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Palmer LD, Peterson JD, Evans JK, Nelson MH, Asrani S, Thompson AC. Posterior Vitreous Detachment and Risk of Neovascular Glaucoma in Eyes with Prior Retinal Vascular Occlusions. Ophthalmol Ther 2024:10.1007/s40123-024-01039-1. [PMID: 39342534 DOI: 10.1007/s40123-024-01039-1] [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: 06/09/2024] [Accepted: 09/16/2024] [Indexed: 10/01/2024] Open
Abstract
INTRODUCTION To investigate the impact of posterior vitreous detachment (PVD) on the risk of developing neovascular glaucoma (NVG) in eyes with occlusions of the retinal artery (RAO) or retinal vein (RVO). METHODS Single-center retrospective case-control study of adults with a history of RVO/RAO. Cases (N = 101) who developed NVG were age and sex matched 1:2 to controls who did not develop NVG (N = 202). Multivariable logistic regression was used to estimate the association between history of PVD and risk of NVG while controlling for other related demographic or clinical factors. RESULTS In initial bivariate analyses, there was no difference in risk of NVG based on eye, lens status, hypertension, history of panretinal photocoagulation (PRP), or retinal surgery (all p > 0.10), a borderline difference based on diabetic retinopathy (DR) (p = 0.06) and prior anti-vascular endothelial growth factor (anti-VEGF) treatment (p = 0.08), and a significant difference based on race/ethnicity, type of vascular event, and PVD status (all p < 0.05). In the final multivariable model, patients without PVD were significantly more likely to develop NVG (OR = 3.07, p = 0.0001) independent of the other covariates. Risk of NVG was greater in those with DR (OR = 1.98, p = 0.0440) and in those with central RVO vs. branch RVO/hemiretinal RVO (OR = 5.77, p < 0.0001). Non-White/Non-Hispanics (OR = 2.56, p = 0.0051) and Hispanics (OR = 3.65, p = 0.0288) were more likely than White patients to develop NVG. CONCLUSIONS Progression to NVG after retinal vascular occlusion is more likely in Non-White/Hispanic patients, those with concomitant DR, and those with CRVO/CRAO. The absence of PVD increases the risk for NVG. Further studies are necessary to understand this relationship.
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Affiliation(s)
- Laura D Palmer
- Wake Forest University School of Medicine, 475 Vine St, Winston Salem, NC, 27101, USA
| | - Jared D Peterson
- Wake Forest University School of Medicine, 475 Vine St, Winston Salem, NC, 27101, USA
- Department of Surgical Ophthalmology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA
| | - Joni K Evans
- Department of Biostatistics and Data Science, Wake Forest University, Winston Salem, NC, USA
| | - Mark H Nelson
- Wake Forest University School of Medicine, 475 Vine St, Winston Salem, NC, 27101, USA
- Department of Surgical Ophthalmology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA
| | - Sanjay Asrani
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Atalie C Thompson
- Wake Forest University School of Medicine, 475 Vine St, Winston Salem, NC, 27101, USA.
- Department of Surgical Ophthalmology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA.
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA.
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Falb T, Heidinger A, Wallisch F, Tomasic H, Ivastinovic D, Lindner M, Tiefenthaller F, Keintzel L, Hoeflechner L, Riedl R, Hommer A, Lindner E. Postoperative Pain after Different Transscleral Laser Cyclophotocoagulation Procedures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2666. [PMID: 36768032 PMCID: PMC9915327 DOI: 10.3390/ijerph20032666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND As the number of surgical options in glaucoma treatment is continuously rising, evidence regarding distinctive features of these surgeries is becoming more and more important for clinicians to choose the right surgical treatment for each individual patient. METHODS For this retrospective data analysis, we included glaucoma patients treated with either continuous wave (CW-TSCPC) or micropulse transscleral cyclophotocoagulation (MP-TSCPC) in an inpatient setting. Pain intensity was assessed using a numeric rating scale (NRS) ranging from 0 (no pain) to 10 (worst imaginable pain) during hospitalization. CW-TSCPC was performed using OcuLight® Six (IRIDEX Corporation, Mountain View, CA, USA) and MP-TSCPC was performed using the IRIDEX® Cyclo-G6 System (IRIDEX Corporation, Mountain View, CA, USA). RESULTS A total of 243 consecutive cases of TSCPC were included. Of these, 144 (59.26%) were treated with CW-TSCPC and 99 (40.74%) with MP-TSCPC. Using the univariable model, the risk for postoperative pain was observed to be lower in MP-TSCPC compared with CW-TSCPC (unadjusted: OR 0.46, 95% CI 0.24-0.84, p = 0.017), but this did not hold using the multivariable model (adjusted: OR 0.52, 95% CI 0.27-1.02, p = 0.056). Simultaneously conducted anterior retinal cryotherapy was associated with a higher risk for postoperative pain (OR 4.41, 95% CI 2.01-9.69, p < 0.001). CONCLUSIONS We found that the occurrence of postoperative pain was not different in CW-TSCPC compared with MP-TSCPC in a multivariable model. In cases of simultaneous anterior retinal cryotherapy, the risk for postoperative pain was significantly higher.
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Affiliation(s)
- Thomas Falb
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
| | - Astrid Heidinger
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
| | - Fabian Wallisch
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
| | - Hrvoje Tomasic
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
| | | | - Marlene Lindner
- Department of Dentistry and Oral Health, Medical University Graz, 8036 Graz, Austria
| | | | - Lukas Keintzel
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
| | - Lukas Hoeflechner
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
| | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, 8036 Graz, Austria
| | - Anton Hommer
- Department of Ophthalmology, Sanatorium Hera, 1090 Vienna, Austria
| | - Ewald Lindner
- Department of Ophthalmology, Medical University Graz, 8036 Graz, Austria
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Glaucoma Detection in Myopic Eyes: Structural and Vascular Assessment by Optic Coherence Tomography Methods. J Glaucoma 2022; 31:947-954. [PMID: 36223326 DOI: 10.1097/ijg.0000000000002121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/22/2022] [Indexed: 11/07/2022]
Abstract
PRCIS Retinal nerve fiber layer (RNFL) thickness is helpful in the diagnosis of glaucoma in myopic eyes but neuroretinal rim (NRR) thickness is the most valuable measure. However, changes in optical coherence tomography angiography (OCT-A) parameters are insufficient for the diagnosis of mild to moderate glaucoma in myopia. PURPOSE To detect how a multimodal evaluation, which includes RNFL, NRR thickness, and optic nerve head (ONH) OCT-A, affects glaucoma diagnosis in myopic patients. MATERIALS AND METHODS Parameters of healthy myopic and myopic glaucoma eyes with an axial length of ≥24 mm were compared. The ONH structural features and peripapillary RNFL thickness were determined with Cirrus 5000 HD-OCT (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA). The Cirrus 5000 HD-OCT with AngioPlex was utilized to perform OCT-A imaging. The sensitivity and specificity levels were calculated by the best cut-off values with area under curve (AUC). RESULTS One hundred healthy myopic and 54 myopic glaucoma eyes were evaluated. In all areas, myopic glaucoma patients exhibited lower RNFL and NRR thickness than healthy myopic individuals ( P <0.05), with the exception of nasal quadrant RNFL thickness ( P =0.152). The mean entire and 4 quadrants of global radial peripapillary capillary (RPC)-perfusion and global RPC flux index (FI) were significantly lower in the group of myopic glaucoma patients except for the nasal quadrant mean RPC perfusion ( P =0.224). The average RNFL and NRR thickness had a significant difference in AUC for the diagnosis of glaucoma in myopic individuals ( P =0.001, for each). The average NRR showed excellent diagnostic performance, whereas the average RNFL showed good diagnostic performance. Average RPC perfusion and average RPC FI showed poor diagnostic ability. The average NRR AUC was more significant than average RPC perfusion and average RPC FI AUC ( P <0.001). CONCLUSIONS Although RNFL thickness was helpful to diagnose glaucoma in patients with myopia, the diagnostic power of NRR thickness performed best. OCT-A parameters showed poor diagnostic accuracy for glaucoma and the observed perfusion decrease in myopic glaucoma eyes was not sufficiently discriminative compared with NRR and RNFL thickness measurements.
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Wang QW, Zuo CG, Li J, Lin XS, Chen W, Zhu QL, Zhou FQ, Lin HT, Chen WR. Effectiveness of surgical management of malignant glaucoma in phakic eyes. Int J Ophthalmol 2022; 15:65-70. [PMID: 35047358 DOI: 10.18240/ijo.2022.01.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 10/08/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To assess the effectiveness of core vitrectomy-phacoemulsification-intraocular lens (IOL) implantation-capsulo-hyaloidotomy in treating phakic eye at least 1mo after the onset of malignant glaucoma. METHODS A retrospective analysis were performed on malignant glaucoma patients treated in Zhongshan Ophthalmic Center between 2016 and 2018. Demographic and clinical data were described. The preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), number of IOP-lowering medications used, and anterior chamber depth (ACD) of the case series were compared by Wilcoxon signed-rank test. RESULTS Thirteen phakic eyes with long time intervals between onset and surgery were identified in this case series. Core vitrectomy-phacoemulsification-IOL implantation-capsulo-hyaloidotomy reduced the IOP (P=0.046) and the number of IOP-lowering medications used (P=0.004), deepened the ACD (P=0.005). Complete success was achieved in 38.5% of the eyes, and anatomical success was achieved in 100% of the eyes without any recurrence. The only postoperative complication observed is corneal endothelial decompensation. It occurred in two cases. CONCLUSION Core vitrectomy-phacoemulsification-IOL implantation-capsulo-hyaloidotomy is safe and effective for treatment of long onset phakic malignant glaucoma.
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Affiliation(s)
- Qi-Wei Wang
- 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 510060, Guangdong Province, China.,New England College of Optometry, Boston, MA 02115, USA
| | - Cheng-Guo Zuo
- 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 510060, Guangdong Province, China.,New England College of Optometry, Boston, MA 02115, USA
| | - Jing Li
- 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 510060, Guangdong Province, China
| | - Xiao-Shan Lin
- 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 510060, Guangdong Province, China
| | - Wan 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 510060, Guangdong Province, China
| | - Qiao-Lin Zhu
- 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 510060, Guangdong Province, China
| | - Feng-Qi Zhou
- New England College of Optometry, Boston, MA 02115, USA
| | - Hao-Tian Lin
- 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 510060, Guangdong Province, China
| | - Wei-Rong 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 510060, Guangdong Province, China
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Cheung H, King BJ, Gast TJ. Presumed activated retinal astrocytes and Müller cells in healthy and glaucomatous eyes detected by spectral domain optical coherence tomography. Ophthalmic Physiol Opt 2020; 40:738-751. [PMID: 32885879 PMCID: PMC7692888 DOI: 10.1111/opo.12731] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/05/2020] [Indexed: 12/02/2022]
Abstract
Purpose To investigate presumed activated retinal astrocytes and Müller cells (ARAM) detected by scanning laser ophthalmoscopy (SLO) and spectral domain optical coherence tomography, and to investigate its presence in healthy controls as well as its relationship to posterior vitreal detachment (PVD) and glaucoma. Methods This retrospective study involved 1337 eyes of 805 controls between ages 8 and 90, and 250 eyes of 146 patients with glaucoma between the ages of 28 and 95. Subjects were counted as possessing ARAM only if they met the following criteria: (1) a patchy, discrete, glittering appearance on SLO, (2) a distinct, flat, hyper‐reflective layer at the internal limiting membrane on at least one B‐scan crossing the glittering area and (3) absence of any surface wrinkling retinopathy. The diagnosis of PVD was based on both the patient’s clinical examination and imaging data. Frequency tables were used to describe categorical variables and differences were compared by means of χ2. Analyses were separated based on right and left eye, first on controls and then between glaucomatous eyes and age‐similar sex‐matched controls. Results ARAM was found in both healthy controls and patients with glaucoma at similar frequencies. There was no association between having glaucoma and the presence of ARAM. ARAM was not different between the sexes but was associated with age and having a PVD. Conclusions This large retrospective study found that ARAM can be seen in healthy controls, is associated with PVD and possibly independently with age, and occurred at similar frequency in glaucomatous eyes.
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Affiliation(s)
- Hin Cheung
- School of Optometry, Indiana University, Bloomington, USA
| | - Brett J King
- School of Optometry, Indiana University, Bloomington, USA
| | - Thomas J Gast
- School of Optometry, Indiana University, Bloomington, USA
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Schwab C, Paar M, Fengler VH, Lindner E, Haas A, Ivastinovic D, Seidel G, Weger M, Wedrich A, Oettl K. Vitreous albumin redox state in open-angle glaucoma patients and controls: a pilot study. Int Ophthalmol 2020; 40:999-1006. [PMID: 31925660 DOI: 10.1007/s10792-019-01268-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/30/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Numerous studies suggest that reactive oxygen species play a crucial role in the development of glaucoma. Since glaucoma patients exhibit posterior vitreous detachment earlier than controls, it has been suggested that reactive oxygen species-increased in glaucoma-also affect the vitreous. In the present study we evaluated the influence of open-angle glaucoma oxidative stress on the redox state of vitreous albumin. METHODS Albumin redox states of the vitreous and plasma were evaluated in 22 subjects-11 open-angle glaucoma patients and 11 controls-matched for age, gender, and vitreous state. According to the redox state of cysteine-34, albumin can be separated into: human mercaptalbumin (the thiol form), human nonmercaptalbumin1 (a reversible modification due to mild oxidation), and human nonmercaptalbumin2 (an irreversible modification due to severe oxidation). RESULTS Albumin of both, the open-angle glaucoma group and the control group, was more oxidized in the vitreous compared to plasma. Furthermore, significantly higher human nonmercaptalbumin1 fractions were found in the vitreous of open-angle glaucoma patients compared to controls. No significant differences were found in the plasma albumin fractions between the groups. CONCLUSION Our results support the hypothesis that oxidative stress plays a crucial role in open-angle glaucoma and that reactive oxygen species in glaucomatous eyes may also affect the vitreous.
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Affiliation(s)
- Christoph Schwab
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Margret Paar
- Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria.
| | - Vera Heike Fengler
- Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria
| | - Ewald Lindner
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Anton Haas
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Domagoj Ivastinovic
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Gerald Seidel
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Martin Weger
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Andreas Wedrich
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Karl Oettl
- Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria
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Blanc J, Seydou A, Ben Ghezala I, Deschasse C, Meillon C, Bron AM, Binquet C, Creuzot-Garcher C. Vitreomacular Interface Abnormalities and Glaucoma in an Elderly Population (The MONTRACHET Study). ACTA ACUST UNITED AC 2019; 60:1996-2002. [DOI: 10.1167/iovs.18-26510] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Julie Blanc
- University Hospital, Department of Ophthalmology, Dijon, France
| | - Alassane Seydou
- Institut National de la Santé et de la Recherche Médicale (INSERM), Clinical Center Investigation, Clinical Epidemiology/Clinical Trials Unit, Universal Hospital, Dijon, France
- Centre des Sciences du Goût et de l'Alimentation, Centre National pour la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA), University Bourgogne Franche-Comté, Dijon, France
| | | | | | - Cyril Meillon
- University Hospital, Department of Ophthalmology, Dijon, France
| | - Alain M. Bron
- University Hospital, Department of Ophthalmology, Dijon, France
- Centre des Sciences du Goût et de l'Alimentation, Centre National pour la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA), University Bourgogne Franche-Comté, Dijon, France
| | - Christine Binquet
- Institut National de la Santé et de la Recherche Médicale (INSERM), Clinical Center Investigation, Clinical Epidemiology/Clinical Trials Unit, Universal Hospital, Dijon, France
- Centre des Sciences du Goût et de l'Alimentation, Centre National pour la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA), University Bourgogne Franche-Comté, Dijon, France
| | - Catherine Creuzot-Garcher
- University Hospital, Department of Ophthalmology, Dijon, France
- Centre des Sciences du Goût et de l'Alimentation, Centre National pour la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA), University Bourgogne Franche-Comté, Dijon, France
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Comparison of cytokine/chemokine levels in aqueous humor of primary open-angle glaucoma patients with positive or negative outcome following trabeculectomy. Biosci Rep 2019; 39:BSR20181894. [PMID: 30967499 PMCID: PMC6499456 DOI: 10.1042/bsr20181894] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 03/07/2019] [Accepted: 04/01/2019] [Indexed: 01/01/2023] Open
Abstract
We aimed to identify differences in cytokine/chemokine levels in the aqueous humor (AH) of primary open-angle glaucoma (POAG) patients who suffered from scarring, compared with POAG patients with no scarring after trabeculectomy surgery. Identification of differently expressed cytokines and chemokines may help to understand scarring and fibrotic processes following trabeculectomy, and to make predictions for the outcome of fistulating surgery in the future. Furthermore, the identification of cell signaling pathways involved in fibrosis offers the opportunity for a more specific antifibrotic therapy with reduced side effects, and an improvement in long-term surgical outcome. Eight samples of AH were collected during trabeculectomy surgery and commercially available cytokine/chemokine arrays were used. Specific, differently expressed proteins (cytokines/chemokines) in AH samples from patients with positive and negative surgery outcomes were detected. These proteins were classified based on their known profibrotic, inflammatory, adhesive, and apoptotic properties. Transforming growth factor β (TGF-β) and vascular endothelial growth factor (VEGF) were among the most important profibrotic cytokines that we detected. Differences in the fold change of protein expression were highly significant between patients after successful and failed trabeculectomy surgery, and these were processed and visualized using ExprEssence software. This pilot study revealed differences in concentrations of cytokines/chemokines in AH between the two examined groups of patients. Our findings suggest that a positive outcome from trabeculectomy is strongly related to an inhibition of the fibrosis process.
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Lack of Major Ophthalmic Findings in Patients with Primary Familial Brain Calcification Linked to SLC20A2 and PDGFB. J Mol Neurosci 2019; 67:441-444. [PMID: 30607898 DOI: 10.1007/s12031-018-1250-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 12/21/2018] [Indexed: 12/13/2022]
Abstract
Primary familial brain calcification (PFBC) is a rare neurodegenerative disorder characterized by symmetrical and bilateral brain calcification. It is typically inherited as an autosomal dominant disorder, and de novo variants have also been described. Interestingly, just recent studies have reported the first autosomal recessive PFBC-causative gene. PFBC patients exhibit high clinical heterogeneity including Parkinsonism, dystonia, ataxia, depression, and migraine. Mice studies, an important research tool, have been a breakthrough in increasing the understanding of PFBC's main signs and symptoms, and many findings reported in these mice have been subsequently reported in patients. One phenotype that has been observed in PFBC mice models but not in PFBC patients, however, is the development of ophthalmic abnormalities. This way, this report focused on performing an ophthalmic assessment in six Brazilian patients genetically diagnosed with PFBC. The assessments showed that none of the PFBC individuals included presented any of the ophthalmic abnormalities reported in mice models, such as cataracts, ocular calcification, abnormal iris and lens morphology, and retinal deterioration. Additionally, of the six PFBC patients described, two SLC20A2 mutation carriers showed physiological excavation of the optic nerve head and partial vitreous detachment, while just one individual presented bilateral narrowing of retinal arterioles. In summary, no evidence of similar ophthalmological abnormalities found in mice were found in our patients; nonetheless, further studies in larger sample size are warranted to corroborate with our findings. To our knowledge, this study is the first to focus on investigating, in PFBC patients, the ophthalmological phenotypes described in the PFBC mice models.
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Holló G. Optical Coherence Tomography Angiography in Glaucoma. Turk J Ophthalmol 2018; 48:196-201. [PMID: 30202616 PMCID: PMC6126098 DOI: 10.4274/tjo.53179] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 06/28/2018] [Indexed: 12/01/2022] Open
Abstract
Optical coherence tomography angiography (OCTA) comprises different OCT-based technologies developed for non-invasive assessment and measurement of optic nerve head and retinal perfusion. Currently the most clinically established approach is based on the split spectrum amplitude decorrelation algorithm, which detects moving red blood cells and eliminates all other information. The two main clinical fields in which OCTA offers clinically useful information are investigation of the macular retina (e.g. in macular degeneration and diabetic macular disease) and glaucoma. For glaucoma, the optic nerve head and the peripapillary retinal perfusion in the retinal nerve fiber layer, and the superficial perifoveal macular vasculature are the areas of interest. This review provides a comprehensive summary of the most important current and potential future applications of OCTA in glaucoma, but it does not address the nonglaucomatous optic nerve head or peripapillary and macular diseases.
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Affiliation(s)
- Gábor Holló
- Semmelweis University, Department of Ophthalmology, Unit of Head, Glaucoma and Perimetry, Budapest, Hungary
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11
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Willekens K, Abegão Pinto L, Lemmens S, Bataillie S, Somers A, Vandewalle E, Stalmans P, Stalmans I. The vitreopapillary interface in healthy and glaucoma: posterior vitreous detachment in the vitreopapillary interface study. Acta Ophthalmol 2018; 96:573-581. [PMID: 30280516 DOI: 10.1111/aos.13818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 04/13/2018] [Indexed: 01/26/2023]
Abstract
PURPOSE To investigate the vitreopapillary interface (VPI) in health and glaucoma according to the different stages of posterior vitreous detachment (PVD) formation. METHODS Prospective single centre study including healthy subjects and glaucoma patients. PVD staging was performed with spectral domain optical coherence tomography. Gender, age, lens status and refractive error were assessed in both groups. Glaucoma patients additionally had a comprehensive ophthalmological investigation including intraocular pressure measurement, visual field testing and confocal imaging of the optic nerve head. RESULTS Data on 523 subjects (993 eyes) were included from the VPI study (clinicaltrials.gov NCT02290795) database (493 eyes of 258 healthy subjects and 500 eyes of 265 glaucoma patients). Healthy subjects were significantly younger than primary open angle glaucoma patients (59.7 ± 14.81 versus 70.0 ± 10.78 years, p < 0.001), but were otherwise matched for refractive error and gender. Significantly more glaucomatous eyes were pseudophakic (26.6% versus 5.1%). Including only phakic nonoperated eyes from subjects between 50 and 80 years old decreased the age difference between healthy and open angle glaucoma (64.1 ± 8.0 versus 65.9 ± 6.7 years, p = 0.051). Comparing these subgroups rendered similar average ages for PVD stages 0 and 4, in contrast to the significant older age for the glaucoma subgroup in stage 1 (64.1 ± 6.01 versus 61.4 ± 8.38 years, p < 0.001) and a trend towards significance in stage 3 (70.8 ± 69.8 versus 67.5 ± 5.92 years, p = 0.051). CONCLUSION The VPI study is a large clinical trial investigating the VPI in health and glaucoma. A subset of glaucoma patients seems to experience stages 1-3 of PVD formation at older age compared to healthy subjects.
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Affiliation(s)
- Koen Willekens
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
- Department of Ophthalmology Neurosciences; Laboratory of Ophthalmology; KU Leuven; Leuven Belgium
| | - Luìs Abegão Pinto
- Department of Ophthalmology; Centro Hospitalar Lisboa Norte; Lisbon Portugal
| | - Sophie Lemmens
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
- Department of Ophthalmology Neurosciences; Laboratory of Ophthalmology; KU Leuven; Leuven Belgium
| | - Sophie Bataillie
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
| | - Alix Somers
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
- Department of Ophthalmology Neurosciences; Laboratory of Ophthalmology; KU Leuven; Leuven Belgium
| | - Evelien Vandewalle
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
- Department of Ophthalmology Neurosciences; Laboratory of Ophthalmology; KU Leuven; Leuven Belgium
| | - Peter Stalmans
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
| | - Ingeborg Stalmans
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
- Department of Ophthalmology Neurosciences; Laboratory of Ophthalmology; KU Leuven; Leuven Belgium
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Ashimatey BS, King BJ, Swanson WH. Retinal putative glial alterations: implication for glaucoma care. Ophthalmic Physiol Opt 2017; 38:56-65. [PMID: 29168194 PMCID: PMC5739949 DOI: 10.1111/opo.12425] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 10/19/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Gliosis-like retinal alterations, presumed to be activated retinal astrocytes and Müller cells (ARAM), have been reported to occur frequently in patients with glaucoma but rarely in controls. We investigated the association between glaucomatous abnormality and the presence, the extent of retinal region, and the spatial distribution, of hyperreflective retinal alterations on optical coherence tomography (OCT) en-face images, presumed to be ARAM. METHODS Findings of hyperreflective structures, presumed to be ARAM, in the central retinal ±24 degrees of OCT en-face images (acquired with the SPECTRALIS® OCT) were compared between 35 younger controls, 42 older controls and 38 patients with glaucoma. Presumed ARAM was defined as reflective structures on the en-face images other than retinal vasculature and retinal nerve fibre bundles. Chi-square tests were used to compare the proportion of younger controls vs older controls with presumed ARAM to investigate the effect of ageing, and the proportion of patients vs age-similar older controls with presumed ARAM to investigate the effect of disease. We also investigated the effect of glaucoma on the retinal area with presumed ARAM when it was present; we used an analysis of covariance (ancova) to compare the retinal area with hyperreflectivity in patients vs controls, adjusting for the effects of age and axial length. RESULTS The mean (S.D.) age of the younger controls, older controls, and patients with glaucoma was 26 (3), 62 (10) and 69 (8) years, respectively. The median (25th quartile, 75th quartile) of the retinal region with the hyperreflective structures, presumed to be ARAM, was zero (0,0), 1 (0,6), and 11 (0,43) degrees square in the younger controls, older controls and patients with glaucoma respectively. The chi-square test investigating the effect of ageing found χ2 (1, N = 77) = 24.8, p < 0.001, and that investigating the effect of disease found χ2 (1, N = 80) = 2.3, p = 0.1. The ancova found F(1, 46) = 10.32, P = 0.02. CONCLUSIONS There was an effect of ageing on the presence of the hyperreflective structures, presumed to be ARAM, on OCT images. Compared to the presence of hyperreflective structures, the extent of retinal region with the hyperreflective structures has a greater potential of being an indicator of glaucomatous degeneration. Further study is needed to investigate the nature of the relation between glaucomatous abnormality and the extent of the retina with the hyperreflective structures, presumed to be ARAM.
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Affiliation(s)
| | - Brett J King
- School of Optometry, Indiana University, Bloomington, USA
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