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Knecht KT, Chiriac G, Guan HD. The potential impact of a vegetarian diet on glaucoma. Surv Ophthalmol 2024; 69:833-841. [PMID: 38768761 DOI: 10.1016/j.survophthal.2024.05.001] [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: 08/22/2023] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/22/2024]
Abstract
Treatment of primary open-angle glaucoma has centered on the lowering of intraocular pressure that damages the optic nerve; however, this strategy is not uniformly successful, especially in normal tension glaucoma, and there is interest in antioxidant, anti-inflammatory, and other neuroprotective strategies. Vegetarian diets are known to be rich in antioxidant and anti-inflammatory components and have a number of established health benefits. Thus, it would be reasonable to assume that vegetarian diets would be beneficial in glaucoma, but this approach has not been well studied. We examine the possible role of vegetarian diets and their components in the incidence and progression of glaucoma.
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Affiliation(s)
- Kathryn T Knecht
- Loma Linda University School of Pharmacy, Loma Linda, California, USA
| | - Gabriela Chiriac
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - Howard D Guan
- Loma Linda University Eye Institute, Loma Linda, California, USA.
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Chang CCJ, Liu B, Liebmann JM, Cioffi GA, Winn BJ. Glaucoma and the Human Microbiome. J Glaucoma 2024; 33:529-538. [PMID: 38809163 DOI: 10.1097/ijg.0000000000002448] [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: 01/17/2024] [Accepted: 05/11/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE OF REVIEW To explore a view of the human microbiome as an interconnected, functional, dynamic system that may be linked to the pathogenesis and progression of glaucoma. METHODS A literature review was undertaken that included publications from 1966 to 2023. RESULTS Bacterial lipopolysaccharides (LPS) activate toll-like receptors (TLR) and mediate the human immune response. The LPS-TLR4 pathway is a potential avenue for the ocular, gut, and oral microbiomes to interface and/or influence ocular disease. Studies of gut dysbiosis have shown that alterations in the healthy microbiota can predispose the host to immune-mediated inflammatory and neurodegenerative conditions, while oral and ocular surface dysbiosis has been correlated with glaucoma. While developmental exposure to commensal microflora has shown to be necessary for the autoimmune and neurodegenerative responses to elevated intraocular pressure to take place, commensal bacterial products like short-chain fatty acids have regulatory effects protective against glaucoma. SUMMARY Alterations to human microbiotas have been associated with changes in intestinal permeability, gene regulation, immune cell differentiation, and neural functioning, which may predispose the host to glaucoma. Select microbes have been highlighted for their potential contributions to glaucoma disease progression or protection, raising the potential for microbiota-based treatment modalities. Current topical glaucoma treatments may disrupt the ocular surface microbiota, potentially having ramifications on host health. Further study of the relationships between human microbiome and glaucoma is needed.
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Affiliation(s)
| | - Benjamin Liu
- Department of Ophthalmology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY
| | | | | | - Bryan J Winn
- Department of Ophthalmology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY
- Ophthalmology Section, Surgical Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA
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Liu W, Guo R, Gao F, Huang D, Zhang X, Ji J, Jansonius NM. Association between primary angle closure glaucoma and uric acid levels in serum and aqueous humor. Heliyon 2024; 10:e30721. [PMID: 38742075 PMCID: PMC11089363 DOI: 10.1016/j.heliyon.2024.e30721] [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] [Received: 01/02/2024] [Revised: 03/11/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
Purpose To evaluate abnormalities in serum and aqueous humor uric acid (UA) levels in primary angle closure glaucoma (PACG). Methods Patients with PACG and age-similar and gender-similar controls (patients scheduled for cataract extraction) were enrolled prospectively. Serum UA levels were determined by enzymatic colorimetry; aqueous humor UA levels by Enzyme-Linked ImmunoSorbent Assay. A t-test was used to compare UA levels between PACG patients and controls, with one-way ANOVA used to compare levels across PACG subgroups with differing disease severity. Comparisons between PACG patients and controls were adjusted for systemic and ocular confounding factors using binary logistic regression. Results In all, 131 PACG patients and 112 controls were included. The serum UA level was 266 ± 69 μmol/L in the PACG group and 269 ± 73 μmol/L in the control group (p = 0.71). The aqueous humor UA level was 35.4 ± 8.2 μmol/L in the PACG group and 53.9 ± 18.6 μmol/L in the control group (p < 0.001). This difference remained significant after adjusting for age, gender, systolic blood pressure, diastolic blood pressure, body mass index, axial length, central corneal thickness, anterior chamber depth, lens thickness, white-to-white distance, corneal endothelial cell density, and serum UA level (odds ratio: 0.88, 95 % confidence interval: 0.83-0.93, p < 0.001). Conclusion Aqueous humor UA levels differ between PACG patients and controls, but serum UA levels do not. This indicates that local UA plays a role in the pathogenesis of PACG, but systemic UA does not.
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Affiliation(s)
- Wei Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ruru Guo
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Fei Gao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Dandan Huang
- Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Xinyi Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Jian Ji
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Nomdo M. Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Li S, Li M, Wu J, Li Y, Han J, Song Y, Cao W, Zhou X. Developing and validating a clinlabomics-based machine-learning model for early detection of retinal detachment in patients with high myopia. J Transl Med 2024; 22:405. [PMID: 38689321 PMCID: PMC11061938 DOI: 10.1186/s12967-024-05131-9] [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: 07/23/2023] [Accepted: 03/26/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Retinal detachment (RD) is a vision-threatening disorder of significant severity. Individuals with high myopia (HM) face a 2 to 6 times higher risk of developing RD compared to non-myopes. The timely identification of high myopia-related retinal detachment (HMRD) is crucial for effective treatment and prevention of additional vision impairment. Consequently, our objective was to streamline and validate a machine-learning model based on clinical laboratory omics (clinlabomics) for the early detection of RD in HM patients. METHODS We extracted clinlabomics data from the electronic health records for 24,440 HM and 5607 HMRD between 2015 and 2022. Lasso regression analysis assessed fifty-nine variables, excluding collinear variables (variance inflation factor > 10). Four models based on random forest, gradient boosting machine (GBM), generalized linear model, and Deep Learning Model were trained for HMRD diagnosis and employed for internal validation. An external test of the models was done. Three random data sets were further processed to validate the performance of the diagnostic model. The primary outcomes were the area under the receiver operating characteristic curve (AUC) and the area under the precision-recall curve (AUCPR) to diagnose HMRD. RESULTS Nine variables were selected by all models. Given the AUC and AUCPR values across the different sets, the GBM model was chosen as the final diagnostic model. The GBM model had an AUC of 0.8550 (95%CI = 0.8322-0.8967) and an AUCPR of 0.5584 (95%CI = 0.5250-0.5879) in the training set. The AUC and AUCPR in the internal validation were 0.8405 (95%CI = 0.8060-0.8966) and 0.5355 (95%CI = 0.4988-0.5732). During the external test evaluation, it reached an AUC of 0.7579 (95%CI = 0.7340-0.7840) and an AUCPR of 0.5587 (95%CI = 0.5345-0.5880). A similar discriminative capacity was observed in the three random data sets. The GBM model was well-calibrated across all the sets. The GBM-RD model was implemented into a web application that provides risk prediction for HM individuals. CONCLUSION GBM algorithms based on nine features successfully predicted the diagnosis of RD in patients with HM, which will help ophthalmologists to establish a preliminary diagnosis and to improve diagnostic accuracy in the clinic.
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Affiliation(s)
- Shengjie Li
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Meiyan Li
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Jianing Wu
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yingzhu Li
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jianping Han
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yunxiao Song
- Department of Clinical Laboratory, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, China.
| | - Wenjun Cao
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China.
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China.
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Tang YP, Zhang XB, Hu ZX, Lin K, Lin Z, Chen TY, Wu RH, Chi ZL. Vitreous metabolomic signatures of pathological myopia with complications. Eye (Lond) 2023; 37:2987-2993. [PMID: 36841867 PMCID: PMC10516974 DOI: 10.1038/s41433-023-02457-4] [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: 06/24/2022] [Revised: 01/17/2023] [Accepted: 02/15/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Pathological myopia (PM) is closely associated with blinding ocular morbidities. Identifying biomarkers can provide clues on pathogeneses. This study aimed to identify metabolic biomarkers and underlying mechanisms in the vitreous humour (VH) of PM patients with complications. METHODS VH samples were collected from 39 PM patients with rhegmatogenous retinal detachment (RRD) (n = 23) or macular hole (MH)/myopic retinoschisis (MRS) (n = 16) and 23 controls (MH with axial length < 26 mm) who underwent surgical treatment. VH metabolomic profiles were investigated using ultra-performance liquid chromatography‒mass spectrometry. The area under the receiver operating characteristic curve (AUC) was computed to identify potential biomarkers for PM diagnosis. RESULTS Bioinformatics analysis identified nineteen and four metabolites altered in positive and negative modes, respectively, and these metabolites were involved in tryptophan metabolism. Receiver operating characteristic analysis showed that seventeen metabolites (AUC > 0.6) in the positive mode and uric acid in the negative mode represent potential biomarkers for PM with complications (AUC = 0.894). Pairwise and pathway analyses among the RRD-PM, MH/MRS-PM and control groups showed that tryptophan metabolism and uric acid were closely correlated with PM. Altered metabolites and pathways in our study were characterized by increased oxidative stress and altered energy metabolism. These results contribute to a better understanding of myopia progression with or without related complications. CONCLUSIONS Our study provides metabolomic signatures and related immunopathological features in the VH of PM patients, revealing new insight into the prevention and treatment of PM and related complications.
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Affiliation(s)
- Yong-Ping Tang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiao-Bo Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Zhi-Xiang Hu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Ke Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Zhong Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Tian-Yu Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Rong-Han Wu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
| | - Zai-Long Chi
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
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Mohammadi M, Yarmohammadi A, Salehi-Abargouei A, Ghasemirad H, Shirvani M, Ghoshouni H. Uric acid and glaucoma: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1159316. [PMID: 37575992 PMCID: PMC10422028 DOI: 10.3389/fmed.2023.1159316] [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] [Received: 02/05/2023] [Accepted: 07/07/2023] [Indexed: 08/15/2023] Open
Abstract
Background Glaucoma, the leading cause of irreversible blindness, is a common disorder that contributes to gradual optic nerve degeneration. The beneficial impacts of uric acid (UA) have been reported in some neurodegenerative conditions such as Parkinson's disease, Alzheimer's disease, and amyotrophic lateral sclerosis. But the results of current studies about the association between serum UA level and glaucoma are conflicting. The present meta-analysis was conducted to provide a better understanding of the association between serum UA level and glaucoma. Methods We searched the databases of PubMed, Scopus, Web of Science, and Google Scholar systematically until November 20, 2022 to identify case-control studies, comparing the serum UA concentrations of the patients with glaucoma and controls. The mean ± standard division difference was used to assess the difference in serum UA concentrations between the glaucoma patients and controls. Results Six studies involving 1,221 glaucoma patients and 1,342 control group were included in the present meta-analysis. This meta-analysis using a random effect model indicated that the mean UA level in glaucoma patients was 0.13 (I2 = 91.92%, 95% CI = -0.42 to 0.68) higher than the controls; however, it was not statistically significant. Conclusions Our findings provide evidence that glaucoma patients have a higher serum UA level compared to the controls, but this difference is not statistically significant. Prospective studies are needed to determine the possible association between increased UA and glaucoma pathogenesis. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022364055, identifier: CRD42022364055.
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Affiliation(s)
- Mohammad Mohammadi
- Students' Research and Technology Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- NeuroTRACT Association, Student's Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amin Salehi-Abargouei
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamidreza Ghasemirad
- Students' Research and Technology Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Shirvani
- Geriatric Ophthalmology Research Center, Shahid Sadoughi University of Medical Science, Yazd, Iran
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamed Ghoshouni
- Students' Research and Technology Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Li S, Li M, Wu J, Li Y, Han J, Cao W, Zhou X. Development and validation of a routine blood parameters-based model for screening the occurrence of retinal detachment in high myopia in the context of PPPM. EPMA J 2023. [PMCID: PMC10015135 DOI: 10.1007/s13167-023-00319-3] [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: 03/17/2023]
Abstract
Background/aims Timely detection and treatment of retinal detachment (RD) could effectively save vision and reduce the risk of progressing visual field defects. High myopia (HM) is known to be associated with an increased risk of RD. Evidently, it should be clearly discriminated the individuals with high or low risk of RD in patients with HM. By using multi-parametric analysis, risk assessment, and other techniques, it is crucial to create cutting-edge screening programs that may be utilized to improve population eye health and develop person-specific, cost-effective preventative, and targeted therapeutic measures. Therefore, we propose a novel, routine blood parameters-based prediction model as a screening program to help distinguish who should offer detailed ophthalmic examinations for RD diagnosis, prevent visual field defect progression, and provide personalized, serial monitoring in the context of predictive, preventive, and personalized medicine (PPPM/3 PM). Methods This population-based study included 20,870 subjects (HM = 19,284, HMRD = 1586) who underwent detailed routine blood tests and ophthalmic evaluations. HMRD cases and HM controls were matched using a nested case-control design. Then, the HMRD cases and HM controls were randomly assigned to the discovery cohort, validation cohort 1, and validation cohort 2 maintaining a 6:2:2 ratio, and other subjects were assigned to the HM validation cohort. Receiver operating characteristic curve analysis was performed to select feature indexes. Feature indexes were integrated into seven algorithm models, and an optimal model was selected based on the highest area under the curve (AUC) and accuracy. Results Six feature indexes were selected: lymphocyte, basophil, mean platelet volume, platelet distribution width, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. Among the algorithm models, the algorithm of conditional probability (ACP) showed the best performance achieving an AUC of 0.79, a diagnostic accuracy of 0.72, a sensitivity of 0.71, and a specificity of 0.74 in the discovery cohort. A good performance of the ACP model was also observed in the validation cohort 1 (AUC = 0.81, accuracy = 0.72, sensitivity = 0.71, specificity = 0.73) and validation cohort 2 (AUC = 0.77, accuracy = 0.71, sensitivity = 0.70, specificity = 0.72). In addition, ACP model calibration was found to be good across three cohorts. In the HM validation cohort, the ACP model achieved a diagnostic accuracy of 0.81 for negative classification. Conclusion We have developed a routine blood parameters-based model with an ACP algorithm that could potentially be applied in the clinic with a PPPM approach for serial monitoring and predicting the occurrence of RD in HM and can facilitate the prevention of HM progression to RD. According to the current study, routine blood measures are essential in patient risk classification, predictive diagnosis, and targeted therapy. Therefore, for high-risk RD persons, novel screening programs and prompt treatment plans are essential to enhance individual outcomes and healthcare offered to the community with HM. Supplementary Information The online version contains supplementary material available at 10.1007/s13167-023-00319-3.
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Affiliation(s)
- Shengjie Li
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Meiyan Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Jianing Wu
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yingzhu Li
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jianping Han
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wenjun Cao
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
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Fea AM, Ricardi F, Novarese C, Cimorosi F, Vallino V, Boscia G. Precision Medicine in Glaucoma: Artificial Intelligence, Biomarkers, Genetics and Redox State. Int J Mol Sci 2023; 24:2814. [PMID: 36769127 PMCID: PMC9917798 DOI: 10.3390/ijms24032814] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/07/2023] [Accepted: 01/18/2023] [Indexed: 02/05/2023] Open
Abstract
Glaucoma is a multifactorial neurodegenerative illness requiring early diagnosis and strict monitoring of the disease progression. Current exams for diagnosis and prognosis are based on clinical examination, intraocular pressure (IOP) measurements, visual field tests, and optical coherence tomography (OCT). In this scenario, there is a critical unmet demand for glaucoma-related biomarkers to enhance clinical testing for early diagnosis and tracking of the disease's development. The introduction of validated biomarkers would allow for prompt intervention in the clinic to help with prognosis prediction and treatment response monitoring. This review aims to report the latest acquisitions on biomarkers in glaucoma, from imaging analysis to genetics and metabolic markers.
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Association between Serum Total Bilirubin Level and Patients with Primary Open-Angle Glaucoma in China: A Cross-Sectional, Case-Control Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2023; 2023:8206298. [PMID: 36718279 PMCID: PMC9884161 DOI: 10.1155/2023/8206298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/19/2022] [Accepted: 01/04/2023] [Indexed: 01/23/2023]
Abstract
Objective To investigate the relationship between peripheral blood total bilirubin (TBIL) levels and the risk of primary open-angle glaucoma (POAG). Methods This study was a cross-sectional, case-control study design. Between April 2021 and January 2022, 198 POAG patients and 205 healthy subjects were recruited from the EENT Hospital of Fudan University. Their clinical information (intraocular pressure, central corneal thickness, vertical cup-disk ratios (VCDR), and axial length) and demographic data were collected. Serum levels of TBIL were measured in enzymes using a Roche C702 biochemical analyzer. The POAG subgroups were classified by gender and VCDR: mild (VCDR ≤ 0.64), moderate (VCDR ≤ 0.85), and severe (VCDR > 0.85). Univariate and multivariate logistic regression analyses were performed. Results The level of TBIL (11.58 ± 5.16 μmol/L) in the POAG group was higher than that in the control group (10.18 ± 3.38 μmol/L; p < 0.05). In the male subgroup, TBIL was also significantly higher than in the normal control group; TBIL levels were lower in the mild subgroup (10.82 ± 4.48 μmol/L), followed by the moderate subgroup (12.00 ± 5.55 μmol/L) and the severe subgroup (14.47 ± 5.45 μmol/L). The results of the multivariate logistic regression analysis showed that high TBIL levels were a risk factor for male POAG, at 1.126 (95% CI 1.009-1.256). Pearson's analysis revealed that TBIL was positively correlated with intraocular pressure (r = 0.134, p = 0.012), VCDR (r = 0.142, p = 0.046), anterior chamber depth (r = 0.190, p = 0.014), and axial length (r = 0.179, p = 0.019) in the patients. However, no statistical difference (p < 0.05) was observed in the female patients with POAG. Conclusion The results showed that high levels of TBIL may be related to the pathogenesis of POAG and that the severity of the disease is positively correlated, especially in male patients.
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Liu W, Guo R, Huang D, Ji J, Gansevoort RT, Snieder H, Jansonius NM. Co-occurrence of chronic kidney disease and glaucoma: Epidemiology and etiological mechanisms. Surv Ophthalmol 2023; 68:1-16. [PMID: 36088997 DOI: 10.1016/j.survophthal.2022.09.001] [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: 03/06/2022] [Revised: 08/26/2022] [Accepted: 09/02/2022] [Indexed: 02/01/2023]
Abstract
As the histology, physiology, and pathophysiology of eyes and kidneys show substantial overlap, it has been suggested that eye and kidney diseases, such as glaucoma and chronic kidney disease (CKD), may be closely interlinked. We review the relationship between CKD and various subtypes of glaucoma, including primary open-angle glaucoma, primary angle- closure glaucoma, normal tension glaucoma, pseudoexfoliation syndrome, and several glaucoma endophenotypes. We also discuss the underlying pathogenic mechanisms and common risk factors for CKD and glaucoma, including atherosclerosis, the renin-angiotensin system, genes and genetic polymorphisms, vitamin D deficiency, and erythropoietin. The prevalence of glaucoma appears elevated in CKD patients, and vice versa, and the literature points to many intriguing associations; however, the associations are not always confirmed, and sometimes apparently opposite observations are reported. Glaucoma and CKD are complex diseases, and their mutual influence is only partially understood.
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Affiliation(s)
- Wei Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ruru Guo
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Dandan Huang
- Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jian Ji
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ron T Gansevoort
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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Młynarczyk M, Falkowska M, Micun Z, Obuchowska I, Kochanowicz J, Socha K, Konopińska J. Diet, Oxidative Stress, and Blood Serum Nutrients in Various Types of Glaucoma: A Systematic Review. Nutrients 2022; 14:nu14071421. [PMID: 35406033 PMCID: PMC9002851 DOI: 10.3390/nu14071421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 12/11/2022] Open
Abstract
Glaucoma is one of the most common causes of irreversible vision loss worldwide. It is an insidious disease with a multifactorial pathogenesis. Despite progress in treatment methods, prevention and lifestyle modifications may be useful in slowing the progression of this disease. This systematic review aimed to evaluate the influence of diet, oxidative stress, and disturbances in blood serum levels of nutrients on the incidence and severity of glaucoma based on scientific reports on the role of nutrition in the pathogenesis and course of glaucoma. This paper presents an analysis of the above issues; however, further research is required to develop this topic. Future clinical trials are needed to assess the influence of nutrition and to develop nutritional management strategies for patients with glaucoma.
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Affiliation(s)
- Maryla Młynarczyk
- Department of Ophthalmology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Białystok, Poland; (M.M.); (Z.M.); (I.O.)
| | - Martyna Falkowska
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Białystok, Mickiewicza 2D, 15-222 Białystok, Poland; (M.F.); (K.S.)
| | - Zuzanna Micun
- Department of Ophthalmology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Białystok, Poland; (M.M.); (Z.M.); (I.O.)
| | - Iwona Obuchowska
- Department of Ophthalmology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Białystok, Poland; (M.M.); (Z.M.); (I.O.)
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Białystok, Poland;
| | - Katarzyna Socha
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Białystok, Mickiewicza 2D, 15-222 Białystok, Poland; (M.F.); (K.S.)
| | - Joanna Konopińska
- Department of Ophthalmology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Białystok, Poland; (M.M.); (Z.M.); (I.O.)
- Correspondence: ; Tel.: +48-600471666
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12
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Association between chronic kidney disease and open-angle glaucoma in South Korea: a 12-year nationwide retrospective cohort study. Sci Rep 2022; 12:3423. [PMID: 35232992 PMCID: PMC8888748 DOI: 10.1038/s41598-022-07190-8] [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: 04/07/2021] [Accepted: 01/19/2022] [Indexed: 02/02/2023] Open
Abstract
Various non-intraocular pressure factors have been identified as possible risk factors for open-angle glaucoma (OAG). However, there is still controversy around the association between OAG and chronic kidney disease (CKD). In this study, we used a nationwide cohort to investigate the risk of OAG in the 12 years following a diagnosis of CKD. This retrospective cohort study included 1,103,302 subjects from the Korean National Health Insurance Service National Sample Cohort database. The CKD group (n = 1318) included patients who were initially diagnosed with CKD between 2003 and 2008. The subjects in the comparison group were matched at a 1:5 ratio using propensity scores. In multivariate Cox regression analysis, a diagnosis of CKD was significantly associated with an increased incidence of OAG (hazard ratio [HR] = 1.546, 95% confidence interval [CI] 1.363–1.754, p < 0.001). Further analysis revealed that the risk of OAG increased with the severity of CKD (mild to moderate CKD [CKD stage 1–3]: HR = 1.280, 95% CI 1.077–1.521, p = 0.005; advanced CKD [CKD stage 4–5]: HR = 1.861, 95% CI 1.589–2.180, p < 0.001). In subgroup analysis, female CKD patients had a greater risk of developing OAG than males, and subjects with CKD aged ≥ 40 years were more likely to develop OAG compared with those aged < 40 years. Our study demonstrates that CKD is a significant risk factor for OAG and that severe CKD is associated with an increased risk of developing OAG.
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13
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Hsueh YJ, Chen YN, Tsao YT, Cheng CM, Wu WC, Chen HC. The Pathomechanism, Antioxidant Biomarkers, and Treatment of Oxidative Stress-Related Eye Diseases. Int J Mol Sci 2022; 23:ijms23031255. [PMID: 35163178 PMCID: PMC8835903 DOI: 10.3390/ijms23031255] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 12/13/2022] Open
Abstract
Oxidative stress is an important pathomechanism found in numerous ocular degenerative diseases. To provide a better understanding of the mechanism and treatment of oxidant/antioxidant imbalance-induced ocular diseases, this article summarizes and provides updates on the relevant research. We review the oxidative damage (e.g., lipid peroxidation, DNA lesions, autophagy, and apoptosis) that occurs in different areas of the eye (e.g., cornea, anterior chamber, lens, retina, and optic nerve). We then introduce the antioxidant mechanisms present in the eye, as well as the ocular diseases that occur as a result of antioxidant imbalances (e.g., keratoconus, cataracts, age-related macular degeneration, and glaucoma), the relevant antioxidant biomarkers, and the potential of predictive diagnostics. Finally, we discuss natural antioxidant therapies for oxidative stress-related ocular diseases.
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Affiliation(s)
- Yi-Jen Hsueh
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (Y.-J.H.); (Y.-N.C.); (Y.-T.T.); (W.-C.W.)
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan
| | - Yen-Ning Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (Y.-J.H.); (Y.-N.C.); (Y.-T.T.); (W.-C.W.)
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
| | - Yu-Ting Tsao
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (Y.-J.H.); (Y.-N.C.); (Y.-T.T.); (W.-C.W.)
| | - Chao-Min Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30012, Taiwan;
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (Y.-J.H.); (Y.-N.C.); (Y.-T.T.); (W.-C.W.)
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
| | - Hung-Chi Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (Y.-J.H.); (Y.-N.C.); (Y.-T.T.); (W.-C.W.)
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
- Correspondence: ; Tel.: +886-3-328-1200 (ext. 7855); Fax: +886-3-328-7798
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14
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Qiu Y, Yu J, Tang L, Ren J, Shao M, Li S, Song Y, Cao W, Sun X. Association Between Sex Hormones and Visual Field Progression in Women With Primary Open Angle Glaucoma: A Cross-Sectional and Prospective Cohort Study. Front Aging Neurosci 2022; 13:756186. [PMID: 35002675 PMCID: PMC8741302 DOI: 10.3389/fnagi.2021.756186] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/02/2021] [Indexed: 11/15/2022] Open
Abstract
Purpose: We evaluated the level of sex hormones in female patients with primary open angle glaucoma (POAG) to determine whether they are associated with the onset and/or progression of POAG. Methods: The cross-sectional study enrolled 63 women with POAG and 56 healthy women as normal control subjects. Furthermore, 57 women with POAG were included and followed-up for at least 2 years in the cohort study. All subjects were evaluated for serum concentration of sex hormones [prolactin (PRL), luteinizing hormone (LH), testosterone (TESTO), follicle-stimulating hormone (FSH), progesterone (PROG), and estrogen (E2)] and underwent visual field (VF) examination. In the cross-sectional study, Spearman analysis, linear regression analysis, and logistic regression analysis were performed to assess risk factors for POAG in women. In the cohort study, Cox regression analyses and Kaplan–Meier survival analysis were performed to identify factors associated with VF progression in women with POAG. Results: In the cross-sectional study, the level of E2 was significantly lower in the POAG group than in the normal group (p < 0.05). Multiple logistic regression showed that the decreased level of E2 was a risk factor of POAG (OR = 0.27, 95% CI = 0.09–0.78, p < 0.05), especially in premenopausal subjects. In the cohort study, there were 29 non-progression subjects and 28 progression subjects. Patients in the progression group had significantly lower levels of E2 than those in the no progression group (p < 0.01). The decreased level of E2 at baseline was associated with POAG progression (HR = 0.08, 95% CI = 0.02–0.46, p < 0.05), especially in premenopausal subjects. Patients with POAG and with lower baseline E2 levels had significantly lower VF non-progression rates than patients with higher E2 levels (log-rank test p < 0.001), especially premenopausal subjects (log-rank test p < 0.05). Additionally, logistic regression analyses, Cox regression analyses, and Kaplan–Meier survival analysis showed that PROG, LH, FSH, and TESTO were risk factors of POAG and/or significantly associated with POAG progression. Conclusion: A decreased E2 level is a POAG risk factor and is associated with VF progression in women with POAG, especially in premenopausal subjects. Additionally, other sex hormones (PROG, LH, FSH, and TESTO) might also play a role in POAG pathogenesis.
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Affiliation(s)
- Yichao Qiu
- Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Jian Yu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Li Tang
- Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Jun Ren
- Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Mingxi Shao
- Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Shengjie Li
- Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China.,Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yunxiao Song
- Department of Clinical Laboratory, Shanghai Xuhui Central Hospital, Shanghai, China
| | - Wenjun Cao
- Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China.,Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University - Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xinghuai Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University - Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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15
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Fiedorowicz E, Cieślińska A, Kuklo P, Grzybowski A. Protein Biomarkers in Glaucoma: A Review. J Clin Med 2021; 10:5388. [PMID: 34830671 PMCID: PMC8624910 DOI: 10.3390/jcm10225388] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/09/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022] Open
Abstract
Glaucoma is a multifactorial disease. Early diagnosis of this disease can support treatment and reduce the effects of pathophysiological processes. A significant problem in the diagnosis of glaucoma is limited access to the tested material. Therefore, intensive research is underway to develop biomarkers for fast, noninvasive, and reliable testing. Biomarkers indicated in the formation of glaucoma include chemical compounds from different chemical groups, such as proteins, sugars, and lipids. This review summarizes our knowledge about protein and/or their protein-like derived biomarkers used for glaucoma diagnosis since 2000. The described possibilities resulting from a biomarker search may contribute to identifying a group of compounds strongly correlated with glaucoma development. Such a find would be of great importance in the diagnosis and treatment of this disorder, as current screening techniques have low sensitivity and are unable to diagnose early primary open-angle glaucoma.
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Affiliation(s)
- Ewa Fiedorowicz
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, Oczapowskiego 1A Street, 10-719 Olsztyn, Poland; (E.F.); (A.C.)
| | - Anna Cieślińska
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, Oczapowskiego 1A Street, 10-719 Olsztyn, Poland; (E.F.); (A.C.)
| | - Patrycja Kuklo
- Department of Ophthalmology, University of Warmia and Mazury, 10-719 Olsztyn, Poland;
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, 10-719 Olsztyn, Poland;
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, 61-553 Poznan, Poland
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16
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Cueto AFV, Álvarez L, García M, Álvarez-Barrios A, Artime E, Cueto LFV, Coca-Prados M, González-Iglesias H. Candidate Glaucoma Biomarkers: From Proteins to Metabolites, and the Pitfalls to Clinical Applications. BIOLOGY 2021; 10:763. [PMID: 34439995 PMCID: PMC8389649 DOI: 10.3390/biology10080763] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/05/2021] [Accepted: 08/08/2021] [Indexed: 12/17/2022]
Abstract
Glaucoma is an insidious group of eye diseases causing degeneration of the optic nerve, progressive loss of vision, and irreversible blindness. The number of people affected by glaucoma is estimated at 80 million in 2021, with 3.5% prevalence in people aged 40-80. The main biomarker and risk factor for the onset and progression of glaucoma is the elevation of intraocular pressure. However, when glaucoma is diagnosed, the level of retinal ganglion cell death usually amounts to 30-40%; hence, the urgent need for its early diagnosis. Molecular biomarkers of glaucoma, from proteins to metabolites, may be helpful as indicators of pathogenic processes observed during the disease's onset. The discovery of human glaucoma biomarkers is hampered by major limitations, including whether medications are influencing the expression of molecules in bodily fluids, or whether tests to validate glaucoma biomarker candidates should include human subjects with different types and stages of the disease, as well as patients with other ocular and neurodegenerative diseases. Moreover, the proper selection of the biofluid or tissue, as well as the analytical platform, should be mandatory. In this review, we have summarized current knowledge concerning proteomics- and metabolomics-based glaucoma biomarkers, with specificity to human eye tissue and fluid, as well the analytical approach and the main results obtained. The complex data published to date, which include at least 458 different molecules altered in human glaucoma, merit a new, integrative approach allowing for future diagnostic tests based on the absolute quantification of local and/or systemic biomarkers of glaucoma.
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Affiliation(s)
- Andrés Fernández-Vega Cueto
- Instituto Oftalmológico Fernández-Vega, Avda. Dres. Fernández-Vega, 34, 33012 Oviedo, Spain; (A.F.-V.C.); (M.G.)
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33012 Oviedo, Spain; (L.Á.); (A.Á.-B.); (E.A.)
| | - Lydia Álvarez
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33012 Oviedo, Spain; (L.Á.); (A.Á.-B.); (E.A.)
| | - Montserrat García
- Instituto Oftalmológico Fernández-Vega, Avda. Dres. Fernández-Vega, 34, 33012 Oviedo, Spain; (A.F.-V.C.); (M.G.)
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33012 Oviedo, Spain; (L.Á.); (A.Á.-B.); (E.A.)
| | - Ana Álvarez-Barrios
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33012 Oviedo, Spain; (L.Á.); (A.Á.-B.); (E.A.)
| | - Enol Artime
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33012 Oviedo, Spain; (L.Á.); (A.Á.-B.); (E.A.)
| | - Luis Fernández-Vega Cueto
- Instituto Oftalmológico Fernández-Vega, Avda. Dres. Fernández-Vega, 34, 33012 Oviedo, Spain; (A.F.-V.C.); (M.G.)
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33012 Oviedo, Spain; (L.Á.); (A.Á.-B.); (E.A.)
| | - Miguel Coca-Prados
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT 06510, USA;
| | - Héctor González-Iglesias
- Instituto Oftalmológico Fernández-Vega, Avda. Dres. Fernández-Vega, 34, 33012 Oviedo, Spain; (A.F.-V.C.); (M.G.)
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33012 Oviedo, Spain; (L.Á.); (A.Á.-B.); (E.A.)
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17
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Perng WT, Hung YM, Lai WY, Chu KA, Wang YH, Wei JCC. Increased risk of glaucoma amongst new-onset gout patients aged 20-39 years: A nationwide population-based cohort study in Taiwan. Int J Clin Pract 2021; 75:e14169. [PMID: 33788372 DOI: 10.1111/ijcp.14169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/11/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To provide epidemiologic evidence of whether gout increases the risk of new-onset glaucoma. METHODS We conducted a 13-year nationwide, population-based, retrospective cohort study to examine the association between the history of gout and risk of glaucoma by using the Longitudinal Health Insurance Database (LHID) of Taiwan. The gout cohort included 52 943 patients with newly diagnosed gout who were recruited between 2000 and 2012. Each patient was propensity score matching with 1:1 person without gout from the LHID. To determine glaucoma occurrence, the study population was followed up until the end of 2013. Cumulative incidence, hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated after adjusting for age, sex, comorbidities, and ever ophthalmic visit. A Cox proportional hazard model was used to analyse the association between gout and incidence of glaucoma amongst patients with different potential risks. RESULTS The adjusted HR for newly diagnosed glaucoma in the gout cohort was 1.00 (95% CI = 0.93-1.07, P = .931), compared with the non-gout cohort. Stratified subgroup analysis revealed that the HRs of glaucoma were 1.36 (95% CI = 1.09-1.70, P = .007), 0.99 (95% CI = 0.87-1.12, P = .871), and 0.95 (95% CI = 0.87-1.03, P = .235) in patients with gout aged 20-39, 40-54, and ≥55 years, respectively (P for interaction = .011). CONCLUSION This nationwide population-based cohort study revealed that gout patients in the age group 20-39 years had a higher risk of glaucoma than non-gout controls.
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Affiliation(s)
- Wuu-Tsun Perng
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Recreational Sport & Health Promotion, National Pingtung University of Science and Technology, Pintung, Taiwan
| | - Yao-Min Hung
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan
- College of Health and Nursing, Meiho University, Pingtung, Taiwan
| | - Wei-Yu Lai
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Kuo-An Chu
- Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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18
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Tang Y, Pan Y, Chen Y, Kong X, Chen J, Zhang H, Tang G, Wu J, Sun X. Metabolomic Profiling of Aqueous Humor and Plasma in Primary Open Angle Glaucoma Patients Points Towards Novel Diagnostic and Therapeutic Strategy. Front Pharmacol 2021; 12:621146. [PMID: 33935712 PMCID: PMC8080440 DOI: 10.3389/fphar.2021.621146] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/01/2021] [Indexed: 12/15/2022] Open
Abstract
Glaucoma is the second leading cause of blindness globally characterized by progressive loss of retinal ganglion cells (RGCs) and irreversible visual deficiency. As the most common type of glaucoma, primary open angle glaucoma (POAG) is currently an unmet medical need with limited therapy by lowering intraocular pressure (IOP). However, some patients continue to progress even though their IOP are controlled. Although early diagnosis and prompt treatment are crucial in preventing irreversible visual impairment, there are currently no biomarkers for screening POAG. Metabolomics has the advantages of illustrating the final downstream products of the genome and establishing the closest link to the phenotype. So far, there is no study investigating the metabolomic profiles in both aqueous humor and plasma of POAG patients. Therefore, to explore diagnostic biomarkers, unveil underlying pathophysiology and potential therapeutic strategies, a widely targeted metabolomic approach was applied using ultrahigh-resolution mass spectrometry with C18 liquid chromatography to characterize the metabolomic profiles in both aqueous humor and plasma of 28 POAG patients and 25 controls in our study. Partial least squares-discriminant analysis (PLS-DA) was performed to determine differentially expressed metabolites (DEMs) between POAG and age-matched controls. The area under the receiver operating characteristic curve (AUC) was calculated to assess the prediction accuracy of the DEMs. The correlation of DEMs with the clinical parameters was determined by Pearson correlation, and the metabolic pathways were analyzed using MetaboAnalyst 4.0. PLS-DA significantly separated POAG from controls with 22 DEMs in the aqueous humor and 11 DEMs in the plasma. Additionally, univariate ROC analysis and correlation analysis with clinical parameters revealed cyclic AMP (AUC = 0.87), 2-methylbenzoic acid (AUC = 0.75), 3'-sialyllactose (AUC = 0.73) in the aqueous humor and N-lac-phe (AUC = 0.76) in the plasma as potential biomarkers for POAG. Moreover, the metabolic profiles pointed towards the alteration in the purine metabolism pathway. In conclusion, the study identified potential and novel biomarkers for POAG by crosslinking the metabolomic profiles in aqueous humor and plasma and correlating with the clinical parameters. These findings have important clinical implications given that no biomarkers are currently available for glaucoma in the clinic, and the study provided new insights in exploring diagnostic biomarkers and potential therapeutic strategies of POAG by targeting metabolic pathways.
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Affiliation(s)
- Yizhen Tang
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Yiqiong Pan
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Yuhong Chen
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Xiangmei Kong
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Junyi Chen
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Hengli Zhang
- Department of Ophthalmology, Shijiazhuang No. 1 Hospital, Hebei, China
| | - Guangxian Tang
- Department of Ophthalmology, Shijiazhuang No. 1 Hospital, Hebei, China
| | - Jihong Wu
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China.,State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
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19
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Sun X, Jiao H, Zhao J, Wang X, Lin H. Rule of UA on Cardiac Myocytes Uric Acid Differently Influence the Oxidative Damage Induced by Acute Exposure of High Level of Glucose in Chicken Cardiac Myocytes. Front Vet Sci 2020; 7:602419. [PMID: 33426022 PMCID: PMC7785973 DOI: 10.3389/fvets.2020.602419] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/30/2020] [Indexed: 12/26/2022] Open
Abstract
Background: Uric acid (UA) is a potent scavenger of oxidants in mammalian and avian species. In humans, hyperglycemia with simultaneous hyperuricemia may exert additional damage to the cardiovascular system. Chickens naturally have hyperglycemia (10.1–11.0 mmol/L) and hyperuricemia (100–900 μmol/L), which makes them an interesting model. Methods: The aim of this study was to investigate the effects of UA on the oxidative damage induced by acute exposure of high level of glucose in chicken cardiac myocytes. Results: Cell viability and the concentrations of thiobarbituric acid reactive substance (TBARS) were decreased by glucose treatment in a dose- and time-dependent manner. After acute exposure to high level of glucose (300 mM), a moderate level of UA (300 μM) increased cell viability and reduced TBARS and glutathione (GSH) content. Compared to the control or to independent high glucose (300 mM) or UA (1,200 μM) treatment, the concurrent treatment of high glucose and high UA significantly increased the TBARS, protein carbonyl contents, and ROS concentration, whereas it decreased the cell viability, superoxide dismutase (SOD) activity, and GSH content. In the presence of high glucose and UA, the nucleic protein expression of nuclear factor erythroid 2-related factor 2 (Nrf2) was decreased and the mRNA levels of the genes cat, sod1, sod2, gss, and gclc were downregulated. Conclusion: In conclusion, acute exposure of high level of glucose induced oxidative damage in the cardiac myocytes of chicken. The present result suggests that an adequate level of uric acid is helpful in alleviating the acute oxidative damage that is induced by high glucose, whereas the inhibition of the Nrf2 pathway by a high level of uric acid may render the cardiac myocytes more vulnerable to suffering from oxidative damage.
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Affiliation(s)
- Xiaolong Sun
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, Tai'an, China.,Shandong Key Lab of Animal Bioengineering and Disease Control and Prevention, Tai'an, China
| | - Hongchao Jiao
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, Tai'an, China.,Shandong Key Lab of Animal Bioengineering and Disease Control and Prevention, Tai'an, China
| | - Jingpeng Zhao
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, Tai'an, China.,Shandong Key Lab of Animal Bioengineering and Disease Control and Prevention, Tai'an, China
| | - Xiaojuan Wang
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, Tai'an, China.,Shandong Key Lab of Animal Bioengineering and Disease Control and Prevention, Tai'an, China
| | - Hai Lin
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, Tai'an, China.,Shandong Key Lab of Animal Bioengineering and Disease Control and Prevention, Tai'an, China
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Ooba N, Iwahashi R, Nogami A, Nakayama T, Kanno A, Tochikura N, Ootsuka S, Fukuoka N. Comparison between high and low potency statins in the incidence of open-angle glaucoma: A retrospective cohort study in Japanese working-age population. PLoS One 2020; 15:e0237617. [PMID: 32804969 PMCID: PMC7430712 DOI: 10.1371/journal.pone.0237617] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/29/2020] [Indexed: 01/20/2023] Open
Abstract
Some findings on the association between glaucoma and statins in the Asian population have been reported. We conducted a retrospective cohort study using health insurance claims data maintained by the JMDC Inc., which comprises data on about three million individuals representing 2.4% of the Japanese population. The association between the potency of statins and open-angle glaucoma in Japanese working-age population was examined using a commercially available health insurance claims and enrollment database. We identified 117,036 patients with a prescription of statins between January 1, 2005 and March 31, 2014; 59,535 patients were selected as new statin users. Of these, 49,671 (83%) patients without glaucoma who were prescribed statins for the first time were part of the primary analysis. New users of statin were defined as those with a prescription of statin at the beginning of the study, but without a prescription six months earlier. The cohort comprised 29,435 (59%) and 20,236 (41%) patients with a prescription of high-potency statin (atorvastatin and rosuvastatin) and low-potency statin (pravastatin, fluvastatin, pitavastatin, and simvastatin), respectively. Using Cox proportional hazards regression analysis, hazard ratios (HRs) were estimated for glaucoma adjusted for baseline characteristics. Although some baseline characteristics were not similar between the high-potency and low-potency statin groups, the standardized difference for all covariates was less than 0.1. No associations were found between high-potency statin use and glaucoma (adjusted HR = 1.08; 95% confidence interval, 0.93-1.24) in the primary analyses, using the risk for glaucoma in the low-potency statin group as reference. The risk of glaucoma with individual statin use was not significantly different from that with pravastatin. No significant association was found between high-potency statins and the increased risk of glaucoma in Japanese working-age population. Further studies are needed to examine the association between statins and glaucoma in the elderly population.
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Affiliation(s)
- Nobuhiro Ooba
- Department of Clinical Pharmacy, Nihon University School of Pharmacy, Chiba, Japan
| | - Rira Iwahashi
- Department of Clinical Pharmacy, Nihon University School of Pharmacy, Chiba, Japan
| | - Akiko Nogami
- Department of Clinical Pharmacy, Nihon University School of Pharmacy, Chiba, Japan
| | | | - Atsushi Kanno
- Department of Hospital Pharmacy, Nihon University Itabashi Hospital, Tokyo, Japan
| | - Naohiro Tochikura
- Department of Hospital Pharmacy, Nihon University Itabashi Hospital, Tokyo, Japan
| | - Susumu Ootsuka
- Department of Hospital Pharmacy, Nihon University Itabashi Hospital, Tokyo, Japan
| | - Noriyasu Fukuoka
- Department of Clinical Pharmacy, Nihon University School of Pharmacy, Chiba, Japan
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Relationship between Oxidative Stress Biomarkers and Visual Field Progression in Patients with Primary Angle Closure Glaucoma. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:2701539. [PMID: 32831992 PMCID: PMC7428947 DOI: 10.1155/2020/2701539] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/22/2020] [Accepted: 06/29/2020] [Indexed: 12/31/2022]
Abstract
Purpose To investigate the serum changes of oxidative stress markers and the relationship between these factors and visual field (VF) progression in patients with primary angle closure glaucoma (PACG). Methods A case-control and a prospective cohort study. A total of 94 patients with PACG and 89 normal controls were enrolled. Furthermore, 94 PACG subjects were followed up for at least two years (once every six months). All participants were evaluated for serum levels of superoxide dismutase (SOD), total antioxidant status (TAS), hydrogen peroxide (H2O2), malondialdehyde (MDA), glutathione peroxidase, glutathione reductase, and detailed eye and systematic examination. Binary logistic regression analysis and Cox regression analysis were performed. Results The serum levels of SOD and TAS in the PACG group were significantly lower than those in the control group (p < 0.001). Meanwhile, PACG subjects had significantly higher levels of MDA and H2O2 than the normal control subjects (p < 0.001). Serum levels of TAS (OR = 0.773, 95%CI = 0.349 − 0.714, p < 0.001), SOD (OR = 0.975, 95%CI = 0.955 − 0.995, p < 0.001), MDA (OR = 1.155, 95%CI = 1.080 − 1.235, p < 0.001), and H2O2 (OR = 1.216, 95%CI = 1.142 − 1.295, p < 0.001) were independent risk/protective factors for PACG. TAS levels (HR = 0.041, 95%CI = 0.008–0.218, p < 0.001), SOD levels (HR = 0.983, 95%CI = 0.971–0.994, p = 0.003), and MDA levels (HR = 1.010, 95%CI = 1.001–1.018, p = 0.015) at baseline were associated with visual field progression. Kaplan–Meier curves reveal that patients with TAS < 0.95/SOD < 143/MDA > 12 had a significantly higher percentage of PACG progression (p < 0.05). Conclusions Decreased levels of TAS and SOD as well as increased levels of MDA at baseline were associated with VF progression in patients with PACG. These findings suggest that oxidative stress was involved in the onset and development of PACG.
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Association between Pretreatment Serum Uric Acid Levels and Progression of Newly Diagnosed Primary Angle-Closure Glaucoma: A Prospective Cohort Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:7919836. [PMID: 30881597 PMCID: PMC6383391 DOI: 10.1155/2019/7919836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/03/2018] [Accepted: 12/16/2018] [Indexed: 12/17/2022]
Abstract
Purpose Increased evidence reveals that uric acid (UA) may have an important neuroprotective effect through its antioxidant properties. The aim of the present study was to investigate the relationship between pretreatment serum UA levels and the progression of newly diagnosed primary angle-closure glaucoma (PACG). Methods This prospective observational cohort study included 64 patients with newly diagnosed PACG who were followed up for a mean period of 12.77 months (range: 3–28 months). All subjects underwent a complete ophthalmological examination during the baseline and final follow-up visits, together with the acquisition of blood samples for UA measurements. During the follow-up period, the progression of PACG was defined as a clinical diagnosis of medically uncontrolled intraocular pressure and a loss of visual field with a mean deviation of >1 dB/year. Univariable and multivariable Cox regression models were used to investigate the association between baseline serum UA levels and the progression of PACG. The cumulative probability of progression of glaucoma was analyzed using the Kaplan-Meier method. Results During follow-up, 32 subjects were defined as progressive PACG, among whom baseline UA values were significantly higher in nonprogressing subjects than in progressing subjects (0.314 ± 0.069 mmol/l versus [vs.] 0.258 ± 0.069 mmol/l, respectively; P = 0.002). Similar results were also observed in male and female subgroups (P < 0.05). In a multivariable model, a decreased baseline serum UA level was associated with an increased risk for progressing PACG: both in male (hazard ratio [HR] 6.088 [95% confidence interval (CI) 1.163–31.8638]; P = 0.032) and female subjects (HR 3.565 [95% CI 1.131–11.236]; P = 0.030). Subjects with high UA levels demonstrated higher cumulative probabilities of nonprogressing PACG than those with low UA levels (male [16.67% vs. 80.00%; P = 0.0084] and female [29.41% vs. 68.00%; P = 0.0182]). Conclusion An association between high baseline serum UA levels and a decreased risk for progressing PACG was found. This primary finding suggests that high serum UA levels may have a protective role against PACG and could slow disease progression.
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