak (5.8%; N=6). Needling and 5-fluorouracil injections were performed in 12.5% (N=13) and 33.7% (N=35), respectively, and 11.5% (N=12) required revision surgery. CONCLUSION The PreserFlo MicroShunt with MMC 0.4 mg/mL showed an overall success rate of 68.3% at 1 year, and led to significant IOP and medication reduction with a low rate of adverse effects.
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Affiliation(s)
- Alexander Tanner
- Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Fadi Haddad
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
| | - Julia Fajardo-Sanchez
- Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ethan Nguyen
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
| | - Kai Xin Thong
- Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sarah Ah-Moye
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
| | - Nicole Perl
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
| | - Mohammed Abu-Bakra
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
| | - Avinash Kulkarni
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
| | - Sameer Trikha
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
| | - Gerassimos Lascaratos
- Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
| | - Miles Parnell
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
| | - Obeda Kailani
- Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
| | - Anthony J King
- Department of Ophthalmology, Nottingham University Hospitals NHS Foundation Trust, Nottingham, UK
| | - Pavi Agrawal
- Department of Ophthalmology, Nottingham University Hospitals NHS Foundation Trust, Nottingham, UK
| | - Richard Stead
- Department of Ophthalmology, Nottingham University Hospitals NHS Foundation Trust, Nottingham, UK
| | | | - Ian Rodrigues
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Saurabh Goyal
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Pirro G Hysi
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Sheng Lim
- Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Cynthia Yu-Wai-Man
- Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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22
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Wasnik RN, Győri-Dani V, Vincze F, Papp M, Pálinkás A, Sándor J. Screening for Patients with Visual Acuity Loss in Primary Health Care: A Cross Sectional Study in a Deprived Hungarian Population. Healthcare (Basel) 2023; 11:1941. [PMID: 37444777 DOI: 10.3390/healthcare11131941] [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: 06/12/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
Screening for visual acuity loss (VAL) is not applied systematically because of uncertain recommendations based on observations from affordable countries. Our study aimed to evaluate the effectiveness of primary health care-based screening. A cross-sectional investigation was carried out among adults who did not wear glasses and did not visit an ophthalmologist in a year (N = 2070). The risk factor role of sociodemographic factors and the cardiometabolic status for hidden VAL was determined by multivariable linear regression models. The prevalence of unknown VAL of at least 0.5 was 3.7% and 9.1% in adults and in the above-65 population. Female sex (b = 1.27, 95% CI: 0.35; 2.18), age (b = 0.15, 0.12; 0.19), and Roma ethnicity (b = 2.60, 95% CI: 1.22; 3.97) were significant risk factors. Higher than primary school (bsecondaryschoolwithoutgraduation = -2.06, 95% CI: -3.64; -0.47; and bsecondaryschoolwithgraduation = -2.08, 95% CI: -3.65; -0.51), employment (b = -1.33, 95% CI: -2.25; 0.40), and properly treated diabetes mellitus (b = -2.84, 95% CI: -5.08; -0.60) were protective factors. Above 65 years, female sex (b = 3.85, 95% CI: 0.50; 7.20), age (b = 0.39, 95% CI: 0.10; 0.67), Roma ethnicity (b = 24.79, 95% CI: 13.83; 35.76), and untreated diabetes (b = 7.30, 95% CI: 1.29; 13.31) were associated with VAL. Considering the huge differences between the health care and the population's social status of the recommendation-establishing countries and Hungary which represent non-high-income countries, the uncertain recommendation of VAL screening should not discourage general practitioners from organizing population-based screening for VAL in non-affordable populations.
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Affiliation(s)
- Rahul Naresh Wasnik
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | | | - Ferenc Vincze
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Magor Papp
- Semmelweis Health Promotion Center, Semmelweis University, 1089 Budapest, Hungary
| | - Anita Pálinkás
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - János Sándor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
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23
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Agarwal R, Agarwal P, Iezhitsa I. Exploring the current use of animal models in glaucoma drug discovery: where are we in 2023? Expert Opin Drug Discov 2023; 18:1287-1300. [PMID: 37608634 DOI: 10.1080/17460441.2023.2246892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Animal models are widely used in glaucoma-related research. Since the elevated intraocular pressure (IOP) is a major risk factor underlying the disease pathogenesis, animal models with high IOP are commonly used. However, models are also used to represent the clinical context of glaucomatous changes developing despite a normal IOP. AREAS COVERED Herein, the authors discuss the various factors that contribute to the quality of studies using animal models based on the evaluation of studies published in 2022. The factors affecting the quality of studies using animal models, such as the animal species, age, and sex, are discussed, along with various methods and outcomes of studies involving different animal models of glaucoma. EXPERT OPINION Translating animal research data to clinical applications remains challenging. Our observations in this review clearly indicate that many studies lack scientific robustness not only in their experiment conduct but also in data analysis, interpretation, and presentation. In this context, ensuring the internal validity of animal studies is the first step in quality assurance. External validity, however, is more challenging, and steps should be taken to satisfy external validity at least to some extent.
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Affiliation(s)
- Renu Agarwal
- School of Medicine, International Medical University, Bukit Jalil, Malaysia
| | - Puneet Agarwal
- School of Medicine, International Medical University, Bukit Jalil, Malaysia
| | - Igor Iezhitsa
- School of Medicine, International Medical University, Bukit Jalil, Malaysia
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24
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Kim AB, Cheng BT, Tanna AP. Delayed Medical Care Due to Lack of Transportation among US Adults with Glaucoma. Ophthalmol Glaucoma 2023; 6:439-441. [PMID: 36990434 DOI: 10.1016/j.ogla.2023.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 02/16/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
Affiliation(s)
- Anne B Kim
- Rush University Medical College, Chicago, Illinois
| | - Brian T Cheng
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Angelo P Tanna
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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25
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Ferry F, Rosato M, Leavey G. Severe mental illness and ophthalmic health: A linked administrative data study. PLoS One 2023; 18:e0286860. [PMID: 37285337 DOI: 10.1371/journal.pone.0286860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/24/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND While evidence has emerged highlighting the potential benefits of the eye as a window to the central nervous system, research on severe mental illness (SMI) and eye health is rare. AIMS We examine the association of SMI with a range of ophthalmic health outcomes, and whether any relationship is modified by age. METHODS We used linked administrative data from general practitioner (GP), hospital and ophthalmic records to examine receipt of any Health and Social Care (HSC) eye-test; and (based on eligibility recorded for a sight test) any glaucoma, any diabetes, and any blindness among the Northern Ireland (NI) hospital population between January 2015 and November 2019 (N = 798,564). RESULTS When compared with non-SMI patients, those with SMI recorded a higher prevalence of having had a sight test, diabetes, and blindness. In fully adjusted logistic regression models, higher likelihood of an eye-test and diabetes (OR = 1.71: 95%CI = 1.63, 1.79 and OR = 1.29: 1.19, 1.40 respectively); and lower likelihood of glaucoma remained (OR = 0.69: 0.53, 0.90). Amongst persons with SMI there was evidence that the likelihood of having had an eye-test was lower in the older age-groups. CONCLUSION Our study provides new evidence on ophthalmic health inequalities associated with SMI. While the study has immediate relevance to its NI context, we believe it is generalizable to wider UK health concerns. We emphasize the need for more research of this type, using large linkable electronic administrative databases to further our understanding of both health inequalities associated with SMI and poor eye health, and health outcomes in general.
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Affiliation(s)
- Finola Ferry
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Northern Ireland, United Kingdom
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Coleraine, Northern Ireland, United Kingdom
| | - Michael Rosato
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Northern Ireland, United Kingdom
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Coleraine, Northern Ireland, United Kingdom
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Northern Ireland, United Kingdom
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Coleraine, Northern Ireland, United Kingdom
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26
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Lee SY, Tseng VL, Kitayama K, Avallone TJ, Yu F, Pan D, Caprioli J, Coleman AL. Associations Between Niacin Intake and Glaucoma in the National Health and Nutrition Examination Survey. J Glaucoma 2023; 32:443-450. [PMID: 36946914 DOI: 10.1097/ijg.0000000000002216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/04/2023] [Indexed: 03/23/2023]
Abstract
PRCIS This study examined the association between dietary niacin intake and glaucoma in the 2005-2008 National Health and Nutrition Examination Survey (NHANES). Increased niacin intake was associated with lower odds of glaucoma overall and among women. PURPOSE To examine the association between dietary niacin intake and glaucoma in the 2005-2008 NHANES. MATERIALS AND METHODS This cross-sectional study included adult participants of the 2005-2008 NHANES. The exposure was dietary niacin intake, which was examined as a continuous and categorical variable. The outcome was glaucoma as defined by regraded disc images. Covariates included age, sex, race/ethnicity, education level, income, body mass index, smoking status, alcohol use, cardiovascular disease, diabetes mellitus, daily energy intake, vitamin B2 and B6 consumption, and macular degeneration. Adjusting for all covariates, logistic regression was performed to examine the association between niacin intake and glaucoma in the overall population and stratified by sex. RESULTS The weighted population included 5371 individuals (109,734,124 weighted), of whom 55 (1.0%) had glaucoma. Each 1 mg increase in niacin intake was associated with a 6% decreased odds of glaucoma odds [adjusted odds ratio (aOR) = 0.94, 95% CI = 0.90, 0.98]. Among women, increased niacin intake was associated with decreased odds of glaucoma both with niacin as a continuous (aOR = 0.89, 95% CI = 0.80, 0.99 per 1 mg increase in niacin intake) and binary variable (aOR = 0.35, 95% CI = 0.14, 0.90 for higher vs lower niacin intake). CONCLUSIONS In the 2005-2008 NHANES population, higher levels of niacin intake were associated with decreased odds of glaucoma overall and in women. Further studies are needed to examine the potential protective effects of niacin on glaucoma risk.
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Affiliation(s)
- Samuel Y Lee
- Department of Ophthalmology, Center for Community Outreach and Policy, Stein and Doheny Eye Institutes, David Geffen School of Medicine at UCLA
| | - Victoria L Tseng
- Department of Ophthalmology, Center for Community Outreach and Policy, Stein and Doheny Eye Institutes, David Geffen School of Medicine at UCLA
| | - Ken Kitayama
- Department of Ophthalmology, Center for Community Outreach and Policy, Stein and Doheny Eye Institutes, David Geffen School of Medicine at UCLA
- Department of Epidemiology
| | | | - Fei Yu
- Department of Ophthalmology, Center for Community Outreach and Policy, Stein and Doheny Eye Institutes, David Geffen School of Medicine at UCLA
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles
| | - Deyu Pan
- Department of Ophthalmology, Center for Community Outreach and Policy, Stein and Doheny Eye Institutes, David Geffen School of Medicine at UCLA
| | - Joseph Caprioli
- Department of Ophthalmology, Center for Community Outreach and Policy, Stein and Doheny Eye Institutes, David Geffen School of Medicine at UCLA
| | - Anne L Coleman
- Department of Ophthalmology, Center for Community Outreach and Policy, Stein and Doheny Eye Institutes, David Geffen School of Medicine at UCLA
- Department of Epidemiology
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27
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Lai ACK, Buchan JC, Chan JCH, Nolan W. Determinants of late presentation of glaucoma in Hong Kong. Eye (Lond) 2023; 37:1717-1724. [PMID: 36100709 PMCID: PMC10219946 DOI: 10.1038/s41433-022-02235-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 07/29/2022] [Accepted: 09/01/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Glaucoma is the commonest cause of irreversible blindness worldwide. As it is typically asymptomatic until advanced, the risk of blindness from late presentation is higher than other eye diseases. This study aims to investigate the risk factors for late presentation of primary glaucoma patients. METHODS We undertook a hospital-based case-control study of a random sample of glaucoma patients from a hospital in Hong Kong. Structured questionnaires and existing information from the electronic patient record were used, and the odds of presenting late were analysed by logistic regression. RESULTS Of 210 recruited participants, 83 (39.5%) presented with advanced glaucoma unilaterally or bilaterally. The mean age of participants was 61.1 ± 11.9 years, with 110 males (52.4%). Univariate analysis revealed that male sex and primary angle-closure glaucoma (PACG) have 3.06 (CI95:1.71-5.48; P < 0.001) and 2.47 (CI95:1.11-5.49; P = 0.03) times higher odds of late presentation, respectively. Multivariate analysis revealed late presenters were 3.54 (CI95:1.35-9.35; P = 0.01) times more likely to have PACG than primary open-angle glaucoma (POAG). Patients with elevated baseline intraocular pressure (IOP) also had 1.06 times higher odds of presenting with advanced glaucoma (CI95:1.02-1.11; P = 0.002). Linear regression revealed that PACG patients present with 7.12 mmHg higher IOP than POAG patients (CI95:4.23-10.0; P < 0.001). CONCLUSION In conclusion, a high proportion of glaucoma patients present late in Hong Kong, with gender and type of glaucoma being significant determinants. Our study shows that PACG presents with higher IOP and, along with male gender, are more likely to have advanced disease than POAG.
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Affiliation(s)
- Anakin Chu Kwan Lai
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.
| | - John C Buchan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Jonathan Cheuk-Hung Chan
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Winifred Nolan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- NIHR Biomedical Research Centre, Moorfields and UCL Institute of Ophthalmology, London, UK
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Castellanos-Perilla N, Garcia-Cifuentes E, Pineda-Ortega J, Lema S, Gelvis G, Cano-Gutierrez CA, Mejia-Vergara AJ. Self-reported glaucoma prevalence and related factors, contribution to reported visual impairment, and functional burden in a cross-sectional study in Colombia. Int Ophthalmol 2023. [PMID: 36864123 DOI: 10.1007/s10792-023-02643-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
PURPOSE Describe the self-reported prevalence of glaucoma in Colombian older adults, emphasizing the most important risk factors and associated daily-life functional alterations. METHODS This a secondary analysis of the Health, Wellness, and Aging survey conducted in the year 2015. Diagnosis of glaucoma was obtained from self-report. Functional variables were assessed through activities of daily living questionnaires. A descriptive analysis followed by bivariate and multivariate regression models adjusting for confounding variables was conducted. RESULTS Self-reported prevalence of glaucoma was 5.67%, with higher rate in women, OR 1.22 (1.13-1.40) p = .003, older age OR 1.02 (1.01-1.02) p < .001, and with higher education OR 1.38 (1.28-1.50) p < .001. Glaucoma was independently associated with diabetes OR 1.37 (1.18-1.61) p < .001 and hypertension 1.26 (1.08-1.46) p = .003. It also showed statistically significant correlations with poor SRH OR 1.15 (1.02-1.32) p < .001, self-reported visual impairment 1.73 (1.50-2.01) p < .001, and impairment in money management OR 1.59 (1.16-2.08) p = .002, grocery shopping OR 1.57 (1.26-1.96) p < .001 and preparing meals OR 1.31 (1.06-1.63) p = .013 and having had falls during the last year OR 1.14 (1.01-1.31) p = 0.041. CONCLUSION Our findings suggest the self-reported prevalence of glaucoma in older adults in Colombia to be higher than reported data. Glaucoma and visual impairment in older adults represent a public health concern, since glaucoma was associated with adverse outcomes like functional loss and risk of falling, affecting the quality of life and their participation in society.
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Affiliation(s)
- Nicolás Castellanos-Perilla
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway. .,Department of Clinical Medicine, University of Bergen, Bergen, Norway. .,Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | - Elkin Garcia-Cifuentes
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia.,Neurology Department, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Juliana Pineda-Ortega
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Sofia Lema
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
| | - Geronimo Gelvis
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Carlos Alberto Cano-Gutierrez
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia.,Geriatrics Unit, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Alvaro J Mejia-Vergara
- Department of Ophthalmology, Stein and Doheny Eye Institutes, University of California, Pasadena, Los Angeles, CA, USA.,Ophthalmology Department, San Ignacio University Hospital, Pontificia Universidad Javeriana School of Medicine, Bogotá, Colombia.,School of Medicine, Ophthalmology Program, Fundación Universitaria Sanitas, Bogotá, Colombia.,Oftalmosanitas Eye Institute, Fundación Universitaria Sanitas, Bogotá, Colombia
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29
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Saravanan M, Xu R, Roby O, Wang Y, Zhu S, Lu A, Du J. Tissue-Specific Sex Difference in Mouse Eye and Brain Metabolome Under Fed and Fasted States. Invest Ophthalmol Vis Sci 2023; 64:18. [PMID: 36892534 PMCID: PMC10010444 DOI: 10.1167/iovs.64.3.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/13/2023] [Indexed: 03/10/2023] Open
Abstract
Purpose Visual physiology and various ocular diseases demonstrate sexual dimorphisms; however, how sex influences metabolism in different eye tissues remains undetermined. This study aims to address common and tissue-specific sex differences in metabolism in the retina, RPE, lens, and brain under fed and fasted conditions. Methods After ad libitum fed or being deprived of food for 18 hours, mouse eye tissues (retina, RPE/choroid, and lens), brain, and plasma were harvested for targeted metabolomics. The data were analyzed with both partial least squares-discriminant analysis and volcano plot analysis. Results Among 133 metabolites that cover major metabolic pathways, we found 9 to 45 metabolites that are sex different in different tissues under the fed state and 6 to 18 metabolites under the fasted state. Among these sex-different metabolites, 33 were changed in 2 or more tissues, and 64 were tissue specific. Pantothenic acid, hypotaurine, and 4-hydroxyproline were the top commonly changed metabolites. The lens and the retina had the most tissue-specific, sex-different metabolites enriched in the metabolism of amino acid, nucleotide, lipids, and tricarboxylic acid cycle. The lens and the brain had more similar sex-different metabolites than other ocular tissues. The female RPE and female brain were more sensitive to fasting with more decreased metabolites in amino acid metabolism, tricarboxylic acid cycles, and glycolysis. The plasma had the fewest sex-different metabolites, with very few overlapping changes with tissues. Conclusions Sex has a strong influence on eye and brain metabolism in tissue-specific and metabolic state-specific manners. Our findings may implicate the sexual dimorphisms in eye physiology and susceptibility to ocular diseases.
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Affiliation(s)
- Meghashri Saravanan
- Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, West Virginia, United States
- Department of Biochemistry and Molecular Medicine, West Virginia University, Morgantown, West Virginia, United States
| | - Rong Xu
- Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, West Virginia, United States
- Department of Biochemistry and Molecular Medicine, West Virginia University, Morgantown, West Virginia, United States
| | - Olivia Roby
- Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, West Virginia, United States
- Department of Biochemistry and Molecular Medicine, West Virginia University, Morgantown, West Virginia, United States
| | - Yekai Wang
- Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, West Virginia, United States
- Department of Biochemistry and Molecular Medicine, West Virginia University, Morgantown, West Virginia, United States
| | - Siyan Zhu
- Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, West Virginia, United States
- Department of Biochemistry and Molecular Medicine, West Virginia University, Morgantown, West Virginia, United States
| | - Amy Lu
- Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, West Virginia, United States
- Department of Biochemistry and Molecular Medicine, West Virginia University, Morgantown, West Virginia, United States
| | - Jianhai Du
- Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, West Virginia, United States
- Department of Biochemistry and Molecular Medicine, West Virginia University, Morgantown, West Virginia, United States
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Sex differences in the association between systemic oxidative stress status and optic nerve head blood flow in normal-tension glaucoma. PLoS One 2023; 18:e0282047. [PMID: 36827337 PMCID: PMC9955941 DOI: 10.1371/journal.pone.0282047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
PURPOSE To investigate the association of systemic oxidative stress markers and optic nerve head (ONH) blood flow in normal-tension glaucoma (NTG) patients, as well as sex differences in this association. METHODS This was a cross-sectional study of 235 eyes with NTG of 134 patients (56 male, 78 female; mean age, 60.9±14.1 years). Laser speckle flowgraphy (LSFG) was used to measure ONH blood flow (mean blur rate in the tissue area of the ONH; MBR-T) and LSFG pulse-waveform parameters, including flow acceleration index in the tissue area of the ONH (FAI-T). Oxidative stress markers, diacron-reactive oxygen metabolites (d-ROMs), and biological antioxidant potential (BAP) were measured with a free radical elective evaluator. Spearman's rank correlation test and a multivariate linear mixed-effect model were used to investigate factors associated with ONH blood flow. RESULTS MBR-T was significantly correlated with age (rs = -0.28, p < 0.001), mean arterial pressure (rs = -0.20, p = 0.002), intraocular pressure (rs = 0.24, p < 0.001), peripapillary retinal nerve fiber layer thickness (rs = 0.62, p < 0.001), and disc area (rs = -0.26, p < 0.001), but not with serum d-ROM level. Separate analyses of the subjects divided by sex showed that BAP was positively correlated to MBR-T (rs = 0.21, p = 0.036) and FAI-T (rs = 0.36, p < 0.001) only in male subjects. Similarly, BAP was significantly associated with MBR-T (β = 0.25, p = 0.026) and FAI-T (β = 0.37, p < 0.001) in male subjects in a multivariate linear mixed-effect model. CONCLUSION A lower serum antioxidant level, as indicated by BAP, was associated with reduced ONH blood flow only in male NTG patients. Our findings suggest that there are sex differences in the involvement of oxidative stress in the pathogenesis of reduced ocular blood flow in NTG.
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Douglass A, Dattilo M, Feola AJ. Evidence for Menopause as a Sex-Specific Risk Factor for Glaucoma. Cell Mol Neurobiol 2023; 43:79-97. [PMID: 34981287 PMCID: PMC9250947 DOI: 10.1007/s10571-021-01179-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/03/2021] [Indexed: 01/07/2023]
Abstract
Glaucoma is a leading cause of irreversible blindness worldwide and is characterized by progressive loss of visual function and retinal ganglion cells (RGC). Current epidemiological, clinical, and basic science evidence suggest that estrogen plays a role in the aging of the optic nerve. Menopause, a major biological life event affecting all women, coincides with a decrease in circulating sex hormones, such as estrogen. While 59% of the glaucomatous population are females, sex is not considered a risk factor for developing glaucoma. In this review, we explore whether menopause is a sex-specific risk factor for glaucoma. First, we investigate how menopause is defined as a sex-specific risk factor for other pathologies, including cardiovascular disease, osteoarthritis, and bone health. Next, we discuss clinical evidence that highlights the potential role of menopause in glaucoma. We also highlight preclinical studies that demonstrate larger vision and RGC loss following surgical menopause and how estrogen is protective in models of RGC injury. Lastly, we explore how surgical menopause and estrogen signaling are related to risk factors associated with developing glaucoma (e.g., intraocular pressure, aqueous outflow resistance, and ocular biomechanics). We hypothesize that menopause potentially sets the stage to develop glaucoma and therefore is a sex-specific risk factor for this disease.
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Affiliation(s)
- Amber Douglass
- grid.484294.7Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA USA
| | - Michael Dattilo
- grid.189967.80000 0001 0941 6502Department of Ophthalmology, Emory Eye Center, Emory University School of Medicine, B2503, Clinic B Building, 1365B Clifton Road NE, Atlanta, GA 30322 USA ,grid.414026.50000 0004 0419 4084Department of Ophthalmology, Atlanta Veterans Affairs Medical Center, Atlanta, GA USA ,grid.213917.f0000 0001 2097 4943Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA USA
| | - Andrew J. Feola
- grid.484294.7Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA USA ,grid.189967.80000 0001 0941 6502Department of Ophthalmology, Emory Eye Center, Emory University School of Medicine, B2503, Clinic B Building, 1365B Clifton Road NE, Atlanta, GA 30322 USA ,grid.213917.f0000 0001 2097 4943Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA USA
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32
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Mehta R, Ray RM, Tussing-Humphreys LM, Pasquale LR, Maki P, Haan MN, Jackson R, Vajaranant TS. Effect of Low-Fat Dietary Modification on Incident Open-Angle Glaucoma. Ophthalmology 2022; 130:565-574. [PMID: 36410561 DOI: 10.1016/j.ophtha.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/10/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE We tested whether dietary modification (DM) altered the risk for incident primary open-angle glaucoma (POAG). DESIGN Secondary analysis of a randomized intervention trial. PARTICIPANTS We linked Medicare claims data to 45 203 women in the Women's Health Initiative Dietary Modification Trial, of which 23 776 participants were enrolled in fee-for-service Medicare Part B and had physician claims. METHODS Women were randomized to follow either DM (a low-fat diet, with increased vegetable, fruit, and grain intake) or their usual diet without modification. Nine thousand three hundred forty women were randomized to the DM intervention, whereas 13 877 women were randomized to the control group. Our analyses were based on an intention-to-treat design, with a follow-up to the end of continuous Medicare coverage, death, or the last clams date (12/31/2018), whichever occurred first. Primary open-angle glaucoma was defined as the first claim with the International Classification of Diseases, Ninth or Tenth Revision, codes. Dietary data were assessed using a food frequency questionnaire. MAIN OUTCOME MEASURES We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of POAG. Subgroup analyses were performed with P values for interaction. RESULTS After exclusion of women with Medicare-derived glaucoma before randomization, the final analysis included 23 217 women (mean age, 64.4 ± 5.8 years). Baseline characteristics were balanced between the intervention and control groups. Primary open-angle glaucoma incidence was 11.1 per 1000 woman-years (mean follow-up, 11.6 ± 7.4 years; mean DM duration, 5.2 ± 3.2 years). We found no overall benefit of DM in reducing incident POAG (HR, 1.04; 95% CI, 0.96-1.12). Race and participant age did not modify this relation (P = 0.08 and P = 0.24 for interaction, respectively). In further analysis of baseline nutrient and food intake stratified by quartile groups, risk of open-angle glaucoma (OAG) in DM participants in the lowest quartile group for percentage calories (kilocalories) from total fat (33.8 or lower) was increased (HR, 1.22; 95% CI, 1.05-1.41; P = 0.007 for interaction). CONCLUSIONS Analysis suggests that DM in participants in the lowest quartile group for percentage calories from total fat at baseline increased the risk of incident OAG among women regardless of age or race. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Rajvi Mehta
- Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois
| | - Roberta M Ray
- Women's Health Initiative, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Lisa Marie Tussing-Humphreys
- Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois; Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois
| | - Louis R Pasquale
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Pauline Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Mary N Haan
- University of California, San Francisco, San Francisco, California
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Madjedi KM, Stuart KV, Chua SYL, Foster PJ, Strouthidis NG, Luben RN, Warwick AN, Kang JH, Wiggs JL, Pasquale LR, Khawaja AP. The Association of Female Reproductive Factors with Glaucoma and Related Traits: A Systematic Review. Ophthalmol Glaucoma 2022; 5:628-647. [PMID: 35691565 PMCID: PMC10051419 DOI: 10.1016/j.ogla.2022.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 05/20/2022] [Accepted: 06/03/2022] [Indexed: 11/25/2022]
Abstract
TOPIC This systematic review summarizes evidence for associations between female reproductive factors (age at menarche, parity, oral contraceptive [OC] use, age at menopause, and postmenopausal hormone [PMH] use) and intraocular pressure (IOP) or open-angle glaucoma (OAG). CLINICAL RELEVANCE Understanding the associations between female reproductive factors and glaucoma may shed light on the disease pathogenesis and aid clinical prediction and personalized treatment strategies. Importantly, some factors are modifiable, which may lead to new therapies. METHODS Two reviewers independently extracted articles in MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials databases to identify relevant studies. Eligibility criteria included studies with human subjects aged > 18 years; a measured outcome of either IOP or OAG; a cohort, case-control, cross-sectional, or randomized controlled trial design; a reported measure of association, such as the hazard ratio, relative risk, odds ratio, or mean difference, with an associated confidence interval; and a measured exposure of at least 1 of the following variables: age at menarche, parity, OC use, age at menopause, or PMH use. RESULTS We included a total of 27 studies. Substantial differences in study designs, exposure and treatment levels, treatment durations, and variable reporting precluded a meaningful quantitative synthesis of the identified studies. Overall, relatively consistent associations between PMH use and a lower IOP were identified. Estrogen-only PMH use may be associated with lower OAG risk, which may be modified by race. No significant associations were found with combined estrogen-and-progesterone PMH use. No strong associations between parity or age at menarche and glaucoma were found, but a younger age at menopause was associated with an increased glaucoma risk, and adverse associations were identified with a longer duration of OC use, though no overall association with OC use was found. CONCLUSIONS The association between PMH use and lower IOP or OAG risk is a potentially clinically relevant and modifiable risk factor and should be investigated further, although this needs to be interpreted in the context of a high risk of bias across included studies. Future research should examine associations with IOP specifically and how the relationship between genetic factors and OAG risks may be influenced by female reproductive factors.
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Affiliation(s)
- Kian M Madjedi
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom; Department of Ophthalmology, University of Calgary, Alberta, Canada.
| | - Kelsey V Stuart
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom
| | - Sharon Y L Chua
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom
| | - Paul J Foster
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom
| | - Nicholas G Strouthidis
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom
| | - Robert N Luben
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom; Medical Research Council, Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Jae H Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, Massachusetts
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anthony P Khawaja
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom
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Rush KL, Burton L, Seaton CL, Smith MA, Li EPH, Ronquillo CE, Hasan K, Davis S, Mattei M. A cross-sectional study of the preventive health care activities of western Canadian rural-living patients unattached to primary care providers. Prev Med Rep 2022; 29:101913. [PMID: 35879934 PMCID: PMC9300582 DOI: 10.1016/j.pmedr.2022.101913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/06/2022] [Accepted: 07/18/2022] [Indexed: 12/03/2022] Open
Abstract
Prevention services, such as screening tests and vaccination, are underutilized, especially by rural populations and patients without a usual primary care provider. Little is known about the compounding impacts on preventive care of being unattached and living in a rural area and there has been no comprehensive exploration of this highly vulnerable population’s prevention activities. The twofold purpose of this research was to examine rural unattached patients’ prevention activity self-efficacy and completion and to explore their experiences accessing healthcare, including COVID-19 impacts. Two thirds of patients had been unattached for over one year, and over 20 % had been unattached for over 5 years; males experienced longer unattachment compared to females. Completion rates of prevention activities were relatively low, ranging from 5.9 % (alcohol screening) to 59 % (vision test). Most participants did not complete their prevention care activities in line with the Lifetime Prevention Schedule timeline: 65 % of participants had less than half of their activities up-to-date and only 6.7 % of participants were up to date on 75 % or more of their prevention activities. Participants with higher prevention self-efficacy scores were more likely to be up-to-date on associated prevention activities but the longer patients had been unattached, the fewer their up-to-date prevention activities. Patients expressed negative impacts of COVID-19 including walk-in clinics shutting down limiting access to care. These results suggest serious gaps in rural unattached patients’ preventive care and highlight the need for support when they are without a usual primary care provider, which can be lengthy.
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Affiliation(s)
- Kathy L Rush
- School of Nursing, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Lindsay Burton
- School of Nursing, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Cherisse L Seaton
- School of Nursing, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Mindy A Smith
- Patient Voices Network, British Columbia, Canada and Department of Family Medicine, Michigan State University, East Lansing, MI, United States
| | - Eric P H Li
- Faculty of Management and Principal's Research Chair (Tier 2) in Social Innovation for Health Equity and Food Security, University of British Columbia, Okanagan, Kelowna, Canada
| | - Charlene E Ronquillo
- Patient Voices Network, British Columbia, Canada and Department of Family Medicine, Michigan State University, East Lansing, MI, United States
| | - Khalad Hasan
- Department of Computer Science, University of British Columbia, Okanagan, Canada
| | - Selena Davis
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mona Mattei
- Division of Family Practice, Kootenay Boundary, Grand Forks, British Columbia, Canada
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35
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Elam AR, Tseng VL, Rodriguez TM, Mike EV, Warren AK, Coleman AL. Disparities in Vision Health and Eye Care. Ophthalmology 2022; 129:e89-e113. [PMID: 36058735 PMCID: PMC10109525 DOI: 10.1016/j.ophtha.2022.07.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 10/14/2022] Open
Abstract
Significant disparities in vision health and eye care exist. To achieve health equity, we must understand the root causes and drivers of health disparities and inequities, including social determinants of health and systemic racism.
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Affiliation(s)
- Angela R Elam
- Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan; Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
| | - Victoria L Tseng
- UCLA Stein and Doheny Eye Institutes, David Geffen School of Medicine, University of California, Los Angeles, California
| | | | - Elise V Mike
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alexis K Warren
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois
| | - Anne L Coleman
- UCLA Stein and Doheny Eye Institutes, David Geffen School of Medicine, University of California, Los Angeles, California; Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
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Sencanic I, Gazibara T, Jaksic V, Grgurevic A, Mrakovic T, Dotlic J. Socio-Demographic, lifestyle and eye-related factors associated with quality of life Among people with glaucoma in Serbia. Eur J Ophthalmol 2022; 33:11206721221128673. [PMID: 36163693 DOI: 10.1177/11206721221128673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to examine socio-demographic, lifestyle and ophthalmological factors associated with poorer Vision Related Quality of Life (VRQoL) in people with glaucoma. METHODS This cross-sectional study included 306 consecutive patients with glaucoma who presented for regular check-ups at the referral center in Belgrade (Serbia) from August 2015 to September 2016. The diagnosis of glaucoma was based on the glaucomatous disc cupping and reproducible visual field impairment on one or both eyes. Quality of life was examined using the validated Glaucoma Quality of Life-15 (GQL-15) and the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ 25). RESULTS A series of adjusted linear regression models showed that glaucoma patients with higher educational attainment, who were employed and still driving had better VRQoL. Worse visual acuity and visual field defect, being in later glaucoma stages, having lower intraocular pressure, having two laser interventions as well as having pseudo-exfoliative glaucoma was associated with worse VRQoL. Intake of fewer medications and having had no trabeculectomies on better eye as well as taking less drops per day on worse eye were associated with better VRQoL. CONCLUSIONS Several socio-demographic, lifestyle and ocular factors can impact VRQoL in glaucoma patients. Identifying people who are at risk of having worse VRQoL could allow for earlier interventions, such as changes in therapy, undergoing surgery, use of mobility aids etc.
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Affiliation(s)
- Ivan Sencanic
- Service d'Ophtalmologie, 478683GHRMSA - Groupe Hospitalier Regional Mulhouse Sud Alsace, France
| | - Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Serbia
| | - Vesna Jaksic
- Clinic for Eye Disease "Prof. dr Ivan Stankovic", University Medical Center "Zvezdara", Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | - Anita Grgurevic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Serbia
| | - Tina Mrakovic
- Clinic for Eye Disease "Prof. dr Ivan Stankovic", University Medical Center "Zvezdara", Belgrade, Serbia
| | - Jelena Dotlic
- Faculty of Medicine, University of Belgrade, Serbia
- Clinic of Obstetrics and Gynecology Clinical Center of Serbia
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Kim MH, Lim SH. Matrix Metalloproteinases and Glaucoma. Biomolecules 2022; 12:biom12101368. [PMID: 36291577 PMCID: PMC9599265 DOI: 10.3390/biom12101368] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 11/19/2022] Open
Abstract
Matrix metalloproteinases (MMPs) are enzymes that decompose extracellular matrix (ECM) proteins. MMPs are thought to play important roles in cellular processes, such as cell proliferation, differentiation, angiogenesis, migration, apoptosis, and host defense. MMPs are distributed in almost all intraocular tissues and are involved in physiological and pathological mechanisms of the eye. MMPs are also associated with glaucoma, a progressive neurodegenerative disease of the eyes. MMP activity affects intraocular pressure control and apoptosis of retinal ganglion cells, which are the pathological mechanisms of glaucoma. It also affects the risk of glaucoma development based on genetic pleomorphism. In addition, MMPs may affect the treatment outcomes of glaucoma, including the success rate of surgical treatment and side effects on the ocular surface due to glaucoma medications. This review discusses the various relationships between MMP and glaucoma.
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Affiliation(s)
- Moo Hyun Kim
- Department of Ophthalmology, Daegu Premier Eye Center, Suseong-ro 197, Suseong-Gu, Daegu 42153, Korea
| | - Su-Ho Lim
- Department of Ophthalmology, Daegu Veterans Health Service Medical Center, 60 Wolgok-Ro, Dalseo-Gu, Daegu 42835, Korea
- Correspondence: ; Tel.: +82-53-630-7572
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Retinal Ganglion Cells: Global Number, Density and Vulnerability to Glaucomatous Injury in Common Laboratory Mice. Cells 2022; 11:cells11172689. [PMID: 36078097 PMCID: PMC9454702 DOI: 10.3390/cells11172689] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/30/2022] Open
Abstract
How many RBPMS+ retinal ganglion cells (RGCs) does a standard C57BL/6 laboratory mouse have on average and is this number substrain- or sex-dependent? Do RGCs of (European) C57BL/6J and -N mice show a different intrinsic vulnerability upon glaucomatous injury? Global RGC numbers and densities of common laboratory mice were previously determined via axon counts, retrograde tracing or BRN3A immunohistochemistry. Here, we report the global RGC number and density by exploiting the freely available tool RGCode to automatically count RGC numbers and densities on entire retinal wholemounts immunostained for the pan-RGC marker RBPMS. The intrinsic vulnerability of RGCs from different substrains to glaucomatous injury was evaluated upon introduction of the microbead occlusion model, followed by RBPMS counts, retrograde tracing and electroretinography five weeks post-injury. We demonstrate that the global RGC number and density varies between substrains, yet is not sex-dependent. C57BL/6J mice have on average 46K ± 2K RBPMS+ RGCs per retina, representing a global RGC density of 3268 ± 177 RGCs/mm2. C57BL/6N mice, on the other hand, have on average less RBPMS+ RGCs (41K ± 3K RGCs) and a lower density (3018 ± 189 RGCs/mm2). The vulnerability of the RGC population of the two C57BL/6 substrains to glaucomatous injury did, however, not differ in any of the interrogated parameters.
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Musa I, Bansal S, Kaleem MA. Barriers to Care in the Treatment of Glaucoma: Socioeconomic Elements That Impact the Diagnosis, Treatment, and Outcomes in Glaucoma Patients. CURRENT OPHTHALMOLOGY REPORTS 2022; 10:85-90. [PMID: 35911786 PMCID: PMC9325663 DOI: 10.1007/s40135-022-00292-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 11/27/2022]
Abstract
Purpose of Review This article reviews socioeconomic elements that impact the access to glaucoma care, early intervention in susceptible patients, and longevity of treatment and patient compliance in various demographic groups. Recent Findings Socioeconomic factors such as insurance eligibility, education, income, marital status, and access to technology can deeply impact the diagnosis and long-term treatment of glaucoma patients. Depending on the severity, and/or urgency of care, many individuals who face these barriers forgo annual eye exams, leading to a higher incidence of untreated glaucoma. Summary Early intervention and regular follow-up are essential for patient compliance in the management of glaucoma. Routine eye care leads to earlier detection and can improve management options and reduce the severity of disease burden.
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Affiliation(s)
| | - Surbhi Bansal
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA USA
| | - Mona A Kaleem
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD USA
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Bioinformatic Prioritization and Functional Annotation of GWAS-Based Candidate Genes for Primary Open-Angle Glaucoma. Genes (Basel) 2022; 13:genes13061055. [PMID: 35741817 PMCID: PMC9222386 DOI: 10.3390/genes13061055] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 12/19/2022] Open
Abstract
Background: Primary open-angle glaucoma (POAG) is the most prevalent glaucoma subtype, but its exact etiology is still unknown. In this study, we aimed to prioritize the most likely ‘causal’ genes and identify functional characteristics and underlying biological pathways of POAG candidate genes. Methods: We used the results of a large POAG genome-wide association analysis study from GERA and UK Biobank cohorts. First, we performed systematic gene-prioritization analyses based on: (i) nearest genes; (ii) nonsynonymous single-nucleotide polymorphisms; (iii) co-regulation analysis; (iv) transcriptome-wide association studies; and (v) epigenomic data. Next, we performed functional enrichment analyses to find overrepresented functional pathways and tissues. Results: We identified 142 prioritized genes, of which 64 were novel for POAG. BICC1, AFAP1, and ABCA1 were the most highly prioritized genes based on four or more lines of evidence. The most significant pathways were related to extracellular matrix turnover, transforming growth factor-β, blood vessel development, and retinoic acid receptor signaling. Ocular tissues such as sclera and trabecular meshwork showed enrichment in prioritized gene expression (>1.5 fold). We found pleiotropy of POAG with intraocular pressure and optic-disc parameters, as well as genetic correlation with hypertension and diabetes-related eye disease. Conclusions: Our findings contribute to a better understanding of the molecular mechanisms underlying glaucoma pathogenesis and have prioritized many novel candidate genes for functional follow-up studies.
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Wu KY, Hodge DO, White LJ, McDonald J, Roddy GW. Association of Metabolic Syndrome With Glaucoma and Ocular Hypertension in a Midwest United States Population. J Glaucoma 2022; 31:e18-e31. [PMID: 34860182 PMCID: PMC9337265 DOI: 10.1097/ijg.0000000000001968] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/19/2021] [Indexed: 12/29/2022]
Abstract
PRCIS For patients with glaucoma, metabolic syndrome was associated with higher intraocular pressure and greater central corneal thickness. Patients with metabolic syndrome were more likely to have ocular hypertension. PURPOSE The purpose of this study was to determine whether glaucomatous optic neuropathy, also known as glaucoma, and ocular hypertension are more likely to occur in patients with metabolic syndrome. PATIENTS AND METHODS Patients in Olmsted County, MN, were identified as having metabolic syndrome based on diagnosis codes, laboratory values, and/or medication use to meet 3 or more of the 5 standard criteria for diagnosing metabolic syndrome: systemic hypertension, hyperglycemia, hypertriglyceridemia, reduced high-density lipoprotein cholesterol, and central adiposity defined by increased body mass index. Patients with glaucoma, including primary open angle, low tension, pigment dispersion, and pseudoexfoliation, were identified using diagnostic codes. The charts of patients with glaucoma were individually reviewed to collect visual acuity, intraocular pressure, cup to disc ratio, central corneal thickness, visual field mean deviation, retinal nerve fiber layer thickness, and treatment of intraocular pressure. Patients with ocular hypertension were separately identified and similarly evaluated. RESULTS For patients with glaucoma, those with metabolic syndrome had higher intraocular pressure and greater central corneal thickness compared with those without metabolic syndrome. After adjustment for central corneal thickness, there was no longer a significant difference in intraocular pressure between groups. Metabolic syndrome was also associated with the diagnosis of ocular hypertension, and although central corneal thickness trended higher in patients with metabolic syndrome, it did not attain statistical significance. CONCLUSION In Olmsted County, though metabolic syndrome was associated with ocular hypertension and higher intraocular pressure in patients with glaucoma, the results were likely related to a thicker central corneal in this patient population.
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Affiliation(s)
- Kristi Y. Wu
- Department of Ophthalmology, Mayo Clinic, Rochester, MN, 55905
| | - David O. Hodge
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, 3222
| | - Launia J. White
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, 3222
| | | | - Gavin W. Roddy
- Department of Ophthalmology, Mayo Clinic, Rochester, MN, 55905
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Glaucoma diagnosis using multi-feature analysis and a deep learning technique. Sci Rep 2022; 12:8064. [PMID: 35577876 PMCID: PMC9110703 DOI: 10.1038/s41598-022-12147-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 04/25/2022] [Indexed: 11/08/2022] Open
Abstract
In this study, we aimed to facilitate the current diagnostic assessment of glaucoma by analyzing multiple features and introducing a new cross-sectional optic nerve head (ONH) feature from optical coherence tomography (OCT) images. The data (n = 100 for both glaucoma and control) were collected based on structural, functional, demographic and risk factors. The features were statistically analyzed, and the most significant four features were used to train machine learning (ML) algorithms. Two ML algorithms: deep learning (DL) and logistic regression (LR) were compared in terms of the classification accuracy for automated glaucoma detection. The performance of the ML models was evaluated on unseen test data, n = 55. An image segmentation pilot study was then performed on cross-sectional OCT scans. The ONH cup area was extracted, analyzed, and a new DL model was trained for glaucoma prediction. The DL model was estimated using five-fold cross-validation and compared with two pre-trained models. The DL model trained from the optimal features achieved significantly higher diagnostic performance (area under the receiver operating characteristic curve (AUC) 0.98 and accuracy of 97% on validation data and 96% on test data) compared to previous studies for automated glaucoma detection. The second DL model used in the pilot study also showed promising outcomes (AUC 0.99 and accuracy of 98.6%) to detect glaucoma compared to two pre-trained models. In combination, the result of the two studies strongly suggests the four features and the cross-sectional ONH cup area trained using deep learning have a great potential for use as an initial screening tool for glaucoma which will assist clinicians in making a precise decision.
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Risk factors for undergoing surgery in patients with newly diagnosed open-angle glaucoma. Sci Rep 2022; 12:5661. [PMID: 35383265 PMCID: PMC8983768 DOI: 10.1038/s41598-022-09832-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the clinical importance of glaucoma surgery, studies on its prevalence and risk factors are limited. We analyzed a database comprising approximately 1,000,000 Korean residents to investigate the prevalence and risk factors for undergoing glaucoma surgery within 5 years of diagnosis with open-angle glaucoma. Of the 4,303 patients evaluated, 226 (5.3%) underwent glaucoma surgery. Factors associated with the likelihood of glaucoma surgery included the use of two or more eye drops (odds ratio [OR], 30.30; 95% confidence interval [CI], 10.95–83.84), intake of oral carbonic anhydrase inhibitor (OR, 1.79; 95% CI, 1.23–2.61), age > 55 years (55–65 years: OR, 1.71; 95% CI, 1.06–2.76; > 65 years: OR 1.72; 95% CI, 1.10–2.70), female sex (OR, 1.46; 95% CI, 1.10–1.94), middle- and high-income (OR, 2.36; 95% CI, 1.30–4.28, OR, 1.86; 95% CI, 1.03–3.35, respectively), and metropolitan residence (OR, 1.61; 95% CI, 1.14–2.26). Our nomogram for predicting the likelihood of glaucoma surgery showed an acceptable result. In conclusion, older age, female sex, and the intensity of intraocular pressure lowering treatment increased the likelihood of undergoing glaucoma surgery. Our findings indicated that a lower socioeconomic status may forestall receiving this necessary surgery, which requires further attention.
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Suh MH, Jung DH, Weinreb RN, Zangwill LM. Optic Disc Microvasculature Dropout in Glaucoma Detected by Swept-Source Optical Coherence Tomography Angiography. Am J Ophthalmol 2022; 236:261-270. [PMID: 34740630 DOI: 10.1016/j.ajo.2021.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To assess the clinical utility of swept-source optical coherence tomography angiography (SS-OCTA) in detecting optic disc microvasculature dropout (MvD-D) in primary open-angle glaucoma (POAG) eyes. DESIGN Cross-sectional study. METHODS The study enrolled 197 eyes of 197 patients with POAG with acceptable-quality SS-OCTA (PLEX Elite 9000; Carl Zeiss Meditec) images. A whole-signal-mode 6.0- × 6.0-mm optic disc cube was obtained with projection artifact removal. Three groups were categorized: no MvD-D (group 1), MvD-D (group 2, complete loss of microvasculature within the optic disc), and indiscernible MvD-D (group 3, poor visualization of the anterior lamina cribrosa [LC]). RESULTS There were 82 (42.1%) and 81 (41.5%) eyes categorized as no MvD-D (group 1) and MvD-D (group 2), respectively. The remaining 32 eyes (16.4%), categorized as indiscernible MvD-D (group 3), had a significantly smaller anterior scleral canal opening (ASCO) area (P < .05). Group 2 had significantly worse visual field (VF) mean deviation (MD), thinner average retinal nerve fiber layer (RNFL), higher prevalence of focal LC defect, and parapapillary deep-layer microvasculature dropout (MvD-P) than the other 2 groups (P < .05). In the multivariable logistic regression analysis, higher prevalence of focal LC defect (odds ratio, 46.91; P < .001) and MvD-P (odds ratio, 48.94; P < .001) remained as factors associated with MvD-D. CONCLUSIONS The presence of MvD-D could be well determined by SS-OCTA in eyes with POAG. MvD-P and focal LC defects were strongly associated with MvD-D. This suggests that SS-OCTA can serve as a useful tool in detecting optic disc microvasculature damage.
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Fine Particulate Matter Exposure Levels in Patients with Normal-Tension Glaucoma and Primary Open-Angle Glaucoma: A Population-Based Study from Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074224. [PMID: 35409910 PMCID: PMC8998620 DOI: 10.3390/ijerph19074224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/20/2022]
Abstract
Patients with NTG or POAG with more than one outpatient or discharge diagnosis from the ophthalmology department were included in the study. These data were merged with the PM2.5 data from the Air Quality Monitoring Network for analysis. This was a case−control study, with 1006 participants in the NTG group and 2533 in the POAG group. To investigate fine particulate matter (PM2.5) exposure levels in patients with normal-tension glaucoma (NTG) and primary open-angle glaucoma (POAG), patient data were obtained from Taiwan’s Longitudinal Health Insurance Database 2000 for the 2008 to 2013 period. We used a multivariate logic regression model to assess the risk for each participant. The PM2.5 exposure levels were divided into four groups: <25th percentile (Q1), <617 μg/mm3; 25th to 50th percentile (Q2), 617 to 1297 μg/mm3; 50th to 75th percentile (Q3), 1297 to 2113 μg/mm3; and >75th percentile (Q4), >2113 μg/mm3. The results are expressed in terms of odds ratio (OR) and 95% CI. A multiple logistic regression was used to compare the results of the NTG group with those of the POAG group. Compared with the PM2.5 Q1 level, the OR of the PM2.5 Q2 level was 1.009 (95% CI 0.812−1.254), the PM2.5 Q3 level was 1.241 (95% CI 1.241−1.537, p < 0.05), and the PM2.5 Q4 level was 1.246 (95% CI 1.008−1.539, p < 0.05). Our research reveals that compared with POAG, the risk of developing NTG is more closely related with PM2.5 exposure, and PM2.5 has a concentration−dose effect. It is hoped that in the future, in the clinical judgment of NTG and POAG, the level of PM2.5 in the environment can be taken as a risk factor.
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Prokosch V, Zwingelberg SB, Mercieca K. [Normal Tension Glaucoma]. Klin Monbl Augenheilkd 2022. [PMID: 35253131 DOI: 10.1055/a-1758-3486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Normal tension glaucoma (NTG) is a subvariant of primary open angle glaucoma (POAG) or a separate entity. NTG is defined as chronic open angle glaucoma without elevated intraocular pressure or normal intraocular pressure. Normal intraocular pressure is between 10 and 21 mmHg and is defined as two times the standard deviation of the mean intraocular pressure in the normal population. In addition to the absence of elevated intraocular pressure, all the classic symptoms of glaucoma are otherwise present. These include a conspicuous glaucomatous optic disc excavation, nerve fibre bundle defects, and corresponding visual field defects. Papillary rim haemorrhages are frequently found. The visual field defects in NDG are usually more central compared to POAG and are therefore described as more disturbing by the patient. The anterior chamber angle is open and there are no other changes suggestive of secondary glaucoma (pigment dispersion, pseudo-exfoliation). The exact pathophysiology of NDG is not well understood. Pathophysiologically, circulatory disturbances in the sense of arterial hypo- as well as hypertension may play an essential role or at least increase the susceptibility of the optic nerve to intraocular pressure fluctuations as well as blood pressure dips. Therefore, this requires not only a purely ophthalmologic but also interdisciplinary treatment of the patient with confirmed NDG. The primary goal of treatment is the reduction of intraocular pressure, which can stop the disease. This article gives an overview of epidemiology, aetiology, clinical findings and therapies.
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Prokosch V, Zwingelberg SB, Mercieca K. Normaldruckglaukome. AUGENHEILKUNDE UP2DATE 2022. [DOI: 10.1055/a-1262-3134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungDas Normaldruckglaukom wird definiert wird als primär chronisches Offenwinkelglaukom, bei dem kein erhöhter Augeninnendruck vorliegt. Trotz normalem Augeninnendruck ist das primäre Ziel der
Behandlung die Augeninnendrucksenkung, mit der es gelingen kann, die Erkrankung aufzuhalten. Dieser Artikel soll eine Übersicht über Epidemiologie, Ätiologie, Pathogenese, klinische Befunde
sowie Therapien geben.
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Somvanshi RK, Zou S, Kadhim S, Padania S, Hsu E, Kumar U. Cannabinol modulates neuroprotection and intraocular pressure: A potential multi-target therapeutic intervention for glaucoma. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166325. [DOI: 10.1016/j.bbadis.2021.166325] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/22/2021] [Accepted: 12/09/2021] [Indexed: 12/31/2022]
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Lee SY, Yang H, Lee K, Seong GJ, Kim CY, Bae HW. Factors Associated With Differences in the Initial Location of Structural Progression in Normal-Tension Glaucoma. J Glaucoma 2022; 31:170-177. [PMID: 35019877 PMCID: PMC8876386 DOI: 10.1097/ijg.0000000000001983] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/28/2021] [Indexed: 11/26/2022]
Abstract
PRCIS Different clinical factors are associated with the location of the first structural progression in glaucoma. PURPOSE The aim was to investigate the underlying clinical parameters affecting the location of the initial structural progression of glaucoma in patients with normal-tension glaucoma (NTG). METHODS This retrospective study included 228 eyes of 228 patients with NTG. In total, 130 eyes of 130 patients demonstrated structural progression (as determined by event-based guided progression analysis using Cirrus HD-optical coherence tomography) in the peripapillary retinal nerve fiber layer (ppRNFL) or macular ganglion cell inner plexiform layer (mGCIPL). Depending on where the progression occurred first, it was defined as either ppRNFL first progression or mGCIPL first progression. Clinical parameters associated with each first progression were identified using logistic regression. RESULTS In total, 50 eyes showed ppRNFL first progression and 64 eyes showed mGCIPL first progression. ppRNFL first progression was significantly associated with female sex [odds ratio (OR)=5.705, P=0.015], lack of systemic hypertension (OR=0.199, P=0.014), disc hemorrhage (OR=4.188, P=0.029), higher mean intraocular pressure (OR=1.300, P=0.03), and lower pattern SD (OR=0.784, P=0.028). In contrast, male sex (OR=0.450, P=0.043), lower central corneal thickness (OR=0.987, P=0.032), higher intraocular pressure fluctuation (OR=1.753, P=0.047), lower systolic blood pressure fluctuation (OR=0.839, P=0.002), and higher diastolic blood pressure fluctuation (OR=1.208, P=0.015) were significantly associated with mGCIPL first progression. CONCLUSIONS Different clinical factors were associated with the initial site of structural glaucoma progression in patients with NTG depending on its peripapillary or macular location, and these findings suggest possible differences in underlying mechanisms of glaucoma damage.
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Affiliation(s)
- Sang Yeop Lee
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine
- Department of Ophthalmology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin
| | | | - Kwanghyun Lee
- Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-do, Republic of Korea
| | - Gong Je Seong
- Department of Ophthalmology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin
| | - Chan Yun Kim
- Department of Ophthalmology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin
| | - Hyoung Won Bae
- Department of Ophthalmology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin
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Early-Onset Glaucoma in egl1 Mice Homozygous for Pitx2 Mutation. Biomedicines 2022; 10:biomedicines10030516. [PMID: 35327318 PMCID: PMC8945683 DOI: 10.3390/biomedicines10030516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 02/04/2023] Open
Abstract
Mutations in PITX2 cause Axenfeld–Rieger syndrome, with congenital glaucoma as an ocular feature. The egl1 mouse strain carries a chemically induced Pitx2 mutation and develops early-onset glaucoma. In this study, we characterized the glaucomatous features in egl1 mice. The eyes of egl1 and C57BL/6J control mice were assessed by slit lamp examination, total aqueous humor outflow facility, intraocular pressure (IOP) measurement, pattern electroretinography (PERG) recording, and histologic and immunohistochemistry assessment beginning at 3 weeks and up to 12 months of age. The egl1 mice developed elevated IOP as early as 4 weeks old. The IOP elevation was variable and asymmetric within and between the animals. The aqueous humor outflow facility was significantly reduced in 12-month-old animals. PERG detected a decreased response at 2 weeks after the development of IOP elevation. Retinal ganglion cell (RGC) loss was detected after 8 weeks of IOP elevation. Slit lamp and histologic evaluation revealed corneal opacity, iridocorneal adhesions (anterior synechiae), and ciliary body atrophy in egl1 mice. Immunohistochemistry assessment demonstrated glial cell activation and RGC axonal injury in response to IOP elevation. These results show that the eyes of egl1 mice exhibit anterior segment dysgenesis and early-onset glaucoma. The egl1 mouse strain may represent a useful model for the study of congenital glaucoma.
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